OBGYN Flashcards
Full term
How long is it
40 weeks which is 9 months
Pre-term
<35 -37 weeks
How many trimesters are there?
3
first trimester
1-3 months
Second trimester
3-6 months
Third trimester
6 month-term
How do you position pregnant patients
And what do you never do with positioning
Lay them on their side
Never lay the patient supine
Blood pressure changes for each trimester
- First - decreases 5-10 mmHg
- Second - time of lowest BP
- Third- returns to pre pregnancy BP
Physiological changes to the respiratory drive
(4)
- Structural changes - uterus shifts diaphram upward, decreasing the length of the lungs
- Chest enlarges 2 cm
- Tidal volume increases 20-30%
- Oxygen consumption increases 15-20%
First stage
Labor and delivery
starts from time of first true, regular contraction and ends with dilation of cervix (10cm)
Second stage
Labor and delivery
Starts with full dilation of cervix (10cm) and ends with birth of baby
3rd stage
Labor and delivery
Begins once the baby is born until after the placenta is delivered
Braxton Hix contractions
What are they
- False labor contractions
How far away from the baby do you cut the umbilical cord?
6-9 inches
APGAR scoring
When do you start this assessment?
1-5 minutes after birth
APGAR scoring
What does it stand for
- A - Appearance
- P - Pulse
- G - Grimace
- A - activity
- R - Respirations
APGAR scoring
What is the range for a normal score?
7-10
How do you care for a new born?
non critical
(4)
- ABCs
- Prevent heat loss
- Dry the neonate
- keep baby skin to skin contact with mother
Nuchal cord
Define
What do you do about this situation?
- The umbilical cord is wrapped around the babies neck
- If it feel loose then free the child by pulling cord over its head
- If its tight stop the delivery process, hold the cord away from the childs neck, and transport
Prolapsed cord
Define
what do we do about this?
- Umbilical cord comes out before the babies head does
- Place a wet towel over the umbilical cord and transport
Breeched presentation
Define
Can we still delivery a child like this?
- child comes out butt first
- Can still delivery with a breeched presentation
Shoulder Dystocia
Define
Can we still delivery this child?
- When one or both of the baby’s shoulders get stuck in the vaginal cavity and the sholder gets dislocated
- Can still deliver
Premature delivery
How many weeks into pregnancy is classified as premature
- Child birth before reaching 24 weeks
Post term delivery
define
Can we deliver this child
- Oversized child
- Cant deliver. take them to the hospital for c section
Meconium
Define
- Babys first poop
- If seen during delivery suction airways (only time you will suction during birth)
Uterine rupture
Define
- Tearing of the uterus
Placenta previa
Define
- When the placenta covers the opening of the cervic
Abruptio placenta
define
What week of pregnancy is it most common?
- When the placenta separates before childbirth
- most common around 25 weeks of pregnancy
- Super rare
Gravida
Define
number of pregnancies
Para
Define
number of deliveries after 20 weeks of pregnancy
How do you administer oxygen to a newborn?
how many lpm
Free flow method by hovering the mask over their face and blowing oxygen on them.
8-10 lpm
Ventilation rate for a newborn that requires PPV
40-60 vpm
What is the earliest a baby can be born and still have a chance at surviving?
24 weeks at the earliest
Bloody show
Define
When does it become concerning
- Could happen pre birth. Water breaks and they could have vaginal bleeding.
- Shouldn’t be having this. Has to do with pre-delivery. Happens sometimes not all the time
- Excessive bleeding for 10-30 minutes, and it’s now concerning
How to measure contractions
Frequency - start of contraction to start of next
Duration - start of contraction to end of contraction
Stages of labor
Names of the 3 stages
Dilation
Expulsion
Placental delivery
Preductal spo2 for a neonate
1 min - 60-65
10 min - 85-90
Increase of 5 % every minute
Postpartum hemorrhage
how much blood loss
More than 500 ml blood
Uterine atony
Failure of uterus to regain muscle tone
Imminent delivery
Crowning, contractions less than 2 mins apart lasting 60 seconds, urge to push, bulging perinium
Neonatal resuscitation needs frequency
- Dry, warm, suction. Tactile stimuli
- O2
- BVM
- Chest compressions
Signs of severely depressed infant
RR >60
HR >180 or <100
APGAR under 4
Expected spo2 for baby
1 min 60-65
10 min 85 to 90
Increase by 5% each minute