Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

S5 - Regional/OB - Test 2 > OB complications > Flashcards

OB complications Flashcards

1
Q

What 3 races are more likely to die from pregnancy-related causes

A
  • African American
  • American Indian
  • Alaska Native
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common causes GLOBALLY of maternal death (3)

A
  • hemorrhage
  • HTN disorders
  • sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most common causes of maternal death in the developed world (3)

A
  • HTN disorders
  • embolic disorders
  • Hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

More things that lead to maternal death globally(7)

A
  • Anemia
  • Obstructed labor
  • HIV/AIDS
  • unsafe abortion
  • early marriage??? hahahha what does this mean - prob that they make 12 yr olds have babies :( ok now i feel bad for laughing :(.. this class depresses me on so many levels ~this class makes me want to die~ i have to add to this card everytime i come across it :) i feel like i am dying a slow, painful death. i feel that.
  • high parity birth
  • advanced maternal age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Preterm delivery (weeks?)

A

prior to 37 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What % of deliveries in the U.S are preterm?

Other countries?

A

12-13%

5-9% in other developed countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Demographic characteristics that increase the risk for preterm labor (9)

*trigger warning* long-ass list on the other side

A
  • non-caucasian
  • extremes of age<17 or >35
  • low socioeconomic status
  • low pre-pregnancy BMI
  • history of preterm delivery
  • inter-pregnancy interval <6mon
  • abnormal uterine atony
  • trauma
  • abdominal surgery during pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Obstetric Factors that increase risk of preterm delivery (7)

*trigger warning

A
  • vaginal bleeding
  • infection
  • short cervical length
  • multiple gestation
  • assisted reproductive technologies
  • preterm premature rupture of membranes
  • polyhydraminos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What procedure is performed to help prevent preterm labor

A

cervical cerclage

BIG ouch, no thx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What 3 drugs are discussed for the potential prevention of preterm labor

A
  • prophylactic antibiotics
  • prophylactic beta-agonists
  • progesterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is used for pain management for cervical cerclage

A

neuraxial andddd maybe a smidge of versed if you ask v nicely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is given to the mother to help babies lung maturation in the event of preterm delivery

A

corticosteroids: betamethasone or dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 2 drugs are given to reduce contractions

A
  • mag sulfate
  • terbutaline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What kind of muscle is the myometrium

A

smooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the incidence of pregnancy-related thromboembolic events

A

1-1.7 per 1000 pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At what stage/period in the pregnancy are moms at highest risk for embolus

A

postpartum (specifically, highest risk in 1st week postpartum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

two most important modifiable risk factors for thromboembolism

A
  • obesity
  • immobility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What complication mimics normal pregnancy symptoms

A

DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Symptoms of DVT

A

lower leg edema and pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is used to diagnose PE

A

U/S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Are D-dimers elevated in normal pregnancies

A

yup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If you suspect PE and the patient does NOT have DVT symptoms what is the next step

A

CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

If you suspect PE, No DVT symptoms, CXR normal then what

A

V/Q scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

If you suspect PE, No DVT symptoms, CXR abnormal then what test do you order

A

CTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When suspecting PE what 2 tests prompt treatment if positive

A
  • CTA
  • V/Q scan

also CUS ( i think this is just for DVT not PE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

If you suspect PE and DVT symptoms are present what test should be performed

A

Compressional U/S (CUS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If CUS is negative what should be performed next in the presence of suspected PE

A

CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What 2 drugs are used to anticoagulate when thromboembolism is diagnosed

A
  • LMWH
  • unfractionated heparin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

At what volumes can venous air embolism become lethal

A

200-300mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What symptoms intraoperatively could indicate a venous air embolism (5)

A
  • chest pain
  • SOB
  • sudden hypoxemia
  • hypotension
  • arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What actions help prevent further air entrainment

A
  • flood field with saline
  • lower surgical field relative to the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

For Airway management during VAE what actions should be taken (4)

A
  • Administer 100% oxygen
  • d/c nitrous
  • intubate
  • support ventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

CV interventions for VAE

A
  • chest compressions
  • IV volume expansion
  • vasopressors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In a VAE situation should delivery be expedited

A

yup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What should be considered after VAE event

A
  • evaluate for intracerebral air
  • consider hyperbaric oxygen therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Confirmatory test for AFE

A

there isn’t one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

AFE airway management

A

100% FiO2
intubate

38
Q

CV support for AFE management

A
  • LUD
  • fluids & vasopressors
  • large bore IV
  • consider A-line
  • chest compressions
39
Q

Should you monitor the fetus and expedite delivery during AFE event

A

obviously

40
Q

heme management during AFE event

A
  • MTP
  • send coags electrolytes
  • normothermia
41
Q

What unit do moms go to after AFE

A

ICU

42
Q

The umbilical cord protrudes ahead of the fetus

A

prolapsed cord

43
Q

What are we concerned about with prolapsed umbilical cord

A

cord compression

44
Q

Most common cause of maternal mortality worldwide

A

hemorrhage (25%)

45
Q

What accounts for 12.5% of pregnancy-related deaths in the US

A

hemorrhage

46
Q

Are most adverse outcomes related to hemorrhage considered preventable

A

yup

47
Q

Failure to do what 3 things has contributed to hemorrhage-related adverse outcomes

