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OB/GYN > OB 4 > Flashcards

OB 4 Flashcards

1
Q

external tocometer

A

measures fetal HR and uterine contractions

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2
Q

normal fetal heart rate

A

110 - 160 bpm

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3
Q

fetal bradycardia

A

<110 bpm

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4
Q

fetal tachycardia

A

> 160 bpm

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5
Q

normal accelerations

A

increase in heart rate of 15 or more, for longer than 15-20 seconds; occuring twice in 20 minutes

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6
Q

early decelerations

A

decrease in HR that occurs with contractions 2/2 head compression

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7
Q

variable decelerations

A

decrease in HR and return to baseline with no relationship to contractions; 2/2 umbilical cord compression

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8
Q

late decelerations

A

decrease in HR after contraction started, no return to baseline until contraction end; 2/2 fetal hypoxia, most serious

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9
Q

lightening

A

fetal descent into the pelvic brim

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10
Q

Braxton-Hicks contractions

A

benign contractions that do not result in cervical dilation; they routinely start to increase in frequency towrds the end of the pregnancy

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11
Q

bloody show

A

blood-tinged mucus from vagina that is released with cervical effacement

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12
Q

stage 1 (labor)

A

from onset of labor to full cervix dilation; if primipara: 6-18 hours, multipara: 2-10 hours

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13
Q

latent phase of labor

A

onset of labor to 4 cm dilation; primipara 6-7 hours, multipara: 4-5 hours

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14
Q

active phase of labor

A

4 cm dilation to full dilation; primipara: 1cm/hr (min), multipara: 1.2cm/hr (min)

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15
Q

stage 2 (labor)

A

full dilation of cervix to delivery of neonate; primipara: 30min to 3 hours, multipara: 5-30 minutes

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16
Q

stage 3 (labor)

A

delivery of neonate to delivery of placenta; 30 minutes

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17
Q

what do you monitor during stage 1 of labor

A

maternal BP and HR, fetal HR and uterine contractions, examine cervix for cervical dilation, effacement and station

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18
Q

station of fetus

A

where the fetus’ head is located in relationship to the pelvis, measures -3 through +3

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19
Q

signs of placental separation

A

fresh blood from vagina, umbilical cord lengthening, uterine fundus rising, uterus becoming firm

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20
Q

induction of labor

A

start labor by medical means

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21
Q

IOL: prostaglandin E2

A

used for cervical ripening; do not give to asthmatic patients (bronchospasm)

22
Q

IOL: oxytocin

A

exaggerates uterine contractions, normally found in posterior pituitary

23
Q

IOL: amniotomy

A

puncture of the amniotic sac via an amnio hook, inspect for prolapsed umbilical cord first

24
Q

prolonged latent stage

A

latent phase (20 hours for primipara and >14 hours for multipara

25
Q

etiology of prolonged latent stage

A

sedation, unfavorable cervix, uterine dysfunction with irregular or weak contractions

26
Q

treatment of prolonged latent stage

A

rest and hydration, most will convert to spontaneous delivery in 6-12 hours

27
Q

protracted cervical dilation

A

slow dilation during the active phase of stage 1 labor, <1.5cm/hr in multipara

28
Q

etiology of protracted cervical dilation

A

power, passenger, passage

29
Q

treatment of protracted cervical dilation

A

cephalopelvic disproportion - cesarean; weak uterine contractions - oxytocin

30
Q

arrest of cervical dilation

A

no cervical dilation for 2 hours

31
Q

arrest of fetal descent

A

no fetal descent for 1 hour

32
Q

eitiology of arrest disorders

A

cephalopelvic disproportion, malpresentation, excessive sedation/anesthesia

33
Q

Leopold maneuvers

A

set of 4 maneuvers that estimate the fetal weight and the preseting part of the fetus

34
Q

frank breech

A

fetus’s hips are flexed with extended knees bilaterally

35
Q

complete breech

A

fetus’ hips and knees are flexed bilaterally

36
Q

footling breech

A

fetus’ feet are first: one leg (single footing) or both legs (double footing)

37
Q

treatment for breech

A

external cephalic version, only performed after 36 weeks gestation

38
Q

shoulder dystoica

A

occurs when head of fetus has been delivered but anterior shoulder is stuck behind the pubic symphysis

39
Q

risk factors for shoulder dystocia

A

maternal diabetes and obesity (macrosomia), postterm pregnancy, h/o prior shoulder dystocia

40
Q

treatment for shoulder dystocia

A

McRoberts maneuver, Rubin maneuver, Woods maneuver, delivery of posterior arm, deliberate fx of fetal clavicle, Zavanelli maneuver

41
Q

McRoberts maneuver

A

first line tx for shoulder dystoica, maternal felxion of knees into abdomen with suprapubic pressure

42
Q

Rubin maneuver

A

rotation of the fetus’ shoulders by pushing the posterior shoulder towards the fetal head

43
Q

Woods maneuver

A

rotation of the fetus’ shoulders by pushing the posterior shoulder toward the fetal back

44
Q

Zavanelli maneuver

A

push the fetal head back into the uterus and perform cesarean delivery, high rate of maternal and fetal mortality

45
Q

postpartum hemorrhage (PPH)

A

bleeding more than 500 mL after delivery; early = less than 24 hours afterwards; late = 24hrs to 6 weeks

46
Q

uterine atony and pph

A

accounts for more than 80%

47
Q

causes of PPH

A

uterine atony, laceration, retained parts and coagulopathy

48
Q

risk factors for atony

A

anesthesia, uterine overdistention, prolonged labor, laceration, retained placenta, coagulopathy

49
Q

how does Sheehan syndrome present

A

inability to breastfeed after PPH

50
Q

treatment of PPH

A

assure that there is no rupture of the uterus or retained placenta, bimanual compression and massage, oxytocin

OB/GYN (4 decks)

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