OB and care of the newborn Flashcards
Ovaries
- Female gonads, or sex glands
- Secrete hormones estrogen and progesterone
- Release egg needed for reproduction
Fallopian tubes
- Extend from the ovaries to uterus
- Hold the eggs
Uterus
- Pear shaped organ that hold the fetus
- Top: FUNDUS
- Middle: BODY
- Bottom: CERVIX
Placenta
- Organ of pregnancy
- Provided oxygen and nutrients to fetus
Umbilical cord
- Infants life line
- One vein: Carries oxygenated blood to fetus
- Two arteries: Carries waste back to the placenta
Amniotic Sac
- Bag of water
- Contains amniotic fluid
- Insulates and protects the pregnancy
Vagina
- The birth canal
What are predelivery emergencies?
- Emergencies relating to pregnancy prior to onset of labor
- Spontaneous abortion, Ectopic pregnancy, Placenta previa, Abruptio placenta, Ruptured uterus, Preeclampsia/ Eclampsia, and Supine hypertensive syndrome
Spontaneous Abortion
- Miscarriage
- Passage of tissue before the 20th week or gestation
- USUALLY in the first trimester, between 8-12 weeks gestation
Ectopic Pregnancy
- First trimester
- Fertilized egg implants anywhere but the uterus
- Usually in fallopian tubes
- Egg starts to grow and develop, rupturing the fallopian tubes
SXSX:
- Intense lower quadrant abd pain described as dull, then sharp, and knife like
- Can lead to internal bleeding and signs of shock possible
Placenta Previa
- 3rd trimester emergency
- Placenta implants itself over the cervix
SXSX:
- LOTS of vaginal bleeding
- NO pain
Abruptio Placenta
- Common in 1st pregnancy
- 3rd trimester emergency
- Placenta prematurely tears away from the uterine wall
- High mortality rate for mom and baby
- Many causes, from hypertension to trauma
SXSX:
- LOTS of pain
- LITTLE/ NO bleeding (infants head is covering the cervix)
Ruptured Uterus
- 3rd trimester
- Spontaneous or traumatic rupture of the uterine wall
- Release fetus into abdominal cavity
Special question:
- Has the patient has a c- section before?
Preeclampsia/ Eclampsia
- 3rd trimester
- Characterized by hypertension and swelling of the extremities
- Preeclampsia turns into Eclampsia when the mother has seizures
- Pregnancy related seizures have high mortality rate for mother and baby
Supine Hypertensive Syndrome
- 2nd and 3rd trimester
- Uterus and growing fetus compress the inferior vena cava when the mom lays flat on her back
- Leads to hypotension when laying down
- Prop a pillow or similar under the patients right side to ensure the fetus does not compress the inferior vena cava
Gravida
- How many pregnancies?
Para
- How many deliveries past 20 weeks gestation
Stage one
- Dilation phase
- Beginning of true labor until full dilation of the cervix
- Braxton hicks contractions: False labor
Stage two
- Expulsion phase
- Full dilation of the cervix until the baby is born
- Look for Nuchal Cord: cord wrapped around babys neck
SXSX:
- Contractions 2-3 minutes apart and lasting 60-90 seconds
- Urge to bear down
- Crowing
Stage three
- Placenta phase
- Delivery of the baby until delivery of the placenta
- 5-20 minutes after
Prolapse Cord
- Umbilical cord presents before the head
- TRUE EMERGENCY
- Baby can compress the cord, cutting off blood supply
- Can insert gloved hand into birth canal to lift presenting part of the baby off of the cord
Breech birth
- Butt or legs present first
- Allow deliver to happen
- If head gets stuck, after 2 minutes, may insert gloved hand into birth canal to make an airway for the baby
Limb presentation
- Single arm or leg is presenting
- TRUE EMERGENCY, cannot deliver in the field
- Patient will need c section
Multiple Births
- Proceed as normal
- Suspect twins or more if: Belly is large after the baby is born, Size of baby does not correlate to the size of the abd, Intense contractions start after delivery of the first baby
Meconium
- Baby had a bowel movement in the amniotic sac
- When water breaks, fluid is greenish or brown
- Tells you that the baby was in distress at one time
Postpartum Hemorrhage
- Any bleeding over 500cc after baby is born
- Place mom on high flow O2
- Massage fundus
- Baby to breast
APGAR out of 10
APPEARANCE: 0-2
PULSE: 0-2
- 1: <100
- 2: >100
GRIMACE: 0-2
ACTIVITY: 0-2
RESPIRATIONS: 0-2
APGAR Scoring
- 7-10: only routine care
- 4-6: Simulate baby, O2
- 0-3: BVM, CPR as needed
How often is APGAR done?
- One minute after birth and five minutes after birth
- As needed after that
Premature birth
Less than 5 pounds or born before 38th week
Postterm Pregnancy
Gestation greater than 42 weeks
Precipitous Delivery
Delivery <3 hours from onset of labor
Shoulder Dystocia
Shoulders larger than head
Premature Rupture of Membranes
Water breaks before onset of true labor
Preterm Labor
Labor between 20th and 37th week
