OB/Peds Exam 2 Flashcards
Antepartum
“Prenatal”…before birth
Intrapartum
During birth
Postpartum
After birth
Prenatal Visit Schedule
Conception - 18 wks q 4 wks. 19-36 wks q 2-3 wks. 37 wks - birth q weekly
Gravida
Any pregnancy, regardless of duration, including the one in progress
Para
A woman who has given birth to one or more children who reached 20 weeks regardless of whether it was alive
Folic Acid
Pevents spina bifida or any neural tube defects. If the pt has cx however, it will increase growth cells
TPALM
T (# of term infants born after 38 wks) P (# of preterm infants born) A (# of abortions) L (# of living children) M (# number of multiple births)
Nagele’s Rule
Identify first day of the LNMP, count backwards 3 months and then add 7 days.
Chloasma
Mask of pregnancy
Goodell’s Sign
Softening of the cervix and the vagina caused by increased vascular congestion
Chadwick’s Sign
Purplish or bluish discoloration of the cervix, vagina, and vulva caused by increased vascular congestion
Hegar’s Sign
Softening of the lower uterine segment
Ballottement
A maneuver by which the fetal part is displaced by a light tap of the examining finger on the cervix and then rebounds quickly
Fetal Heartbeat
detected as early as 10 wks using a Doppler. Ranges between 110-160 bpm.
Endocrine Changes
Addition of placenta as a temporary endocrine organ that produces large amts of estrogen and progesterone. hPL increases maternal insulin resistance providing the fetus with glucose for growth.
Colostrum
High in protein, fat-soluble vitamins and minerals, low in calories, fat and sugar. Contains the mothers antibodies to diseases and is secreted for the first 2-3 days after birth
Hyperemesis Gravidarum
Excessive nausea and vomiting that can significantly interfere with food intake and fluid balance, fetal growth may be restricted. Dehydration impairs perfusion of the placenta, reducing the delivery of blood oxygen and nutrients to the fetus.
Manifestations of Hyperemesis Gravidarum
Differs from morning sickness in one of the following ways: persistent n/v, significant weight loss, dehydration, electrolyte and acid-base imbalances
Cerclage
Suturing of an incompetent cervix that opens when the growing fetus grows against it, it is successful in most cases. Low hCG or low fetal heart rate by 8 weeks may be an ominous sign
Hydatidiform Mole
AKA gestational trophoblastic disease or molar pregnancy…May cause hemorrhage, clotting abnormalities, hypertension, or cx development later. More likely in women at the age of extremes of reproductive life.
Placenta Previa
Occurs when the placenta develops in the lower part of the uterus rather than the upper
Marginal (Placenta Previa)
Placenta reaches within 2-3 cm of the cervical opening
Partial (Placenta Previa)
Placenta partly covers the cervical opening
Total (Placenta Previa)
Placenta completely covers the cervical opening
Manifestations of Placenta Previa
Painless vaginal bleeding, usually bright red, is the main manifestation.
Abruptio Placentae
The premature separation of a placenta that is normally implanted
Manifestations of Abruptio Placentae
Bleeding accompanied by abdominal or lower back pain
Eclampsia
Progression to eclampsia from preeclampsia occurs when the woman has one or more generalized tonic-clonic seizures (may result in cerebral hemorrhage, abruptio placentae, fetal compromise, or death of the mother or fetus)
HELLP Syndrome
A variant of GH that involves hemolysis, elevated liver enzymes, and low platelets.
Magnesium Sulfate for Tx of GH
An anticonvulsant given to prevent seizures; given IV for 12-24 hrs, Poor urine output may allow toxic level to be reached. It inhibits uterine contractions so most women receive oxytocin which puts them at an increased rick of hemorrhage. Therapeutic serum level is 4-8 mg/dL.
TORCH
Toxoplasmosis, “O”ther, Rubella, Cytomegalovirus, Herpes……Infections that can be devastating for the fetus or newborn.
Cytomegalovirus
A widespread infection that commonly occurs during the childbearing years. Often asymptomatic in the mother. Infant may have mental retardation, seizures, blindness, deafness, dental abnormalities, petechiae. There is no effective tx for CMV infection.
Rubella
A mild viral disease with a low fever and rash. In very early pregnancy it can disrupt the formation of major body systems, later it is more likely to damage organs that are already formed. Microcephaly, Mental retardation, Congenital Cataracts, Deafness, Intrauterine Growth Restrictions may be present in the embryo/fetus. Immunization is NOT used during pregnancy because it is a live attenuated.
Manifestations of IICP
Slowed pulse rate, irregular respirations, increased BP
