OB (PART 2) Flashcards
SIGNS INDICATING COMPLICATIONS
- Vaginal Bleeding
- Persistent Vomiting
- Chills and Fever
- Sudden Escape of Clear Fluid From the Vagina
- Pregnancy-Induced Hypertension
- Increase or Decrease in Fetal Movement
- 8th to 12th week AOG
- Non pathological uterine contractions
Braxton Hicks Contractions
- protozoan infection
- spread most commonly with uncooked meat/ through handling cat stool in soil or cat litter
Toxoplasmosis
normal occurrence in pregnancy so long as no proteinuria
Ankle Edema
if the infection crosses the placenta = could lead to____
CNS damage
tx for toxoplasmosis
sulfonamides or Pyrimethamine
- causes only a mild rash and mild systemic illness in a woman
- but the teratogenic effects on a fetus can be devastating (hearing impairment, cognitive and motor challenges, cataracts, cardiac defects)
Rubella
- member of the herpes virus family, is another teratogen that can cause extensive damage to a fetus
- no treatment for the even if it presents in the mother with enough symptoms to allow detection
- infant may be born severe neurologically challenged
Cytomegalovirus
tx for herpes simplex virus
Intravenous or oral acyclovir (Zovirax)
virus spreads into the bloodstream (viremia) and crosses the placenta to a fetus posing substantial fetal risk
Herpes Simplex Virus (Genital Herpes Infection)
tx for syphilis in first trimester
benzathine penicillin
if syphilis left untreated beyond the 18th week of gestation
hearing impairment, cognitive challenge,
osteochondritis, and fetal death are possible
total calorie for pregnant
2500
total protein for pregnant
71 g daily
indian sit that stretches perineal muscles without occluding blood supply to the lower legs
Tailor Sitting
also stretches perineal muscles. useful position for second-stage labor
Squatting
tighten the muscles of perineum strengthen the pubococcygeal muscles and bulbocavernosus
Kegel Exercises
- helps relieve backache during
- pregnancy and early labor
- making the lumbar spine more flexible.
- increases flexibility and helps relieve back pain
- otso otso
Pelvic Rocking
is the best for maintaining
cardiovascular fitness without stressing the body since the buoyancy of the water lessens the impact on joints and ligaments
Water exercise
is the settling of the fetal
head into the inlet of the true pelvis.
Lightening
used to describe the release of the cervical plug
Show
Color change of the vagina from pink to violet
Chadwick’s sign
Softening of the cervix
Goodell’s sign
Softening of the lower uterine segment
Hegar’s sign
lower uterine segment is tapped on a bimanual examination, the fetus can be felt to rise against abdominal wall
Ballottement
Periodic uterine tightening occurs
Braxton Hicks
Preliminary Signs of Labor
Excess Energy
Goodell’s sign
Braxton Hicks Contractions
- begin and remain irregular
- felt first abdominally and remain confined to the abdomen and groin
- disappear with ambulation or sleep
- do not increase in duration, frequency, or intensity
- do not achieve cervical dilatation
false contraction
- begin irregularly but become regular and predictable
- felt first in lower back and sweep around in abdomen
- continue no matter what the womans level of act.
- increase in duration, frequency, or intensity
- achieve cervical dilatation
true contraction
Signs of TRUE Labor
Show
Uterine Contractions
Rupture of the Membranes
A woman’s pelvis is of
adequate size and contour.
Passage
is of appropriate size and in an advantageous position and presentation
Passenger
full flexion
vertex
moderare flexion/ military attitude
sinciput
partial extension
brow
poor flexion/ complete extension
face
refers to the relationship of the presenting part of a fetus to the level of the ischial spines
Station
The mother is asked to take a deep breath, hold the breath (closed glottis), and push downward when uterine contraction starts.
valsalva maneuver
relationship between the
long (cephalocaudal) axis of
the fetal body and the long
(cephalocaudal) axis of a
woman’s body
Lie
buttocks or feet
Breach
Shoulder
transverse
3 powers of labor
Uterine Contractions
Cervical Changes
Dilatation
contractions is
rhythmicity and progressive
lengthening and intensity
- Uterine Contractions
shortening and thinning of the cervical canal
Effacement
enlargement or widening of the cervical canal
Dilatation
Refers to the psychological
state or feelings
Psyche
- cervical dilatation: 0-3cm
- contractions: 40 sec every 5 mins
latent phase
- cervical dilatation 4 to 7 cm
- Contractions 40 to 60 seconds, 3 to 5 mins interval
Active phase
- cervical (full) dilatation 9 to 10 cm
- Full effacement
- Contractions 60 to 90 seconds, 2 to 3 mins interval
Transition phase
TRUE LABOR to Full dilatation
First Stage
from full dilatation and
cervical effacement to
birth of the infant
Second Stage
administered to second stage
Pudendal block
administered to first stage
Lumbar epidural block
birth of the infant to delivery of the placenta
Third Stage
Signs of Placental Separation
- Lengthening of the cord
- Sudden gush of blood
- Change in the shape of the uterus
- Firm contraction of the uterus
- Appearance of the placenta at the vaginal opening
Separate at center first
Schultze
Separate from edge first
Duncan
- first few hours after birth
- Perineal Repair
Fourth Stage
- time of reflection
- 2- to 3-day period
- Mother is passive
- Dependency in activity
- usually wants to talk about her pregnancy rather than new role
- Expressed little interest in caring for her child
- holds her new child with a sense of wonder
Taking-In Phase
- begins to initiate action
- begins to take a strong interest for her child
Taking-Hold Phase
- woman finally redefines her new role
Letting-Go Phase
2nd most frequent cause of bleeding early in pregnancy
Ectopic Pregnancy
- sharp, stabbing pain in one of her lower
abdominal quadrants at the time of rupture - scant vaginal spotting
Ectopic Pregnancy
medication given when ectopic pregnancy hasn’t ruptured yet
Methotrexate
- is a condition of pregnancy in which the placenta is implanted abnormally in the uterus
- most common cause of painless bleeding in the third 3rd of pregnancy
Placenta Previa
occurs when the placenta separates from the inner wall of the uterus before birth
abruptio placenta
is a condition in which vasospasm occurs during pregnancy in
both small and large arteries
PIH
classic signs of PIH
hypertension, proteinuria, and edema
elevated blood pressure (140/90 mm Hg) but has no proteinuria or edema
Gestational hypertension
Classic signs are present
Preeclampsia
- Classic signs + seizure
- cerebral edema is so acute that a grand-mal seizure (tonic-clonic) or
coma occurs
Eclampsia
tx for pih
Low dose aspirin
Antiplatelet Therapy
hydralazine (Apresoline) labetalol
nifedipine
Magnesium sulfate
Diazepam
