Obs emergencies Flashcards
1
Q
6 important energencies
A
- antepartum hemm
- uterine rupture
- uterine inversion
- shoulder dystocia
- cord prolapse
- amniotic fluid embolism
2
Q
5 causes of antepartum hemmorage
A
- placenta previa - PAINLESS vag. bleed
- abruptio placenta - premature separation or normally implanted placenta - bleed and PAIN
- Vasa previa - FETAL vessels that cross membranes located in lower uterine segment in advance of fetal part - not protected
- LUTS lesions
- unclassified
3
Q
what to always give in hemmorage
A
Rh Ig if Rh neg.
4
Q
findings in uterine rupture
A
- fetal brady
- severe abdo pain
- vaginal bleed
- loss of presenting part
- intraabdo hemmorage
- hypovolemic shock
5
Q
causes of rupture
A
- uterine scar
- excessive contradindications
- trauma
- spontaneous
6
Q
mgmt of rupture
A
- stabilize mom
- treat hypovolemia
- call for help
- emerg. laparotomy
7
Q
def. uterine inversion
A
fundus below os
8
Q
3 causes of inversion
A
- excessive cord traction
- fundal pressure
- placenta accreta
9
Q
mgmt of inversion
A
- uterine punch
- stabilize mom
- call for help
10
Q
def. shoulder dystocia
A
impaction of anterior shoulder above symphysis in the AP diameter to remainder of body cannot be delivered in normal manner
11
Q
risks for shoulder dystocia
A
- port term
- mat. obesity
- fetal macrosomia
- previous dystocia
- operative vag. deliv.
- prolonged labor
- poorly controlled DM - fat shoulder
12
Q
maternal and fetal complications of dystocia
A
maternal - hemmorhage fetal - - birth trauma - fractures - brachial plexus palsy - hypoxic ischemia - death
13
Q
what to do in dystocia
A
(ALARMER) A-ask for help L - lift, hyperflex legs A - anterior shoulder disimpaction R -rotation of post. shoulder M -manual delivery of post. arm E- episiotimy R - roll over on all fours
14
Q
3 options if nothing works
A
- fratcure clavicle
- symphysiotomy
- zavanelli - push head back in and CS
15
Q
4 things NOT to do
A
- pull on head
- push on fundus
- panic
- pivot
