OB exam 2 Flashcards
VEAL CHOP MINE
Acronym for the FHR pattern, cause, and management
FHR variability
Normal irregularity of rhythm; determinant of fetal wellbeing
FHR absent variability
Absent or smooth flat baseline is a sign of fetal compromise
FHR minimal variability
Detectable but equal to or. Less than 5/min
FHR moderate variability
6 to 25/min
FHR marked variability
Greater than 25/min
FHR sinusoidal variability
Repeat cycle of upward increase in the HR followed by a decrease longer than 30 min
R/t severe fetal anemia, fetal asphyxia, fetal infection, fetal cardiac anomalies,etc
Cord compression and how it is relieved
reposition mother to side or trendelenburg or knee to chest to move baby off of cord.
What interventions are performed for absent variability
Normal FHR
Baseline 110-160 over 10 minutes
FHR tachycardia
Above 160- r/t maternal fever, fetal hypoxia, intrauterine infection, drugs
FHR bradycardia
Baseline below 110; r/T profound hypoxia, anesthesia, Beta adrenergic blocking drugs
Interventions for late decelerations
Roll mom to L side for perfusion =priority
Stop oxytocin and inc IVF and O2
Differences between intermittent vs continuous monitoring
Epidural complications
CNS depression
hypotension
dec RR
allergic rxn
Prevention for epidural complications
Epidural
First stage of labor
dilation 0cm-10cm
Latent phase=0-3cm
Active phase=4-7cm
Transition phase=8-10 cm
How many stages of labor
Four
Phases of first stage of labor
Latent, active, and transition phase
Stage of cervical dilation-Starts with onset of regular contractions and ends with complete dilation
Describe second stage of labor
Stage of expulsion- Begins with complete cervical dilation and ends with delivery of fetus
Describe the third stage of labor
Delivery of neonate and placenta(- begins immediately after fetus is born and ends when placenta is delivered
Describe the fourth stage of labor
Maternal homeostatic stabilization stage-begins after the delivery of the placenta and continues for one to four hours after delivery
VBAC
vaginal birth after ceasarean
Qualifications for VBAC
What is OP position?
What will help with back labor
Fetal fibronectin test
Bishop score
What is Bishop score used for
What score is best for induction(Bishop)
Describe pain management in labor
Pharmacologic pain management in labor
Non-pharmacologic pain management in labor
Contractions
How are contractions measured
Duration-contractions
Resting phase-contractions
Strength-contractions
Frequency-contractions
How are contractions measured
Chorioamnionitis
Tx for chorioamniotis
Diagnostics for chorioamniotis
5 P’s of labor
Passenger, passageway, powers, position, psychological
What causes variable decelerations
Cord compression
When is a vacuum delivery indicated?
What medications are needed in the room for birth- medications mom and baby
What happens during uterine rupture
S/s uterine rupture
True vs false labor
True labor has cervical change!
Signs of true labor
Bloody show, contractions that increase with intensity, presenting part of infant engages, CERVICAL CHANGE
Where do we listen for FHR? What if baby is breech?
What are tocolytics
When are tocolytics used
When is oxytocin given
When is oxytocin contraindicated
What is GBS screening done for
GBS screening
Why is it important to know? -GBS screening
What is station
How is station measured
How do we facilitate descent of fetus
Precipitous delivery
What do we need to monitor for in precipitous delivery
When is mag sulfate given
When is it no longer safe to give/use mag sulfate
Signs of labor
Cord prolapse
Interventions for cord prolapse
What is betamethasone for
What is a doula how do they assist?
Effleurage
When is effleurage done
What is ROM? What needs to be documented
Important to know about ROM
What are Leopold’s done for?
Leopolds maneuer
C section indications
7 cardinal movements
Acceleration-FHR
Increase in FHR from baseline by 15bpm lasting 15 seconds or more; determinant of fetal wellbeing
Deceleration-FHR
Decreases in FHR from normal baseline: variable, early,late, prolonged
Management for variable deceleration
Maternal repositioning -L side=best
Management for early deceleration
Identify labor progress
Management for acceleration
No interventions
Late deceleration management
Execute interventions—PERFUSION FIRST
Passenger- 5 P’s
Presentation, lie(relationship brown maternal and fetal spine-transverse/parallel), attitude(relationship btwn fetal body parts-flexion=normal,extension), fetal position, station
Fetal station-5 P’s
Fetal head relation to mother’s ischial spine -3 to+3
Passageway-5 P’s
Birth canal- bony pelvis, pelvic floor, vagina, vaginal opening
Powers-5P’s
Uterine contractions(causes effacement and dilation)
Involuntary urge to push
Voluntary bearing down
Position-5P’s
Occiptoposterior=normal, occiptotransverse=okay
Occipitoanterior=makes things slower
Psychological-5P’s
Mental state influences course of labor
Relaxed=more tolerant of pain
Anxiety and fear—>release catecholamines->inhibit contractions and divert bloodflow from placenta
Variable deceleration interventions
Change position first (r/t cord compression)
Late decel intervention
Roll mom to L side, stop oxytocin, inc IVF and O2 immediately (r/t utero-placental insufficiency)
Early decel interventions
Labor check- how far along is mom, intervention not necessary
Prolong decel interventions
Lasts greater than 2 minutes-intervention Necessary! Reposition mom, inc IVF, stop oxytocin , OR prep
