Ob Flashcards
What is effacement?
Measure of how soft the cervix is
What is station?
How far baby is in the vaginal tract
What is the definition of the first stage of labor?
From regular contractions to full diltation
What is the definition of the second stage of labor?
Ffrom dilation to delivery of infant
What is the definition of the third stage of labor?
From delivery of infant to the delivery of the placenta
How long do stages 1-3 of labor typically last?
1 = 6-20 hours
2 = 30 minutes to 3 hours
3 =0-30 minutes
What are the three major things you can do to improve FHR?
Change mom’s position
Give O2
Stop oxytocin
What is the maneuver to treat cord prolapse? Ultimate treatment?
- Elevate the presenting part off the cord
- Go to C-section=
- Knee-chest positioning
What are the components of the HELPER mnemonic for shoulder dystocia?
Help Episiotomy Legs flexed Pressure (suprapubic) Enter vagina (rubins or Wood maneuver) Remove posterior arm
What is the Wood’s screw maneuver?
In this maneuver the anterior shoulder is pushed towards the baby’s chest, and the posterior shoulder is pushed towards the baby’s back, making the baby’s head somewhat face the mother’s rectum.
Tried only after the McRoberts maneuver
What is the cause of uterine bleeding over 24 hours after birth?
Retained POC
What are the causes of uterine bleeding less than 24 hours after birth? (4)
Lacs
Retained POC
Abnormal involution
Uterine atony
What is the most common cause of uterine bleeding less than 24 hours after delivery?
Uterine atony
What is the definition of the postpartum period?
6 weeks after delivery
What is lochia?
Sloughing of the decidual tissue
How long after delivery can lochia be present?
6 weeks
When does endometritis typically present?
2-3 days postpartum
What is the initial treatment for mastitis? What is the abx of choice if needed?
- Initial treatment is supportive with compresses, continued feeding
- Dicloxacillin
What is the classic presentation of abruptio placenta?
Painful vaginal bleeding diagnosed with US and fetal stress testing
Painless vaginal bleeding in the 2nd-3rd trimester = ?
Placenta previa
How do you diagnose placenta previa?
US
What is the treatment for placenta previa?
Watchful waiting vs c-section
What is the natural history of placenta previa?
About 50% go away
What gestation age defines premature rupture of membranes?
Less than 37 weeks
What are the major risks associated with PPROM?
Chorioamnionitis
Endometritis
What is the classic presentation of PPROM?
Gush of fluid followed by leak
What sort of pelvic exam is indicated if there is PPROM?
Sterile
What is a risk factor associated with PPROM that is not infectious?
Cord prolapse
What is the treatment for PROM over 37 weeks?
Hospitalized and induce delivery
What is the treatment for PPROM under 27 weeks?
Expectant
+/- corticosteroids to hasten fetal lungs
What are the two major medications that are used as tocolytics?
Mg sulfate
Terbutaline
What are the absolute contraindications to tocolysis?
- Acute vaginal bleeding
- Fetal distress
- Chorioamnionitis
- Preeclampsia
- sepsis
- DIC
What is the general management of gestational HTN before 20 weeks gestation?
- antiHTN meds
- Frequent rechecks of urine and BP by OB
What are the components of the classic triad of preeclampsia?
HTN
Proteinuria
Edema
What defines mild and severe preeclampsia based on BP?
140/90 - 160/110 is range for mild/moderate.
Under how many weeks gestation are steroids given to encourage fetal lung maturity?
36 weeks
How many weeks postpartum can you develop preeclampsia?
6 weeks
What is the treatment for a threatened abortion?
Pelvic rest
What is the most common cause of Ectopic pregnancies?
Adhesions
