OB Flashcards
Risk factors for high spinal
- high BMI
- abdominal girth
- compressed thecal sac
- spinal canal abnormalities
- higher lumbar insertion
finer needle gauge - immediate placement in the supine position
risk factors of amniotic fluid embolism
conditions that increase the likelihood of amniotic fluid entering the uterine veins
- multiparity
- placenta previa
- placental abruption
- cervical lacerations
- uterine rupture
- operative vaginal delivery
types and frequencies of abnormal placentation
Accreta (75-78%): loss of decidual layer and placenta adheres directly to the myometrium
Increta (15%): placenta invades the myometrium
Percreta (5%): placenta invades through the myometrium into the serosa.
Risk factors for postpartum neuropathies
- prolonged 2nd stage of labour
- difficult instrumental delivery
- nulliparity
- prolonged use of lithotomy position
most common never injury of pregnancy
meralgia paresthetica
- neuropathy of the lateral femoral cutaneous nrve
- purely sensory never
- numbness, tingling, burning of the anterolateral aspect of the thigh
may arise both during pregnancy or intrapartum
features of severe preeclampsia
- Blood pressure greater than or equal to 160/110 mm Hg
- Thrombocytopenia (platelet count less than 100,000/mm3)
- Serum creatinine concentration greater than 1.1 mg/dL or greater than 2 times the baseline serum creatinine concentration
- Pulmonary edema
- New-onset cerebral or visual disturbances
- Impaired liver function
definition of preeclampsia
- Blood pressure greater than or equal to 140/90 mm Hg after 20 weeks’ gestation
- Proteinuria (greater than or equal to 300 mg/24 h, protein-creatinine ratio greater than or equal to 0.3, or 1+ or greater on urine dipstick specimen)
demographic risk factors for preeclampsia
- Advanced maternal age greater than 35 years
- Black race
- Hispanic ethnicity
genetic risk factors for preeclampsia
- History of preeclampsia in previous pregnancy
- Family history of preeclampsia
- History of placental abruption, fetal growth restriction, or fetal death
- Partner who fathered a preeclamptic pregnancy in another woman (through fetal genes)
medical conditions that are risk factors for preeclampsia
- Obesity
- Chronic hypertension
- Diabetes mellitus
- Chronic renal disease
- Antiphospholipid antibody syndrome
- Systemic lupus erythematosus
obstetric conditions that are risk factors for preeclampsia
- Multiple gestation
- Hydatidiform mole
risk factors for sepsis during pregnancy
- CHF
- chronic liver disease
- chronic renal disease
- cerclage
- retained products
Antimicrobials that are contraindicated in pregnancy (7)
Chloramphenicol Erythromycin Nalidixic acid FLuroquinolones Nitrofurantoin Tetracyclines Trimethoprim
~ ____ % less local anesthetic is required for epidural and spinal anesthesia in pregnant pt than in non-pregnant pts
20-30
Signs of uterine rupture
- Triad of abdominal pain, FHR abnormalities and maternal hemorrhage is rare 9%
Other signs
- Vaginal bleeding
- Uterine hypertonia
- Cessation of labour
- Maternal hypotension
- Loss of the fetal station
- Decrease in cervical dilatation
- Change in fetal presentation
