OB Emergencies abnormal deliveries Flashcards
The most common cause of vaginal bleeding during pregnancy is?
Abortion/miscarriage
The expulsion of the fetus prior to 20 weeks gestation. Also called a miscarriage.
Abortion
Vaginal bleeding with clots and tissue, cramping abdominal pain or backache. If it is late in the first trimester or later, a fetus may be passed which may remain attached by the umbilical cord.
Signs and symptoms of a spontaneous abortion
Abnormal implantation of fertilized egg outside of he uterus.
Ectopic pregnancy
Abdominal pain, diffuse tenderness moving to specific unilateral sharp pain lower abdominal quadrant. Missing a period, decreased menstrual flow with brownish color, shorter in duration. A rigid abdomen may be present and pain may be referred to a shoulder on the affected side. Vaginal bleeding, signs of shock/hypoperfusion along with syncope may be present.
Signs and symptoms of a ectopic pregnancy
Placenta implants on the lower half of the uterus, either partially or completely blocking the cervical opening.
Placenta previa
Signs and symptoms of a placenta previa Bright red vaginal bleeding without pain. May be spotting or recurrent hemorrhage. May be precipitated by recent intercourse or vaginal examination and is normally seen in the third trimester.
Signs and symptoms of a placenta previa
Premature separation of the placenta from the uterine wall.
Abruptio placenta
Vaginal bleeding may be present or may not be depending on the location of separation. Sudden sharp tearing pain and a stiff, board-like abdomen. If complete separation occurs, significant hemorrhage and hypoperfusion/shock will occur. This may occur during labor.
Signs and symptoms of abruptio placenta
Increase in systolic blood pressure by 30 mmHg and/or a diastolic increase by 15 mmHg over patient’s baseline on two occasions within a 6 hour time period and protein in patient’s urine (damage to organs). Occurs after 20 weeks of gestation, most commonly seen in the last trimester and may rarely occur postpartum.
Preeclampsia
Signs and symptoms of preeclampsia Hypertension, edema, headache, visual disturbances, pulmonary edema, and significant decrease in urine output.
Signs and symptoms of preeclampsia
Generalized tonic-clonic seizures in a patient who is pregnant and likely has a history of preeclampsia.
Eclampsia
Seizures that may be preceded by visual disturbances (flashing lights or dark spots). Pain in the epigastric or right upper abdominal quadrant may also precede a seizure. Edema and hypertension are likely present.
Signs and symptoms of eclampsia
Intermittent contraction of the uterus that are painless with no dilation or effacement (thinning/shortening) of the cervix. This sometimes termed “false labor”. Virtually impossible to distinguish in the field.
Braxton-Hicks Contractions
when true contractions occur (dilation and effacement begin) and ends with the complete dilation/effacement of the cervix.
Stage 1 of labor
complete dilation of the cervix and ends when the fetus is delivered.
Stage 2 of labor
Begins with the delivery of the fetus and ends with the delivery of the placenta.
Stage 3 of labor
Average normal maternal blood loss with delivery
500 ml or 1 pint
Dusky colored extremities with pink central color in a neonate. Common in the first hours of life.
Acrocyanosis
Appearance. Pulse. Grimace. Activity. Respirations.
APGAR Score
Other than normal signs of respiratory distress/arrest or hypoxia, when should respiration be given to a neonate?
If the heart rate falls below 100 BPM.
Other than in cardiac arrest, when should chest compression be given to a neonate?
If the heart rate falls below 60 BPM with no response to ventilatory support.
A condition in which the buttocks or both feet of the fetus present first in birth instead of the cranium.
Breech presentation
When the umbilical cord presents during birth before the fetus.
Prolapsed cord