Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RNC-OB > Obstetric Complications > Flashcards

Obstetric Complications Flashcards

1
Q

What should you do for latent phase arrest (prodromal labor)?

A

Expectant management if no indication to deliver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is hypertonic dysfunction/ what do you do for it?

A

High frequency low amplitude contractions with significant maternal discomfort

Therapeutic rest (morphine sleep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the two active phase disorders?

A

Protraction disorders

Arrest disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is protraction of the active phase of labor in a nullipara and multipara?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is arrest of active phase?

A

Cessation of previously normal active phase dilation for >2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can cause active phase disorders?

A

Inadequate ctx
Malpresentation
CPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How many MVU’s are needed in a 10 minute period to be considered adequate ?

A

200-250

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is considered protraction of second stage for a nullipara/multipara?

A

Nullipara

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How long can second stage take as long as the fetus is tolerating labor for a nullipara/multipara?

A

Nullipara- 2hrs without anesthesia, 3 with

Multipara- 1 hr without anesthesia, 2 with

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How long does third stage normally last?

A

10 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When is it considered a retained placenta?

A

If placenta not delivered by 30 minutes

*risk of hemorrhage inc proportionally to time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is expectant management of third stage?

A

No early cord clamping, no cord traction, no oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does dystocia mean/what three things can cause it?

A

Abnormal labor

Powers
Passenger
Passageway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is active management of third stage?

A

Early cord clamping, controlled cord traction, oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is considered precipitous labor?

A

Delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can be associated with precipitous labor?

A

Tachysystole, cocaine use, abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A shoulder dystocia occurs when head to delivery time is > ___

A

One minute OR use of ancillary measures to deliver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are risk factors for a shoulder dystocia?

A 
AMA
Inc gest age
DM
obesity
Prior shoulder dystocia
Prior infant >4500grams
Dystocia
Operative vaginal delivery
Large paternal birth weight 
Hispanic
Male fetus
Positive 50g screen with neg 3hr GTT
macrosomia (>4000grams, inc abdominal circumference)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a sign of shoulder dystocia?

A

Turtle sign

Failure to achieve external rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are fetal complications of a shoulder dystocia?

A

Asphyxia and/or acidosis
Brachial plexus injuries (erbs/klumpkes palsy)
Fractured humerus or clavicle
Fetal death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are maternal complications of a shoulder dystocia?

A 
Bladder injury
Cervical/vaginal/perineal lacs
Hematoma
Separation of symphysis 
Uterine rupture 
Pp hemorrhage
Infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a normal amniotic fluid volume?

A

1000ml at 36wks, then slowly decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is oligohydramnios?

A

AFI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is polyhydramnios?

A

AFI >24cm at term

Associated with CNS or GI anomalies or maternal diabetes

Can cause preterm labor (uterine distention)

Can do amnioreduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How can hypoxia cause meconium stained fluid?

A

Hypoxia results in fetal vagal response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is PROM? What is active vs expectant management with PROM?

A

SROM >1hr prior to start of labor
Active- induction
Expectant- can delay induction 96 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is PPROM?

A

SROM prior to 37 wks

Antibiotics and glucocorticoid for 24-34 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is anaphylactoid syndrome of pregnancy?

A

“Amniotic fluid embolism”
Amniotic fluid/debris enter maternal circulation
Massive anaphylactic response

Two phases:
Acute cardiorespiratory collapse
Hemorrhagic phase/DIC

mortality 80%
Most pts die within one hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is placenta previa?

A

Placenta covers cervical os
Marginal- edge of placenta within 2-3cm
Bright red painless bleeding
Cesarean delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the risk factors for a placenta previa?

A 
AMA
prior uterine surgery
Fibroids or other uterine abnormalities
Cigarette smoking
Multiple gestational
Multiparity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is abruptio placentae?

A

Detachment of placenta from uterine wall
Bleeding with pain
Bleeding may be concealed
Ultrasound may not be reliable
Rigid, tender abdomen
Risk of DIC
fetal tachycardia, bradycardia, absent variability, late decels, sinusoidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is vasa previa?

