OB (PART 2) Flashcards by 10 - COLOBONG, DIANA YSABEL

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

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8th to 12th week AOG
Non pathological uterine contractions

Braxton Hicks Contractions

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protozoan infection
spread most commonly with uncooked meat/ through handling cat stool in soil or cat litter

Toxoplasmosis

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normal occurrence in pregnancy so long as no proteinuria

Ankle Edema

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if the infection crosses the placenta = could lead to____

CNS damage

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tx for toxoplasmosis

sulfonamides or Pyrimethamine

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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

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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

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tx for herpes simplex virus

Intravenous or oral acyclovir (Zovirax)

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virus spreads into the bloodstream (viremia) and crosses the placenta to a fetus posing substantial fetal risk

Herpes Simplex Virus (Genital Herpes Infection)

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tx for syphilis in first trimester

benzathine penicillin

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if syphilis left untreated beyond the 18th week of gestation

hearing impairment, cognitive challenge,
osteochondritis, and fetal death are possible

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total calorie for pregnant

2500

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total protein for pregnant

71 g daily

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indian sit that stretches perineal muscles without occluding blood supply to the lower legs

Tailor Sitting

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also stretches perineal muscles. useful position for second-stage labor

Squatting

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tighten the muscles of perineum strengthen the pubococcygeal muscles and bulbocavernosus

Kegel Exercises

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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

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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

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is the settling of the fetal
head into the inlet of the true pelvis.

Lightening

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used to describe the release of the cervical plug

Show

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Color change of the vagina from pink to violet

Chadwick’s sign

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Softening of the cervix

Goodell’s sign

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Softening of the lower uterine segment

Hegar’s sign

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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