ob/gyn

Question 1

antepartum emergencies

Answer 1

occur in pregnant women prior to onset of delivery; often involve heavy hemorrhage

Question 2

spontaneous abortion/miscarriage

Answer 2

delivery of the fetus and placenta before fetus is viable (able to survive); most occur in first trimester; symptoms: cramps/abdominal pain, severe vaginal bleeding, passage of blood/tissue clots

Question 3

placenta previa

Answer 3

placenta implants near the opening of the cervix, rather than above the fetus, causing placenta to pre-maturely be torn from the uterus when cervix dilates for delivery and cause a lot of bleeding; may obstruct the fetus from coming out; symptoms: heavy vaginal bleeding, but no pain

Question 4

abrupteo placentae

Answer 4

arteries between placenta and uterus rupture, causing placenta to split from the uterine wall prematurely- causes severe bleeding and prevents exchange of nutrients between placenta and fetus; if complete abruption, 100% fetal mortality rate; if partial abruption, mortality rate correlated with degree of tear; may or may not be vaginal bleeding- if fetus is blocking vaginal canal, it may block the high volume of internal bleeding from coming out; symptoms of hypovolemic shock

Question 5

ruptured uterus

Answer 5

weakening of uterine wall due to stretching/enlargement of the uterus during pregnancy causes uterus to rupture; fetus slips out into abdominal cavity; risk factors: previous c-section, trauma, prior rupture

Question 6

ectopic pregnancy

Answer 6

egg implants outside the uterus, usually in the fallopian tube; as fetus and placenta grow, there is not enough room resulting in the rupture of surrounding tissue; causes severe hemorrhage that may be fatal for mom and fetus; signs of shock are present

Question 7

preeclampsia

Answer 7

pregnancy induced high blood pressure and swelling in the abdomen, pulmonary edema (swelling), visual changes, and protein found in the urine (and decreased urine); generally in 3rd trimester; second leading cause of maternal death (along with eclampsia); can occur up to 20 days postpartum

Question 8

eclampsia

Answer 8

includes the symptoms of preeclampsia but is more severe and includes coma or seizures

Question 9

supine hypotensive syndrome

Answer 9

weight of fetus in 3rd trimester presses down on inferior vena cava- results in less blood flow entering right atrium-decreased stroke volume-decreased cardiac output

Question 10

first stage of labor

Answer 10

Dilation: from when the contractions begin to when cervix is fully dilated- fetus enters dilated cervix from uterus; amniotic sac ruptures before or during this stage

Question 11

second stage of labor

Answer 11

Expulsion: begins with complete cervical dilation; ends with delivery of the baby; baby moves through the vagina until crowing occurs- baby sticks head out; after crowning occurs, mom pushes with each contraction

Question 12

third stage of labor

Answer 12

delivery of placenta; mom continues having contractions until placenta comes out

Question 13

nuchal cord

Answer 13

umbilical cord is wrapped around infant’s neck

Question 14

prolapsed cord

Answer 14

umbilical cord appears at entrance to birth canal before head of baby; cord can get pressed against uterine wall by fetus, cutting off oxygen supply to baby- big emergency

Question 15

breech birth

Answer 15

lower extremities of fetus start coming out first; comes out upside down

Question 16

meconium

Answer 16

fetus has bowel movement while in the amniotic fluid, if deprived of O2; if meconium debris is inhaled by fetus, may result in infection or pneumonia; suction mouth and trachea

Question 17

treatment of eclampsia/preeclampsia

Answer 17

place in dark, quiet room; left lateral recumbent position; use quiet voice; give suction and O2 if seizure

Question 18

neonatal care- APGAR

Answer 18

appearance-pulse-grimace-activity-respirations

Question 19

birth asyphyxia

Answer 19

major cause of newborn death; unable to get enough oxygen, baby isn’t able to breathe

Question 20

neonatal ABC’s

Answer 20

Airway-place in sniffing position, suction if needed; Breathing- give O2 if needed/BVM (40-60 breaths per min); Circulation- take pulse (apical, umbilical, or brachial), compressions if needed

Question 21

neonatal chest compressions

Answer 21

1 finger below nipple line; perform if already did BVM for 30 seconds and HR<60; ratio is 3:1; reassess every 30 sec- if HR>60, then stop compressions