A

Fetal vessels over cervical os
Extremely dangerous
ROM or dilation and rupture vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What happens if the decidua basalis fails to control trophoblast invasion beyond the endometrium?

A

Placenta accrete

34
Q

What is placenta accreta vera?

A

Chorionic villi attach to myometrium but do not invade muscle tissue

May be able to manually remove

35
Q

What is placenta increta?

A

Chorionic villi invade INTO myometrium

Cannot be removed

36
Q

What is placenta percreta?

A

Chorionic Villi invade THROUGH myometrium and penetrate uterine serosa (perimetrium)

May invade surrounding tissue/organs

37
Q

What is the most significant risk factor for placenta accreta?

A

Prior cesarean section(s)

38
Q

What are the risks after 40 wks gestation?

A

Oligo, macrosomia, meconium, IUFGR

39
Q

What are the main causes of preterm delivery?

A

50% idiopathic- unknown
30% underlying infectious processes
20% iatrogenic- elective for complications

40
Q

What do you need to know about fetal fibronectin? (fFN)

A 
Glycoproteins found in plasma 
Done between 24-34wks
Collected from posterior vaginal fornix
High negative predictive value
Poor positive predictive value
Not valid within 24 hrs of intercourse/sve
41
Q

What cervical length is associated with PTL?

A
42
Q

What are the four classes of tocolytics?

A

Sympathimimetics: terbutaline
Magnesium sulfate
Calcium channel blockers: nifedipine
NSAIDS: indomethacin

43
Q

How do glucocorticoids work?

A

Stimulates the synthesis of fetal proteins and peptides
Stimulated synthesis of surfactant
Promotes maturation of germinal matrix which reduces occurrence of intraventricular hemorrhage

44
Q

What are monozygotic twins?

A

Come from same egg
Identical
Can share placenta and/or amnion

45
Q

What are dizygotic twins?

A

Come from two eggs
Not identical
Always have separate placentas and amnions

46
Q

What is twin-to-twin transfusion syndrome?

A

Blood supply of monochrorionic twins become connected- they share a blood supply

Donor twin- smaller, pale, anemic, dehydrated

Recipient twin- larger, red, too much blood, inc blood pressure, may develop cardiac failure

47
Q

What is a big concern with mono/mono twins?

A

Becomes easy for twins to become entangled in each other’s cords

Entanglement may cause one twin to become stuck in birth canal

48
Q

What is active management of third stage?

A

Early cord clamping, controlled cord traction, oxytocin

49
Q

What is considered precipitous labor?

A

Delivery

50
Q

What can be associated with precipitous labor?

A

Tachysystole, cocaine use, abruption

51
Q

A shoulder dystocia occurs when head to delivery time is > ___

A

One minute OR use of ancillary measures to deliver

52
Q

What are risk factors for a shoulder dystocia?

A 
AMA
Inc gest age
DM
obesity
Prior shoulder dystocia
Prior infant >4500grams
Dystocia
Operative vaginal delivery
Large paternal birth weight 
Hispanic
Male fetus
Positive 50g screen with neg 3hr GTT
macrosomia (>4000grams, inc abdominal circumference)
53
Q

What is a sign of shoulder dystocia?

A

Turtle sign

Failure to achieve external rotation

54
Q

What are fetal complications of a shoulder dystocia?

A

Asphyxia and/or acidosis
Brachial plexus injuries (erbs/klumpkes palsy)
Fractured humerus or clavicle
Fetal death

55
Q

What are maternal complications of a shoulder dystocia?

A 
Bladder injury
Cervical/vaginal/perineal lacs
Hematoma
Separation of symphysis 
Uterine rupture 
Pp hemorrhage
Infection
56
Q

What is a normal amniotic fluid volume?

A

1000ml at 36wks, then slowly decreases

57
Q

What is oligohydramnios?

A

AFI

58
Q

What is polyhydramnios?

