Obstetrics Flashcards
What does APGAR stand for?
Appearance
Pulse
Grimace
Activity
Respiration
How often should the APGAR score be calculated?
At 1 min and 5 mins. if the score <7 at 5 mins. repeat q5 until 20 mins.
what is station 0?
Fetal head engaged at ischial spine.
Where is the fundal height ast 20 wk?
Umbilicus
When does regression of the fundal height occur?
37-40 weeks
Where is the fundal height at 36 weeks?
xiphoid process
Chadwick sign
The mucous membranes of the vulva, vagina, and cervix become congested and may appear bluish at 8-12 weeks gestation
When can fetal cardiac activity detected by handheld doopler
10-12 weeks of gestation
If ovulation occurs of day 14, how soon after ovulation does implantation occurs?
8-10 days later
transvaginal ultrasound examination
transvaginal ultrasound gestational landmarks at 4.5-5 wks
Gestational Sac
transvaginal ultrasound gestational landmarks at 5-6 week?
Yolk sac
transvaginal ultrasound gestational landmarks at 5.5-6 wks?
embryonic cardiac activity
When can the embryo be measured using the crown and rump length in the 1st trimester?
6-7 weeks.
_______________contractions are uncoordinated contractions that start about one month before labor that do not cause dilation and effacement of the cervix.
Braxton-Hicks
In the __________ stage of labor, powerful uterine contractions constrict blood vessels in the uterine wall and shear the placenta off of the decidua, allowing it to be delivered out of the vagina.
3rd stage
Increased estrogen levels during the last few weeks of pregnancy leads to (more/fewer) __ oxytocin receptors on the myometrial cells of the uterus.
more
Infants considered preterm are born when?
Between 20-36 weeks & 6 days
When is an infant considered full term?
Born at 37-42 weeks
What is Naegele’s rule?
It is used to estimate the due date. 1st day of LMP - 3months + 7 days.
Ex: LMP 6/25 - 3 mo = 3/25 + 7 days = April 1st
What is cervical effacement?
Thinning of the cervix as the uterine fundus contractions and pulls on the cervix.
-Graded 0% (thick cervix) - 100% (thin)
What are the stages of labor?
Stage 1: begins with onset of labor contractions & ends with cervical effacement & dilation
Stage 2: Begins with the pushing of the baby and expulsion of the baby via the vagina.
Stage 3: Deliver of the placenta
There are 3 stages of pregnancy, which correponds to approximately how many weeks in each?
13 weeks
1st trimester: conception - 13 weeks
2nd trimester: 14wks -27wks
3rd: 28-40 wks
What is the role of HCG (Human chorionic gonadotropin) in the 1st trimester of pregnancy?
HCG is produced by the trophoblast days after fertilization.
HCG rescues the corpus luteum from degeneration, stimulating the continued production of progesterone = NO MENSES
In the 2nd and 3rd trimester what lipid is used to synthesize progesterone & estrogen by the placenta & fetus?
Cholesterol
Where in the pituitary gland is oxytocin released?
Posterior pituitary gland
What are the efffects of prostaglandins on the uterus?
Prostaglandins increase in response to estrogen and oxytocin increase.
1)increase calcium concentration of the uterine smooth muscle cells.
2)promote gap junction formation b/w uterine smooth muscle cells = increased contractility
3)soften, thins & dilates cervix
How long does the 1st stage of labor last?
8-12 hours nulliparous
5-8 hours multiparous
What is the difference between the 2 phases of stage 1 labor?
Latent phase: slowed cervical dilation 0-6 cm
Active phase: fast cervical dilation 6-10 cm
What does the 2nd stage of labor entails?
full cervical dilation and fetus delivery
When is Group B strep testing conducted in pregnancy?
35-37 weeks
When is Glucose challenge test conducted in pregnancy?
28 wks
What is the most common breech presentation?
Frank breech is the most common.
-Buttocks presenting
-Both feet to head with hips flexed
How is complete breech different from frank breech?
In complete breech the buttocks is presenting but the knees are pulled to the chest and bent in the fetal position. (hips & knees are both flexed)
in frank only the hips are flexed.
What is the second most common breech presentation?
In complete breech. One or both hips not completely flexed. The presenting part may be buttocks, one foot or both feet.
What is the treatment for breech presentation?
external cephalic version or cesarean section
At what gestational age is antenatal corticosteroids and tocolytic therapy not used?
34 weeks gestation.
What is the 1st line tocolytic use in patients 32-34 gestation
Nifedipine is a calcium channel blocker
Why is magnesium sulfate typically adminstered?
Magnesium is adminstered at 24-32 weeks gestation to provide neuroprotection against cerebral palsy.
What is the most common type of vulvar cancer?
Squamous cell carcinoma
