Obstetrics

Question 1

The 4ms pertaining to current pregnancy

Answer 1

Maturity- Gestationsal Age est due date
Multipara- # of fetuses
Meconium- Presence of meconium
Medications- Medications currently being used

Question 2

Pre Term is less than how many weeks?

Answer 2

32

Question 3

When is APGAR score taken?

Answer 3

1 Min and 5 Min after birth

Question 4

Assess BGL if Hypoglycaemic, what will BGL be in the first 2 hours?

Answer 4

2.5 mmol

Question 5

If baby is less than 32 Weeks, what is the consideration?

Answer 5

Do not dry, wrap in plastic wrap

Question 6

Where to place probe for SP02 on baby?

Answer 6

Right hand or wrist

Question 7

Neonatal Res. Rate and Pressure amount?

Answer 7

40-60 BPM , PEEP of 5 cm

Question 8

MRSOPA

Answer 8

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

Question 9

Depth for infant compressions

Answer 9

1/3 of the diameter of the chest

Question 10

Ration of CPR for infant

Answer 10

3:1

90 Compressions , 30 Ventilations

Continue resuscitation until HR is above 60 bpm

Question 11

CARDIO

Answer 11

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

Question 12

APGAR scores and there severity

Answer 12

0-3 - Critically Low
4-6 - Fairly Low
7-10 - Generally Normal

Question 13

APGAR

Answer 13

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 )

Question 14

Risk factors for pre-eclampsia

Answer 14

Diabetic
Multiple Fetuses
Teenagers or Women over 35
Hx of pre-eclampsia

Question 15

Pre- Eclampsia perameters

Answer 15

SBP - up by 30 mmhg
DBP- up by 15 mmhg

140/90 would be considered hypertensive

Question 16

Moderate - Severe Symptoms of Pre/ Eclampsia

Answer 16

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

Question 17

Pregnancy term #s

Answer 17

Around 40 Weeks, divides into 3 13 week trimesters

Question 18

Spontaneous Abortion (Miscarriage)

Answer 18

1- Expulsion of fetus prior to the 20th week of gestation
2- 10-20 % end in miscarriage
3- cramping, Abdominal pain, backache, bleeding

Question 19

Ectopic Pregnancy Presentation

Answer 19

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

Question 20

Placenta Previa

Answer 20

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

Question 21

Abruptio Placentae

Answer 21

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

Question 22

Pregnancy IV

Answer 22

16 gauge preferred and more than one site if possible

Avoid AC area

Maintain SBP of 90 mmhg

Question 23

Lovset’s Maneuver

Answer 23

Turning the infant to bring down the anterior shoulder

Question 24

Service delivery model level of hospital

Answer 24

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