Obstetrics and Maternity Flashcards
The calculation of the duration of pregnancy is based on __________
the first day of the last menstrual period
What are the weeks involved in each trimester of pregnancy?
- trimester 1: weeks 1 - 12
- trimester 2: weeks 13 - 28
- trimester 3: weeks 29 - 40+
What are the three stages of labour?
- 1st stage:
- Dilation of cervix by regular and painful contractions; this stage may last up to 12 hours
- 2nd stage:
- Birth of the infant; this stage may last between 2 and 3 hours, but can also be much shorter in subsequent deliveries
- 3rd stage:
- Delivery of the placenta; this stage may last up to 1 hour
When a midwife is present the responsibility for maternal resuscitation falls upon ________
paramedics!
What is the definition of “term” with reference to pregnancy
37-40 weeks gestation
What is the definition of “pre-term” with reference to pregnancy
24-36 weeks gestation
pregnancies at <24 weeks gestation are not considered viable, and the concept of term/pre-term does not apply
The vaginal discharge of mucus and blood during labour is known as:
Show or “Bloody Show”
What is the clinical term and significance of “water breaking”.
- Spontaneous rupture of membranes
- Outpouring of normally clear or pinkish fluid; can occur from prior to onset of labour until baby is born
- Does not herald imminent delivery in isolation
Greenish or brown stained amniotic fluid visible in ruptured membranes is indicative of:
Meconium-stained amniotic fluid, a sign of fetal distress and risk for aspiration
What are indicators of imminent birth? (up to 6 signs)
- active pushing or grunting
- rectal pressure (e.g., urge to use bowels or bladder)
- anal pouting or bulging perineum
- strong unstoppable urge to push
- presenting part on view or crowning
- patients stating, “I’m going to have the baby,” or “It’s coming now”
What is the definition and significance of precipitous birth?
- unusually rapid labour, less than four hours long with extremely quick birth
- the rapid change in pressure from intrauterine life may cause cerebral irritation
What are normal changes to cardiovascular physiology in pregnancy?
- Blood pressure experiences minimal changes, though there is an initial decrease in the first and second trimesters with a return to baseline in the third; systolic blood pressures above 160 mmHg and diastolic pressures greater than 110 mmHg are considered significant
- Heart rate elevates by 15-20 beats per minute; normal heart rate in pregnancy is 80-110 beats per minute
- Cardiac output increases by 30-40% to a normal volume of 6-7 L per minute during pregnancy
- Non-specific ST segment changes are sometimes seen on ECG, along with Q waves in leads III and aVF and atrial and ventricular ectopic beats
- Systemic vascular resistance often decreases due to the effects of progesterone
True or False; hypertension is a normal finding in pregnancy
Blood pressure experiences minimal changes, though there is an initial decrease in the first and second trimesters with a return to baseline in the third; systolic blood pressures above 160 mmHg and diastolic pressures greater than 110 mmHg are considered significant
What does the acronym GTPAL stand for?
G - Gravida: number of previous pregnancies
T - Term: number of deliveries between 37 and 40 weeks gestation
P - Pre-term: number of deliveries before 37 weeks gestation
A - Abortions: number of abortions (spontaneous or therapeutic)
L - Living: number of living children
multiparity (twins, triplets, etc.) are listed as single deliveries
A 41-year-old person is 36 + 4 pregnant with twins. They have triplets that were born at 33 weeks, a 12-year old born at 41 weeks, and had a spontaneous abortion 15 years ago.
Describe their gestational history in GTPAL format
G4 T1 P1 A1 L4
- twins/triplets are counted as single deliveries, but multiple living children