A

AFI >24cm at term

Associated with CNS or GI anomalies or maternal diabetes

Can cause preterm labor (uterine distention)

Can do amnioreduction

59
Q

How can hypoxia cause meconium stained fluid?

A

Hypoxia results in fetal vagal response

60
Q

What is PROM? What is active vs expectant management with PROM?

A

SROM >1hr prior to start of labor
Active- induction
Expectant- can delay induction 96 hours

61
Q

What is PPROM?

A

SROM prior to 37 wks

Antibiotics and glucocorticoid for 24-34 wks

62
Q

What is anaphylactoid syndrome of pregnancy?

A

“Amniotic fluid embolism”
Amniotic fluid/debris enter maternal circulation
Massive anaphylactic response

Two phases:
Acute cardiorespiratory collapse
Hemorrhagic phase/DIC

mortality 80%
Most pts die within one hour

63
Q

What is placenta previa?

A

Placenta covers cervical os
Marginal- edge of placenta within 2-3cm
Bright red painless bleeding
Cesarean delivery

64
Q

What are the risk factors for a placenta previa?

A 
AMA
prior uterine surgery
Fibroids or other uterine abnormalities
Cigarette smoking
Multiple gestational
Multiparity
65
Q

What is abruptio placentae?

A

Detachment of placenta from uterine wall
Bleeding with pain
Bleeding may be concealed
Ultrasound may not be reliable
Rigid, tender abdomen
Risk of DIC
fetal tachycardia, bradycardia, absent variability, late decels, sinusoidal

66
Q

What is vasa previa?

A

Fetal vessels over cervical os
Extremely dangerous
ROM or dilation and rupture vessels

67
Q

What happens if the decidua basalis fails to control trophoblast invasion beyond the endometrium?

A

Placenta accrete

68
Q

What is placenta accreta vera?

A

Chorionic villi attach to myometrium but do not invade muscle tissue

May be able to manually remove

69
Q

What is placenta increta?

A

Chorionic villi invade INTO myometrium

Cannot be removed

70
Q

What is placenta percreta?

A

Chorionic Villi invade THROUGH myometrium and penetrate uterine serosa (perimetrium)

May invade surrounding tissue/organs

71
Q

What is the most significant risk factor for placenta accreta?

A

Prior cesarean section(s)

72
Q

What are the risks after 40 wks gestation?

A

Oligo, macrosomia, meconium, IUFGR

73
Q

What are the main causes of preterm delivery?

A

50% idiopathic- unknown
30% underlying infectious processes
20% iatrogenic- elective for complications

74
Q

What do you need to know about fetal fibronectin? (fFN)

A 
Glycoproteins found in plasma 
Done between 24-34wks
Collected from posterior vaginal fornix
High negative predictive value
Poor positive predictive value
Not valid within 24 hrs of intercourse/sve
75
Q

What cervical length is associated with PTL?

A
76
Q

What are the four classes of tocolytics?

A

Sympathimimetics: terbutaline
Magnesium sulfate
Calcium channel blockers: nifedipine
NSAIDS: indomethacin

77
Q

How do glucocorticoids work?

A

Stimulates the synthesis of fetal proteins and peptides
Stimulated synthesis of surfactant
Promotes maturation of germinal matrix which reduces occurrence of intraventricular hemorrhage

78
Q

What are monozygotic twins?

A

Come from same egg
Identical
Can share placenta and/or amnion

79
Q

What are dizygotic twins?

A

Come from two eggs
Not identical
Always have separate placentas and amnions

80
Q

What is twin-to-twin transfusion syndrome?

A

Blood supply of monochrorionic twins become connected- they share a blood supply

Donor twin- smaller, pale, anemic, dehydrated

Recipient twin- larger, red, too much blood, inc blood pressure, may develop cardiac failure

81
Q

What is a big concern with mono/mono twins?

A

Becomes easy for twins to become entangled in each other’s cords

Entanglement may cause one twin to become stuck in birth canal

RNC-OB (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions