Obstetrics: Notes

Question 1

Blastocyst

Answer 1

A hollow ball of cells- normally implants in the thickened uterine lining
This is what the ovum becomes after fertilization

Question 2

Spermatozoan

Answer 2

Male sex cells

Question 3

Ovum

Answer 3

Egg pre-fertilization

Question 4

Progesterone

Answer 4

Hormone that prepares the uterine lining for implantation of the blastocyst

Question 5

What does the placenta do?

Answer 5

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.

Question 6

How much amniotic fluid is in the amniotic sack at 20 weeks gestation?

Answer 6

500 to 1000 mL

Question 7

How much fluid can be held by the uterus at the end of pregnancy?

Answer 7

1000 g, Or 2 pounds

Question 8

What is the total capacity of the uterus at the end of pregnancy?

Answer 8

5000 mL

Question 9

What does progesterone due to the airway?

Answer 9

Causes decreasing resistance that results in a 20% increase in oxygen consumption and a 40% increase in title volume.

Question 10

How much does maternal blood volume increase during pregnancy?

Answer 10

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.

Question 11

What is the ductus anteriosus?

Answer 11

The duct that allows the pulmonary vein to insert into the aortic arch in infants.

Question 12

What is the Foramen Ovale?

Answer 12

The hole that allows blood to pass from the right atrium to the left of atrium without passing through the ventricles.

Question 13

Where does the umbilical vein connect?

Answer 13

Directly into the inferior Vena Cava through a specialists structure called the Ductus Venosus

Question 14

What is a sonogram?

Answer 14

Reveals the age of the fetus.

Question 15

What agents cannot be used to treat pregnant diabetic patients?

Answer 15

Oral hypoglycemic agents

Question 16

Preeclampsia (hypertension in mothers) puts pregnant mothers at additional risk for what major physiological problems?

Answer 16

Stroke, seizure, and renal failure

Question 17

When is a prolapsed cord?

Answer 17

Umbilical cord that comes out of the uterus ahead of the fetus

Question 18

Placenta Previa

Answer 18

When the placenta is pulled away from the uterine wall.

Question 19

What are the signs, symptoms, and treatment of Placenta Previa?

Answer 19

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

Question 20

Abruptio Placentae

Answer 20

Premature separation (abruption) of a normally implanted placenta from the uterine wall.

Question 21

Prolapsed cord and treatment

Answer 21

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

Question 22

Limp Presentation and treatment

Answer 22

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

Question 23

Cephalopelvic Disproportion

Answer 23

When infants head it is too big to pass through the maternal pelvis easily

Question 24

Precipitous Delivery and treatment

Answer 24

When birth occurs in less than three hours of labor
Treatment:
Be ready for rapid delivery
Control the infants head
Keep the infant warm

Question 25

Shoulder Dystocia and treatment

Answer 25

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

Question 26

Turtle sign

Answer 26

Indication of shoulder dystocia
Happens when infants head retracts back into the vagina because shoulders are trapped between the symphysis pubis and the sacrum.

Question 27

Postpartum Hemorrhage

Answer 27

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

Question 28

Meconium stain

Answer 28

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.

Question 29

Uterine Atony

Answer 29

Lack of uterine muscle tone