OB Flashcards
For OB patients, you want to make sure to have this type of cart
Difficult Airway
When is there the greatest cardiac demand on parturients?
During and right after delivery.
When are parturients at greatest risk for myocardial ischemia?
During and right after delivery, because this is the period of greatest cardiac demand
A parturient is considered a full stomach after ____ weeks
12
Why are pregnant women at risk for gallstones?
Everything in the GI tract slows down, causing stasis.
A fetus is considered acidotic if pH is
7.2
Fetal bradycardia is considered
Normal amount of variability for a fetal HR
5-25bpm
Normal fetal HR
110-160
This can cause fetal bradycardia
Maternal hypotension, maternal hypoxemia, uterine contractions/hyperstimulation, vagal head compression, umbilical cord compression.
Treat with fluids, positioning, and oxygen, stop oxytocin.
CO returns to normal ___ weeks post-partum
4 weeks
HR will increase by ____, CO increases by ____, and SV increases by _____
HR 23-30%
CO by 30-50%
SV by 20-50%
BP changes
SVR decreases by 20%, but SBP is unchanged. This is probably due to the increase in CO. MAP however, decreases slightly.
What can cause hypotension in parturients?
Supine positioning
Induction agents
Sympathetic blockade from regional blocks
Treatment of maternal hypotension
Positioning, fluids, O2, TED stockings, Ephedrine & Phenylephrine
Compression of IVC vs. aorta
IVC compression causes a decrease in venous return, CO, and thus causes hypotension.
Aortic compression is usually not associated with s/s, but does decrease uteroplacental perfusion
Plasma volume increases by __%, but RBC volume only increases by ___
50%
30%
Coagulation in parturients
Clotting factors increase (in preparation of delivery). Plts remain the same or decrease slightly.
Plasma cholinesterases in parturients (increase/decrease)
decrease.
Will have prolonged duration of sux!
EBL for vaginal delivery
500cc
EBL for c-section
800 - 1000 cc
1500 cc for hysterectomy
Regional anesthesia is not advised if plt counts are below
70,000
When should you suspect a PE?
parturients are at risk for PE because their coagulation factors have increased. PE should be suspected if mother has SOB, chest pain, coughing up blood, arrhythmias, pain or tenderness in legs.
We want mothers to ambulate early and wear compression stocking!!
Respiratory changes in parturients
Decrease in FRC (20%)
Small airways close faster
Increased WOB
O2 demand increases by 30% (increase in TV by 50%, RR also increases)