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Clinical Life Sciences 2 > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Approximately how much does vascular volume increase by in pregnancy?

A

1.5L

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2
Q

By how much does CO increase in pregnancy?

A

40%

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3
Q

Why is there an increased risk of shock in pregnancy?

A

Due to having increased physiological parameters mothers can hide shock symptoms much better initially

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4
Q

What blood pressure is important to look at in antenatal notes?

A

Booking B.P.

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5
Q

How much does heart rate increase by in pregnancy?

A

Approx 20%

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6
Q

Which type of cell increases in number more than the other in pregnancy WBCs or RBCs?

A

WBCs

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7
Q

What 3 changes result in obs patients becoming hypercoagulative?

A
  1. An increase in clotting factors
  2. Decreased coagulation inhibitor levels
  3. Decreased fibrinolytic factors
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8
Q

What 2 main vessels can be compressed by the uterus in pregnancy?

A

Inferior Vena Cava

Aorta

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9
Q

What action does progesterone have on the GI tract?

A

It reduces gut motility

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10
Q

By how much can the diaphragm be displaced in pregnancy?

A

5cm

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11
Q

Why is it important to place an ET tube in a maternal arrest?

A

The increased risk of acid reflux

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12
Q

What is the process whereby the uterus drops in late pregnancy giving the mother relief when breathing?

A

Lightening

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13
Q

How do pregnant women allow for increased oxygen demand?

A
  • An increase in tidal volume
  • Deeper breaths
    NO RR CHANGE
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14
Q

How do we stop the aorta and IVC being compressed?

A

Left Lateral Tilt

Manual Uterine Displacement

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15
Q

Due to reduced sensitivity of chemoreceptors and increased oxygen uptake what happens to PCO2? What are the risks?

A

PCO2 falls

This can result in respiratory alkalosis

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16
Q

The pooling of sugar rich urine and relaxed ureters leads to increased risk of what?

A

UTI’s

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17
Q

The significant RAA system activation and increased ERPF and GRF leads to what change in total body water?

A

Total body water changes from about 6.5L-8.5L

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18
Q

What condition is characterised by hypertension and protein urea?

A

Preeclampsia

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19
Q

Why can mothers have decreased levels of iodine?

A

Iodine is needed for foetal brain development

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20
Q

What can hypercortisolism play a part in the development of?

A

Gestational diabetes

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21
Q

What do oestrogen and relaxin do during pregnancy? What can that result in?

A

Soften pelvic connective tissue leading to aches and pains

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22
Q

What happens to levels of oestrogen and progesterone over pregnancy?

A

They increase progressively and drop off at full term

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23
Q

What hormone causes beta cell hyperplasia in pregnancy?

A

Oestrogen

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24
Q

List some risk factors for maternal diabetes?

A
  • Obesity
  • Age
  • Hx of diabetes
  • Sedentary lifestyle
  • PCOS
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25
Q

What occurs to cause gestational diabetes?

A

Insulin resistance

26
Q

Why do protein and fat levels fluctuate in pregnant women

A

Because fat and protein are vital for foetal development

27
Q

Why do babies need so much fat?

A

Because they have not developed the ability to shiver yet so need it for insulation

28
Q

Why do pregnant mothers need to absorb more calcium?

A

For foetal bone development and to help undo the damage caused by calcium being broken down from their own bones to help foetal development

29
Q

In what range of weeks does labour usually occur within?

A

37 - 42 weeks

30
Q

What hormone has inhibited labour throughout pregnancy?

A

Progesterone

31
Q

What reduces uterine activity (why we need to keep mothers calm in labour)

A

Adrenaline

32
Q

How many stages are there to labour?

A

3

33
Q

What are the two aspects of mechanical ‘pressure’ that initiate the onset of labour?

A
  1. Uterine stretch

2. Pressure on the cervix

34
Q

What occurs in stage 1 of labour?

A

Onset of rhythmical contractions until full cervical dilation (10cm)

35
Q

What is the ‘normal’ presentation of the foetus during labour?

A

Vertex

36
Q

What does the muscular shortening and narrowing of the uterus lead to?

A

Expulsion uterine contractions

37
Q

What is crowning defined as?

A

When the foetal head distend soon the vulva and does not recede between contractions

38
Q

Where should the babies head be facing initially during a normal labour?

A

The perineum

39
Q

What is restitution?

A

When babies head turns towards a either thigh, anterior shoulder under pubic bone

40
Q

What shoulder should be delivered first?

A

Anterior shoulder

41
Q

What is the term for when the baby is born ‘bending’ at the side?

A

Lateral flexion

42
Q

What is involved in stage 3 of labour?

A

Delivery of the placenta

43
Q

What are indications of placental separation?

A

Contractions - fungus narrowing and rising
Lengthening of umbilical cord
Trickling of blood

44
Q

Why do you want to avoid mum pushing very hard when she is crowing?

A

To avoid perineal trauma

45
Q

What 4 things are essential in your assessment of a newborn

A

Colour
Tone
Breathing
Heart Rate

46
Q

If you have to clamp the cord when can you do this?

A

After it has stopped pulsing

47
Q

What are the 2 types of antepartum haemorrhage? >24 weeks

A
  • Placenta praevia

- Placental abruption

48
Q

What are the causes (4T’s) of PPH

A
  • Tone (uterine atony - most common cause)
  • Tissue
  • Thrombin
  • Trauma
49
Q

Under what number of weeks is a baby defined as ‘pre - term’

A

<37 weeks

50
Q

What 4 things make up your immediate assessment of a newborn?

A

Colour
Tone
Breathing
Heart Rate

51
Q

What is placenta praevia?

A

It is when the placenta develops low down in the uterus partially or completely covering the cervix

52
Q

What is placental abruption?

A

When bleeding occurs between the placenta and wall of the uterus due to a detachment of the placenta

53
Q

What are the two kinds of placental abruption?

A
  • Concealed

- Revealed

54
Q

What are two possible diagnoses for bleeding in early pregnancy? <24 weeks

A

Ectopic pregnancy

Miscarriage

55
Q

What is the flow of actions in newborn life support?

A
  1. Assess (C.T.B.HR)
  2. 5 INFLATION breaths
  3. Assess (C.T.B.HR)
  4. Ventilate 30 seconds
  5. Assess (C.T.B.HR)
  6. CPR (3:1)
  7. Assess HR every 30 seconds
56
Q

Under what HR value in a newborn is it necessary to start resuscitation?

A

<60/min

57
Q

What can be done to treat a PPH?

A 
Uterine rub 
Misoprostol (Sublingual or PR) 
TXA
Fluids 
Direct pressure 
Bi-Manual compression
58
Q

Between what weeks is the ‘first trimester’?

A

1-12

59
Q

Between what weeks is the ‘second trimester’?

A

13-26

60
Q

Between what weeks is the ‘third trimester’?

A

27-end of pregnancy (37-42)

61
Q

What two main things can cause a placental abruption?

A

Hypertension (preclampsia)

Trauma

Clinical Life Sciences 2 (7 decks)

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