Obstetrics Flashcards
The 4ms pertaining to current pregnancy
Maturity- Gestationsal Age est due date
Multipara- # of fetuses
Meconium- Presence of meconium
Medications- Medications currently being used
Pre Term is less than how many weeks?
32
When is APGAR score taken?
1 Min and 5 Min after birth
Assess BGL if Hypoglycaemic, what will BGL be in the first 2 hours?
2.5 mmol
If baby is less than 32 Weeks, what is the consideration?
Do not dry, wrap in plastic wrap
Where to place probe for SP02 on baby?
Right hand or wrist
Neonatal Res. Rate and Pressure amount?
40-60 BPM , PEEP of 5 cm
MRSOPA
M - Mask
R- Reposition
S- Suction
O- Open the mouth
P- Pressure increase, In 5cm increments to a MAX of 40 cm / MAX of 30 cm in Pre-term
A- Alternate airway
Depth for infant compressions
1/3 of the diameter of the chest
Ration of CPR for infant
3:1
90 Compressions , 30 Ventilations
Continue resuscitation until HR is above 60 bpm
CARDIO
C- chest movement with each breath
A- Airway - secured with ETT or supraglottic airway
R- Rate - 3:1 every 2 seconds
D- Depth 1/3 of AP chest diameter
I/O- Inspired O2- 100 % through PPV device
APGAR scores and there severity
0-3 - Critically Low
4-6 - Fairly Low
7-10 - Generally Normal
APGAR
A- Appearance ( 0 - Blue or Pale all over / 1- Blue extremities/ pink body [acrocyanosis] / 2- Pink body and Pink extremities no cyanosis )
P- Pulse ( 0- No pulse / 1- Less than 100 / 2- greater than or equal too 100 )
G- Grimace ( 0- No response to stimuli / 1- grimace or feebal cry when stimulated / 2- cry or pull away when stimulated)
A- Activity ( 0- No tone / 1- Some flexion / 2- Flexed arms and legs that resist extension)
R- Respiration ( 0- Absent / 1- weak, irregular, gasping / 2- strong cry )
Risk factors for pre-eclampsia
Diabetic
Multiple Fetuses
Teenagers or Women over 35
Hx of pre-eclampsia
Pre- Eclampsia perameters
SBP - up by 30 mmhg
DBP- up by 15 mmhg
140/90 would be considered hypertensive
Moderate - Severe Symptoms of Pre/ Eclampsia
BP greater than 150/100
Generalized Edema
SOB / Pulmonary Edema
Severe Headache
Visual Disturbances
Blindness
Confusion
Upper right quadrant abdominal pain or epigastic pain
Nausea
Seizures
Hyperreflexia
CONTACT OLMC if these symptoms present
Pregnancy term #s
Around 40 Weeks, divides into 3 13 week trimesters
Spontaneous Abortion (Miscarriage)
1- Expulsion of fetus prior to the 20th week of gestation
2- 10-20 % end in miscarriage
3- cramping, Abdominal pain, backache, bleeding
Ectopic Pregnancy Presentation
1-Assume any penal pt of child bearing age with lower abdominal pain within the FIRST trimester is experiencing an Ectopic pregnancy
2-Fertilized at has implanted outside the uterus
3- Presents with sharp lower abdominal pain, referred to the shoulder, right abdomen and bleeding
Placenta Previa
1- Abnormal implantation of placenta on the lower half of the uterine wall, resulting in partial or complete covering of the cervix
2- bleeding occurs when the uterus begins to stretch and cervix dilates to prepare for delivery, this causes the placenta to tear away from the uterus
3- painless bright red bleeding
In the SECOND or THIRD trimester
Abruptio Placentae
Premature separation of normally implanted placenta
Presentation depend on the type of separation-
Partial- May be vaginal bleeding may or may not be associated with back or thigh pain, with sharp tearing pain and development of stiff, board like abdomen
Complete- massive vaginal bleeding, severe bleeding, and maternal shock
Confirm events leading up to the bleeding as well as the colour, amount of bleeding ( how many pads used ) and its duration
save collected cloths or tissue for assessment at the hospital
Pregnancy IV
16 gauge preferred and more than one site if possible
Avoid AC area
Maintain SBP of 90 mmhg
Lovset’s Maneuver
Turning the infant to bring down the anterior shoulder
Service delivery model level of hospital
Level 0 - No obstetrical services
Level 1 A - No operating room capability
Level 1 B - 24/7 operating groom and C- section capability
Level 1 C - 24/7 OR plus obstetrical specialist
Level 2 - Full obstetrics, surgical and pediatric services, including L2 NICU ( level 2 NICU +32 )
Level 3 - ‘’ NICU +20 week gestation and very sick neonates
