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Special Populations > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Fetal development in first trimester

A

All major organ systems develop

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2
Q

Fetal development in second trimester

A

Completion of organ development

Placenta produces sufficient progesterone to maintain endometrial lining and continue through pregnancy

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3
Q

Fetal development in third trimester

A

Fetal weight gain

Estrogen production by placenta accelerates at the end of the trimester to stimulate labour and delivery

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4
Q

Pre-embryonic stage

A

0-2 weeks

Cell multiplication and differentiation

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5
Q

Embryonic stage

A

4-8 weeks

Body systems form and heart begins beating

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6
Q

Fetal stage

A

> 8 weeks

Rest of development occurs

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7
Q

Functions of placenta

A

Develops 3 weeks after fertilization

  1. Temporary blood rich organ
  2. Transfers heat
  3. Gas exchange of CO2 and O2
  4. Delivers nutrients (glucose, K+, Na+, Cl-)
  5. Carries away waste (urea, uric acid, creatinine)
  6. Serves as an early liver
  7. Barrier against harmful substances
  8. Endocrine gland that secretes hormones throughout pregnancy
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8
Q

Waste products carried away by placenta

A

Urea - breakdown of proteins

Uric acid - breakdown of purine

Creatinine - waste product by muscles

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9
Q

Major cardiovascular changes during pregnancy

A 
Increased blood volume
Increased plasma volume
Increased RBCs
Increased risk of thrombosis
Increased heart size
Increased heart rate
Decreased blood pressure
Increased stroke volume and cardiac output
Increased workload on heart
Sensitivity to position
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10
Q

Supine hypotension syndrome

A

Compression of vena cava, abdominal aorta, pelvic and femoral arteries

If pressure not released:

  • decreased cardiac output
  • decreased blood pressure
  • lower extremity edema
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11
Q

Wharton’s jelly

A

Gelatinous substance that prevents kinking of umbilical cord

Has a high water content for fast shrinkage after birth

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12
Q

Function of amniotic fluid

A
  1. Protects fetus from trauma
  2. Separates fetus from fetal membrane
  3. Permits fetal muscle development and movement
  4. Facilitates symmetrical growth and development of fetus
  5. Helps keep temperature constant
  6. Acts as an excretion collection system
  7. Cushions the cord
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13
Q

4 M’s

A

Meconium
Multiples
Maturation
Medication

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14
Q

GTPALM

A 
Gravida
Term
Preterm
Abortions
Living
Multiples
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15
Q

Estimated date of confinement (due date)

A

First day of last menstrual period, add 7 days, subtract 3 months

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16
Q

Fetal alcohol syndrome

A

Thought to constrict blood vessels and send them into spasms, reducing blood flow to the baby

Leading cause of birth defects

17
Q

Effects of tobacco on fetus

A 
Decreased fetal growth
Increased spontaneous abortion
Increased SIDS deaths
Increased premature rupture of membranes
Increased premature labour
18
Q

Spontaneous or induced abortion

A

Termination of pregnancy before 20 weeks gestation (some sources up to 28 weeks)

S/S= cramping, abdo pain, back ache, vaginal bleeding

19
Q

Stages of abortion

A
  1. Threatened abortion - attempting to take place, and can progress or subside
    - vaginal bleeding in first half of pregnancy; continue normal activity
  2. Inevitable abortion - spontaneous abortion that cannot be prevented
    - severe abdo pain caused by uterine contractions, vaginal bleeding, cervical dilation
  3. Incomplete abortion - some products of conception remain in the uterus
    - potential shock
    - OLMC if products are protruding; fundal massage
  4. Missed abortion - fetus dies during first 20 weeks, but remains in uterus
    - gradually diminishing of s/s of pregnancy, brownish discharge
  5. Septic abortion - uterus becomes infected
20
Q

Placenta previa

A

Abnormal implantation of placenta on the lower half of the uterus

Total or partial
Painless vaginal bleeding in third trimester
C-section required for treatment

21
Q

Abruptio placenta

A

Premature separation of a normally implanted uterus

Partial, sever, or complete with either concealed or apparent hemorrhage
Life threatening
S/S= sudden onset of severe abdo pain with or without bleeding
Treat for shock, fluid resuscitation, rapid transport in left lateral recumbent

22
Q

Pre-eclampsia

A

Pregnancy induced hypertension

S/S= gradual hypertension (160-180 mmHg), proteinurea, peripheral edema, HA, N/V, rapid weight gain, visual disturbances, pulmonary edema

23
Q

Effects of pre-eclampsia

A

Mother:
- impaired renal/liver function, cerebral hemorrhage, placenta abruption, HELLP syndrome

Fetus:
- reduced fetal growth and development

24
Q

Human placental lactogen (hPL)

A

Cortisol, growth hormone, and progesterone cause high levels of glucose, but makes mother’s body resistant to insulin so more glucose is available to the fetus

Can cause macrosomia (large baby)
Glucose tolerance test administered at 26-28 weeks

25
Q

Stages of labour

A
  1. Dilation stage
  2. Expulsion stage - full dilation to delivery of fetus
  3. Placenta stage - end of baby delivery to delivery of placenta
26
Q

Duration of contraction

A

Beginning to end of one contraction

27
Q

Frequency of contraction

A

Beginning of one contraction to the beginning of next contraction

28
Q

Functions of vernix

A
  1. Facilitates passage through birth canal
  2. Moisturizes skin
  3. Prevents heat loss and environmental stress
  4. Protective barrier against bacteria

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