Obstetrics: Notes Flashcards
Blastocyst
A hollow ball of cells- normally implants in the thickened uterine lining
This is what the ovum becomes after fertilization
Spermatozoan
Male sex cells
Ovum
Egg pre-fertilization
Progesterone
Hormone that prepares the uterine lining for implantation of the blastocyst
What does the placenta do?
Transfers heat, exchange is oxygen and carbon dioxide, Deliver nutrient such as glucose, Potassium, sodium, chloride. It also carries away wastes.
The placenta also secretes progesterone and estrogen which are vital to maintain the pregnancy.
Finally, the placenta serves as a protective barrier against harmful substances.
How much amniotic fluid is in the amniotic sack at 20 weeks gestation?
500 to 1000 mL
How much fluid can be held by the uterus at the end of pregnancy?
1000 g, Or 2 pounds
What is the total capacity of the uterus at the end of pregnancy?
5000 mL
What does progesterone due to the airway?
Causes decreasing resistance that results in a 20% increase in oxygen consumption and a 40% increase in title volume.
How much does maternal blood volume increase during pregnancy?
45%, this means that a mother can lose 30 to 35% of her blood without significant vital sign changes. Heart rate also increases 10 to 15 BPM.
What is the ductus anteriosus?
The duct that allows the pulmonary vein to insert into the aortic arch in infants.
What is the Foramen Ovale?
The hole that allows blood to pass from the right atrium to the left of atrium without passing through the ventricles.
Where does the umbilical vein connect?
Directly into the inferior Vena Cava through a specialists structure called the Ductus Venosus
What is a sonogram?
Reveals the age of the fetus.
What agents cannot be used to treat pregnant diabetic patients?
Oral hypoglycemic agents
Preeclampsia (hypertension in mothers) puts pregnant mothers at additional risk for what major physiological problems?
Stroke, seizure, and renal failure
When is a prolapsed cord?
Umbilical cord that comes out of the uterus ahead of the fetus
Placenta Previa
When the placenta is pulled away from the uterine wall.
What are the signs, symptoms, and treatment of Placenta Previa?
Signs and symptoms: Painless bright red bleeding, often after sexual intercourse or vaginal exam. Treatment: Treat for shock Oxygen IV Access Monitor Vitals Transport to appropriate hospital
Abruptio Placentae
Premature separation (abruption) of a normally implanted placenta from the uterine wall.
Prolapsed cord and treatment
When the umbilical cord precedes the fetal presenting part
Treatment:
Insert two fingers into the vagina and lift presenting part of fetus off the cord to stop compression of cord and cessation of circulation to child
Place mother in knee-chest position
Apply a dressing moistened with sterile saline to the exposed cord
Limp Presentation and treatment
When a limb comes out first from the mother's vagina Treatment: Don't touch it Please mother in need to chest position Provide high flow oxygen Transport immediately
Cephalopelvic Disproportion
When infants head it is too big to pass through the maternal pelvis easily
Precipitous Delivery and treatment
When birth occurs in less than three hours of labor Treatment: Be ready for rapid delivery Control the infants head Keep the infant warm
Shoulder Dystocia and treatment
When the infants shoulders are larger than their head
Treatment:
Do not pull on the infants head!
Give oxygen to the mother
Have mother dropped her buttocks off the end of the bed, and then flex her thighs upward
Apply firm pressure with open hand above the symphysis pubis
Turtle sign
Indication of shoulder dystocia
Happens when infants head retracts back into the vagina because shoulders are trapped between the symphysis pubis and the sacrum.
Postpartum Hemorrhage
Loss of more than 500 cc’s of blood immediately following delivery.
Usually caused by Uterine Atony, but can be caused by placenta prevue, abruptio placentae, retained placental parts, clotting disorders in the mother, or vaginal and cervical tears
Treatment:
Complete primary assessment immediately
Oxygen
Begin fungal massage
Established two large bore IVs of normal saline
Medical direction may request oxytocin/pitocin 20 mg in 1 L of normal saline to run at 125 mL/hour
Meconium stain
If meconium is thick, visualize the infant’s glottis and suction the hypopharynx and trachea using a clean endotracheal tube each time until all meconium has been cleared from the airway.
Uterine Atony
Lack of uterine muscle tone
