OB Procedures

Question 1

purpose of an amniotomy

Answer 1

-enables elctronic fetal monitoring

Question 2

what is the first thing we do after performing amniotomy

Answer 2

assess FHR

Question 3

risks of performing amniotomy

Answer 3

• prolapse and compression of the cord
• risk of infec incr the longer membranes have been ruptured
• abruptio placenta

Question 4

what is abruptio placenta

Answer 4

when the placenta pulls apart from the wall of the uterus

Question 5

indications for performing an amniotomy

Answer 5

• fetal compromise (IUGR, Rh incompatibility)
• SROM near term
• post term preg
• chorioamniotitis
• HTN a/w preg
• maternal medical conditions (pre-eclampsia)
• fetal death

Question 6

def chorioamniotitis

Answer 6

infec of the chorion

Question 7

when the AFI is low, what does that indicate?

Answer 7

the placenta is not functioning at its max capacity anymore

Question 8

contraindications for amniotomy

Answer 8

• placenta previa
• vasa previa
• abnormal presentation
• cord prolapse
• prev uterine surgery
• non reassuring FHR patterns

Question 9

why is previous uterine surgery contraindicated for amniotomy

Answer 9

risk of there being a weakness in the uterine wall

Question 10

other methods of induction/augmentation of labor

Answer 10

• cervical ripening

- oxytocin admin

Question 11

what is cervadil and how does it work

Answer 11

• looks like a tampon
• mom admitted to antepartum and monitored overnight
• ripens cervix

Question 12

what natural material contains prostaglandins

Answer 12

sperm

Question 13

how does a transcervical cath work?

Answer 13

-foley cath and open up balloon

Question 14

what should be done before inserting transcervical cath

Answer 14

admin pain meds

Question 15

how is oxytocin administered for induction of labor

Answer 15

-diluted as an isotonic solution and given as a secondary infusion

Question 16

when can oxytocin not be given and why

Answer 16

if the cervix is not ripened

- baby runs the risk of going into distress

Question 17

def external version

Answer 17

promotes vaginal birth by changing fetal presentation from a breech or transverse lie to a cephalic lie

Question 18

def internal version

Answer 18

changing the position of a second twin after the birth of a first twin

Question 19

what meds is mom given before external version

Answer 19

tocolytics

Question 20

what is immediately done following external version

Answer 20

assess FHR

Question 21

what risks are a/w external version

Answer 21

• cord prolapse
• premature labor due to softened cervix
• nuchal cord

Question 22

maternal trauma a/w operative delivery

Answer 22

• vaginal wall laceration

- hematoma

Question 23

infant trauma a/w operative delivery

Answer 23

ecchymosis
lacerations
abrasions
facial nerve injury/ auditory nerve injury
intracranial hemorrhage
CP - if severe

Question 24

what two methods care considered operative vaginal birth

Answer 24

• forceps

- vacuum extractor

Question 25

benefits of giving birth w/ an intact perineum (episiotomy)

Answer 25

less blood loss
less pain
earlier resumption of comfortable intercourse PP

Question 26

what is the preferred uterine incision and why

Answer 26

low transverse

- less likely to rupture in a subsequent preg