Obstetrics

Question 1

What is considered “term” gestation?

Answer 1

> 37 weeks

Question 2

What is considered preterm?

Answer 2

24- 37 weeks.

Question 3

What is the first stage of labour?

Answer 3

Onset of regular painful contractions to full cervical dilation.

Question 4

What is second stage labour?

Answer 4

Time from full cervical dilation to birth of baby.

Question 5

What are the signs of imminent birth?

Answer 5

Active pushing/ grunting 
Rectal pressure 
Anal pouting
Unstoppable urge to push 
Crowning

Question 6

What is the definition of precipitate birth?

Answer 6

Rapid labour less than 2 hours which can cause cerebral irritation due to rapid changes in pressure.

Question 7

What are the main changes in Physiology for pregnant pts?

Answer 7

HR 80 to 110
RR 14-19
Increased CO 
Increased O2 demand 
Increase tidal volume 
Increased blood volume

Question 8

What is the definition of spontaneous rupture of membranes?

Answer 8

Gush of clear or pink fluid. Occurs prior to onset of labour.

Question 9

What is meconium stained amniotic fluid?

Answer 9

Greenish/ brown stained amniotic fluid.

Question 10

What is the basic care in obstetric emergencies?

Answer 10

Left lateral tilt ( to prevent compression on vena cava and aorta)
If supine: 30 degree tilt with wedge under right hip.
If spinal: 15 tilt under right hip.

Question 11

Why are pregnant pts able to compensate?

Answer 11

Pregnant pts have a higher volume of blood in circulation. And can therefore lose more blood before showing signs of shock.

Question 12

What is the definition of preeclampsia/ eclampsia?

Answer 12

Eclampsia is the presence of seizures with pts with hypertension. Usually new onset >20weeks gestation.

Signs of pre-eclampsia include: hypertension, headache, visual disturbances, nausea.

Question 13

What are the numbers of significant and severe hypertension in pre-eclampsia.

Answer 13

Significant: >140/90
Severe: >170/110

Question 14

What is the process of a normal birth?

Answer 14

• Encourage pt to push with each contraction.
• Ask mother to pant with open mouth if head advances too quickly.
• if precipitous apply gentle backward pressure on head.
• check for cord. If loose slip over head. If tight puppy clamps and cut.
• head will turn to face mother inner thigh
• hold head and apply gentle downward pressure to deliver top shoulder.
• apply gentle upward pressure to deliver lower shoulder.
• baby will follow quickly
• note time of birth
• place baby skin to skin
• allow cord to stop pulsating <3mins
• apply clamps 10cm and 15cm from baby
• cut in between.