OB 2 Flashcards by Heather McKnight

when do you screen for group B strep?

universal screening at 35-37 weeks gestation

swab both lower vagina and rectum

How well did you know this?

Not at all

Perfectly

GBS

MC neonatal sepsis

PCN is tx

How well did you know this?

Not at all

Perfectly

placenta completely covers cervical os

Complete previa

How well did you know this?

Not at all

Perfectly

placenta overlies part, but not all of cervical os

partial previa

How well did you know this?

Not at all

Perfectly

placental edge in lower uterine segment but does not reach internal os

low-lying placenta

How well did you know this?

Not at all

Perfectly

painless bright red vaginal bleeding in 3rd trimester

placenta previa

How well did you know this?

Not at all

Perfectly

RF of placenta previa

prior C-section
multiple gestations
multiple induced abortions
advanced maternal age

How well did you know this?

Not at all

Perfectly

dx placenta previa

ultrasound

How well did you know this?

Not at all

Perfectly

Placental tissue extends into superficial layer of myometrium

Placenta accrete

How well did you know this?

Not at all

Perfectly

entire placenta separates from uterine wall

complete placenta abruption

How well did you know this?

Not at all

Perfectly

premature separation of normally implanted placenta

occurs due to any number of causes (trauma, idiopathic, etc.)

placental abruption

How well did you know this?

Not at all

Perfectly

painful vaginal bleeding that may not be externally present

placental abruption

How well did you know this?

Not at all

Perfectly

blood penetrates uterus; uterine serosa becomes blue-purple in coloration

complication of ____ called ____

placental abruption

called couvelaire uterus

How well did you know this?

Not at all

Perfectly

bleeding occurring during vasa previa belongs to…

fetus!

How well did you know this?

Not at all

Perfectly

common cause of small gestional age

tobacco

How well did you know this?

Not at all

Perfectly

macrosomia newborns are common among ____ mothers

DB mothers

How well did you know this?

Not at all

Perfectly

Gestational HTN

onset after 20 weeks gestational age w/o proteinuria

How well did you know this?

Not at all

Perfectly

Development of hypertension after 20 weeks’ gestational age with proteinuria

Peeclampsia

How well did you know this?

Not at all

Perfectly

when to evaluate edema

does not improve with rest

involves upper extremities, face, sacral region

How well did you know this?

Not at all

Perfectly

earliest week that delivery is recommended with severe preeclampsia

34 weeks

How well did you know this?

Not at all

Perfectly

drugs encouraged/recommended during pregnancy for HTN

methyldopa

labetalol

How well did you know this?

Not at all

Perfectly

how to treat and prevent preeclampsia

magnesium sulfate when induction (at labor time) is initiated

How well did you know this?

Not at all

Perfectly

loss of patellar reflexes

warmth feeling, flushing

slurred speech

muscle paralysis

respiratory difficulty

hypermagnesemia - Mag toxicity

treated with calcium gluconate

How well did you know this?

Not at all

Perfectly

eclampsia means you now have…

seizures

How well did you know this?

Not at all

Perfectly

HELLP

HTN in pregnancy ``` H: hemolysis E: elevated L: liver enzymes L: low P: platelet count ```

HELLP is MC in

multiparous pts

RUQ pain N/V General malaise are all sx of...

HELLP syndrome

peripartum cardiomyopathy occurs in..

last month of pregnancy or within 6 months of delivery

dx test required for peripartum cardiomyopathy

ECHO

medication to avoid when treating peripartum cardiomyopathy

ACE-i

what is peripartum cardiomyopathy

dilated cardiomyopathy that presents in pregnancy with no demonstrable cause for heart failure/hx of heart disease

MC isoimmunization of the mother

delivery of baby/placenta

what is the Rh factors of mom? dad? in Rh incompatibility of pregnancy

Mom: Rh Neg Dad: Rh Pos

isoimmunization of pregnancies requires administration of...

RhoGam

Death of fetus in utero > 20 weeks’ gestation

intrauterine fetal demise

- Absent fetal movement - Decrease in pregnancy symptoms (e.g., nausea, breast tenderness) - Vaginal bleeding - Labor/contractions

signs and sx of intrauterine fetal demise

How to dx intrauterine fetal demise

U/S

MC reason for intrauterine fetal demise

unexplained

BEAU-CHOPS of maternal cardiac arrest

B: bleeding/DIC E: embolism A: anesthesia complications U: uterine atony ``` C: cardiac conditions H: hypertension/preeclampsia O: others (5H's and 5T's) P: placenta previa/abruption S: sepsis ```

Shorter and less intense than true labor Not associated with cervical dilation

Braxton-Hicks Contractions

Fetal head descends into maternal pelvis Associated with increased pelvic pressure

Lightening

cervical thinning

effacement

Extrusion of mucus from endocervical glands Bleeding from small vessels Associated with cervical thinning (effacement)

Bloody show of maternal changes prior to labor

relation of fetal long axis to maternal long axis

fetal lie

position of fetus lowest in birth canal

fetal presentation

relation of fetal presenting part relative to maternal pelvis

fetal position

Cervical dilatation expressed in

centimeters

Cervical effacement expressed as

% of thinning

Level of presenting part relative to ischial spines

fetal station

Meconium is a sign of

fetal distress

edema of fetal scalp

Caput succedaneum

Episiotomy

cutting vaginal opening to enlarge it

MCC of postpartum hemorrhage

uterine atony

Absence of uterine muscle tone resulting in hemorrhage

uterine atony

abnormal labor

labor dystocia "difficult labor"

Leading indication for Cesarean delivery in the United States

labor dystocia

MC breech presentation

frank: butt first with hips flexed and knees extended

Maternal hips hyperflexed to increase AP diameter; usually accompanied by downward suprapubic pressure

McRobert's maneuver for shoulder dystocia

common neuro finding with shoulder dystocia

brachial plexus injuries

Full term Clear amniotic fluid; no meconium or purulent fluid Spontaneous breathing/crying Good muscle tone

reassuring characteristics of the newborn

5 signs of apgar scoring

``` color HR reflex activity muscle tone respirations ```

when do you do apgar scoring

1 minute and then 5 minutes after delivery then every 5 minutes all the way to 20 minutes if initial 5 minute score is <7

when does the umbilical cord fall off?

Sloughs off in 3-5 days

erythromycin in the eyes...

treats gonococcal infection

pulse < 100 bpm

provide positive pressure ventilation

Pulse < 60 bpm despite PPV

chest compression

pulse < 60 bpm despite PPV and chest compressions

give epi

MC source of bleeding for postpartum hemorrhage

uterine atony (80&)

how do you prevent uterine atony

nipple massage nursing uterine massage administer oxytocin

must wait how long for sexual activity after birth

minimal 2 weeks postpartum

postpartum blues

occurs in 70-80% mild, intermittent feelings of sadness, anxiety, anger onset of 2-4 days and abates by 1-2 wks

postpartum blues vs. postpartum depression

interferes with daily functioning worsens over weeks unknown causes

Individuals with... are more likely to have ____ Personal history of depression/anxiety Family history Acute stressors Child with difficult health issues Depression in pregnancy (strong predictor)

postpartum depression

postpartum psychosis is a ....

medical emergency