OB Flashcards
normal maternal changes (6)
1) HR increases2) B/P decreases in the 2nd trimester, returns to normal in 3rd trimester3) CO increases4) plasma increases 40%, >increase in clotting factors, risk of PE5) hormones: progesterone and relaxin relaxes sphincters6) decreased functional/residual lung volume
normal maternal changes (6)
1) HR increases2) B/P decreases in the 2nd trimester, returns to normal in 3rd trimester3) CO increases4) plasma increases 40%, >increase in clotting factors, risk of PE5) hormones: progesterone and relaxin relaxes sphincters6) decreased functional/residual lung volume
Assessment “DES”
dilationeffacement (thickness of cervix) station (fetal head relation to pubic bone)
Normal FHR 120-160 fetal tachycardia due to……fetal bradycardia due to…..
………….sepsis………….hypoxia
variability #1 cause of poor variability
normal variability = 10-15 bpm …..fetal hypoxia
general rule regarding accelerations/decelerations
in relation to uterine contraction. accelerations are always gooddecelerations can be bad
early decelerations
they mirror contractionsthe head is pressed against the cervixbenign
variable decelerations
caused by cord compression during uterine contraction
sinusoidal variations
caused by accidental tap of the umbilical cord, fetal hypovolemia, anemia, acidosis
Assessment “DES”
dilationeffacement (thickness of cervix) station (fetal head relation to pubic bone)
Normal FHR 120-160 fetal tachycardia due to……fetal bradycardia due to…..
………….sepsis………….hypoxia
variability #1 cause of poor variability
normal variability = 10-15 bpm …..fetal hypoxia
general rule regarding accelerations/decelerations
in relation to uterine contraction. accelerations are always gooddecelerations can be bad
early decelerations
they mirror contractionsthe head is pressed against the cervixbenign
variable decelerations
caused by cord compression during uterine contraction
sinusoidal variations
caused by accidental tap of the umbilical cord, fetal hypovolemia, anemia, acidosis
Anaphylactoid Syndrome of Pregnancy
caused by maternal exposure to fetal cellsDIC and anaphylaxis Symptoms: pleuritic chest pain, tachypnea, tachycardia, feverTx: fluid resuscitation, increase PEEP, FFP, Plts, Cryoprecipitate
Meconium
inactivates surfactant. deep suction only if baby is not vigorous
umbilical cord prolapse
noticed by variable decelerationselevate cord to relieve pressure give tocolytics
PIH
can causes placental insufficiency tx options: labetolol (beta blocker), hydralazine (alpresoline), methyldopa (levodopa)
McRobert’s maneuver
for shoulder dystocia, knees to chest, and application of suprapubic pressure
Mauriceau’s maneuver
breech delivery use of fingers to relieve pressure from the baby’s nose and applying downward suprapubic pressure
HELLP
Hemolysis/Elevated Liver Enzymes/Low Plateletsseen with pre-eclampsia and eclampsiaRUQ pain (liver), jaundice, malaise give Mag Sulfate, steroids (to stimulate fetal lung maturity), hypertension (use labetalol, hydralazine, or methyldopa)
HTN, proteinuria, edema
pre-eclampsia, eclampsia
pre-eclampsia s/srisk factorsFHM
no seizures HTN, proteinuria, edemaextremes of age, 1st pregnancy
placenta abruption
painful bleedingMVA or blunt traumaexsanguination or placental insufficiency
placenta previa
painless bright red bleedingavoid vaginal exams
postpartum hemorrhage
> 500mL blood loss (24 hours after delivery)
uterine rupture
“stomach is hard as a board” (caused by peritonitis) fetal parts show through mother’s skin
If mother is Rh negative….
always give Rhogam because the majority of the population are Rh positive and the mother has Rh antibodies
