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ACP COPR > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Hormones

A

Gonadotropin
Follicule Stimulating
Luteinizing
Progesterone
HCG

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2
Q

Placenta Functions

A
  1. Gas exchange
  2. Nutrients
  3. Excretion
  4. Transfer of heat
    5.Hormone production (HCG)
  5. Barrier
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3
Q

Terms and trimesters

A

Full-term: 37-42
Pre-term: <37

1st: Week 1-12
2nd: Week 13-27
3rd: Week 28-birth

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4
Q

Anatomical Changes

A

Blood volume increased by 40-50% at term.
RBC increases by 33% (need for iron sups)
WBC and platelets also increase
Heart size increases by 10-15%
CO increased by 40%
HR increases by 15-20 beats/min
BP does not increase, but may drop. DPB may drop by 10-15 mmHg.
O2 Consumption increases by 20% with an increase in Vt by 40%
ECG: left axis, III TWI, and low voltage.

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5
Q

Fundal Changes

A

22 weeks = 20cm, and increases by 1cm each week after. If the length is longer or shorter, it may indicate uterine growth problems or breach (shorter), or twins (longer).

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6
Q

Blood Loss During Birth

A

Vaginal: 500ml
C-Section: 1000ml

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7
Q

Abortion

A

Expulsion of the fetus from any cause before the 20th week.
Spontaneous or induced.

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8
Q

Stages and types of Abortion

A

Threatened: vaginal bleeding in the first trimester, cramping, and discomfort (rarely severe pain). Will progress to INcomplete abortion or subside and allow pregnancy to continue. POCUS to rule out ectopic.

Inevitable: Severe abdo pain, strong uterine contractions, vaginal bleeding(may be massive). Shock

Incomplete: Products are expelled but some remain in-utero. Collect the fetus and placenta, and gently remove protruding tissues. Watch for shock

Complete: All products expelled.

Missed: Fetus dies in utero but not expelled.

Septic: Uterus becomes infected after abortion, puerperal fever.

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9
Q

Third Trimester Bleeding

A

Abruptio Placenta
Placenta Previa
Uterine Rupture

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10
Q

Primigravida

A

Pregnant for the first time

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11
Q

Primipara

A

(Primip) Women who has had only one birth

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12
Q

Multigravida

A

A woman who has been pregnant 2+ regardless of outcome.

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13
Q

Nullipara

A

Never delivered

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14
Q

Management of 3rd Trimester Bleeding

A
  1. Left lateral recumbent
    2.100% NRB @ 15LPM
  2. Rapid Transport
  3. IV and bolus to maintain BP
  4. ECG and vitals
  5. Loosely place trauma pads over the vagina.
  6. Pharmacology (tocolytics, MgSO4++, oxytocin)
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15
Q

1st Trimester Bleeding

A

Molar pregnancy
Ectopic pregnancy
Miscarriage/abortion

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16
Q

Stages of Labour

A

1st Stage: Onset of labor pains, may radiate into the back. Contractions at 5-15 min intervals. Cervix dilates.\

2nd Stage: Baby’s head enters the canal. Contractions become more intense and frequent. 2-3min intervals. Concludes when baby is delivered.

3rd Stage: Starts at delivery of the baby and ends when the placenta is delivered.

17
Q

False Labour

A

Contraction: Irregularly spaced
Interval: Remains long
Intensity: Remains the same
Analgesics: Effective
Cervix: No change

18
Q

True Labour

A

Contraction: Regularly spaced
Interval: Gradually shortens
Intensity: Gradually Increases
Analgesics: Non-effective
Cervix: Progressive dilation and effacement.

19
Q

Breech Presentations

A

Breech- Bum or feet first
Footling- one or both feet are dangling
Transverse- arm may be out
Cord Prolapse - The cord is out
Shoulder Dystocia

20
Q

Postpartum Hemorrhage Management and Risk Fx.

A

Hemorrhage (>500ml)
1. Uterine Massage
2. Put baby on mother’s breast
3. Oxytocin, 20u in 1000ml NS @ 250ml/h
4. Notify the hospital
5. Transport
6. Start another IV
7. Do not attempt an INTERNAL exam of the vagina
8. Do not pack the vagina
9. Manage external bleeding from tears

Risk Factors: prolonged labor, retained products, grand multiparity, multiple pregnancy, placenta previa, full bladder, trauma, DIC.

21
Q

Pregnancy Complications

A

PE - Sudden onset dyspnea, tachycardia, AFib, or postpartum hypotension.
Uterine Inversion- Presents with hypovolemia, and pain, visible if prolapsed.
Supine Hypotensive Syndrome- Nausea, dizziness, tachycardia, claustrophobia. Tx. Delivery or Left Lateral Recumbent.
Meconium Staining- Fetal distress

ACP COPR (20 decks)

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