A
  • recognize risk factors
  • accurately estimate blood loss
  • initiate treatment in a timely fashion
48
Q

What is the primary mechanism for controlling blood loss during delivery

A

uterine contraction (due to oxytocin)

49
Q

Uterine contractions constrict which vessels

A

spiral arteries and placental veins

50
Q

coagulation mechanisms after disruption of vascular integrity

A
  1. platelet aggregation and plug formation
  2. local vasoconstriction
  3. clot polymerization
  4. fibrous tissue fortification of the clot
51
Q

What 2 things are considered LATE signs of hemorrhage especially in young healthy patients

A
  • tachycardia
  • hypotension
52
Q

As blood loss increases does the reliability of EBL increase or decrease

A

decrease

53
Q

When the placenta implants near/on the cervix

A

Placenta Previa

54
Q

Incidence of placenta previa

A

4:1000

55
Q

Complication associated with placenta previa

A

antepartum hemorrhage

56
Q

If a patient is known placenta previa and is having elective/non-urgent CD, is there still a significant risk for hemorrhage

A

yup

57
Q

With placenta previa is there an increased or decreased risk for placenta accrete

A

increased

58
Q

Which form of anesthesia for placenta previa cases is associated with more stable hemodynamics and lower transfusion rates

A

epidural anesthesia

59
Q

Is it okay to use 50% nitrous to limit volatile agents in a active bleeding Previa patient

A

yup

60
Q

When the placenta separates from the uterus prior to delivery

A

placental abruption

61
Q

What populations have been found to have an increased risk for placental abruption

A
  • African American women
  • patients hospitalized for acute and chronic respiratory disease
62
Q

Obstetric Conditions associated with placental abruption (5)

A
  • advanced maternal age
  • multiparity
  • preeclampsia
  • premature rupture of membranes
  • chorioamnionitis
63
Q

maternal comorbidities associated with placental abruption (5)

A
  • HTN
  • resp illness (acute or chronic)
  • substance abuse
  • cocaine use
  • tobacco use
64
Q

Which type of trauma direct or indirect is associated with placental abruption

A

both do :(

65
Q

Anesthesia management considerations for placental abruption vaginal delivery

A
  • neuraxial
  • treat hypovolemia
  • sympathectomy can increase risk to extend abruption
  • consider PCA
66
Q

Placental abruption anesthesia management for CD

A
  • General preferred
  • aggressive volume resuscitation
  • uterine atony requires uterotonic drugs
67
Q

Risk factors for Uterine rupture (7)

A
  • prior uterine surgery
  • induction of labor
  • high dose oxytocin
  • connective tissue disorder
  • forceps
  • internal podalic version
  • excessive fundal pressure
68
Q

what volume is considered Postpartum hemorrhage for vaginal delivery

A

>500ml

69
Q

What volume is considered postpartum hemorrhage for CD

A

>1000 mL

70
Q

Common causes of postpartum hemorrhage

A
  • uterine atony
  • retained placenta
  • genital trauma
  • uterine inversion
  • placenta accreta
71
Q

Most common cause of severe postpartum hemorrhage (80%)

A

uterine atony

72
Q

First-line drug for prophylaxis and treatment of uterine atony

A

oxytocin

73
Q

side effects of oxytocin

A
  • tachycardia
  • hypotension
  • myocardial ischemia
74
Q

What other intervention is recommended besides uterotonic agents to help prevent uterine atony

A

uterine massage

75
Q

2 treatments for uterine atony besides oxytocin

A
  • Ergot alkaloids-fungus-methergine (wut)
  • prostaglandins-hemobate
76
Q

Least common hematoma seen with genital trauma

A

retroperitoneal

77
Q

retained placenta

A

failure to completely deliver placenta

78
Q

What can be given to help relax the uterus in the presence of retained placenta

A
  • high-dose volatile
  • nitroglycerin
79
Q

What serious OB condition is associated with concurrent vagal reflex mediated bradycardia

A

Uterine Inversion

80
Q

What dose of Nitroglycerin may be needed to relax the uterus for uterine inversion

A

200-250mcg (larger dose)

81
Q

Placenta accreta

A

placenta that invades the uterine wall and is inseparable from it

82
Q

accreta vera

A

adherence of the basal plate of the placenta to the myometrium

83
Q

chorionic villi invade the myometrium

A

Increta

84
Q

invasion through the myometrium, into serosa and maybe other organs

A

percreta

85
Q

with what OB complication may an Internal iliac artery balloon catheter be necessary

A

placenta accreta

86
Q

in 2/3 of cases of placenta accreta blood loss exceeds

A

2000cc

87
Q

in 15% of placenta accreta blood loss exceeds

A

5000cc

88
Q

in 6.5% of placenta accreta cases, blood loss exceeds

A

10,000cc (holy shit)

is there even that much blood in there rip

89
Q

What 3 OB complications trigger DIC

A
  • retention of dead fetus
  • placental abruption
  • AFE
90
Q

What often accompanies DIC

A
  • circulatory shock
  • renal failure
91
Q

Label the degree of Previa: Marginal, Total, or Partial

A

A. Total

B. Partial

C. Marginal

92
Q
A

S5 - Regional/OB - Test 2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions