Obstetrics Part 1 Flashcards
What are the ovaries?
Female Gonads/ Sex glands.
Where are the ovaries located?
One of each side of the uterus.
What do the ovaries do?
Secrete the hormones estrogen and progesterone and develop and release a mature egg.
What is the ovum?
The ovary that is released each month.
Explain Ovulation
During the first 7 days of the menstrual cycle, follicles grow. These follicles secrete estrogen into the bloodstream to prepare the uterus lining. On day 7 the follicles stop growing and degenerate except for one that continues to grow. One of the fallopian tubes surrounds the follicle. The follicle bursts open ejecting the egg. The fimbria (the tiny projections of the fallopian tube) sweep the egg inside the fallopian tubes. Contractions move the egg to the uterus.
What are the fallopian tubes?
Thin flexible tubes that extend from the uterus to the ovary.
What is the Uterus?
A pear-shaped organ that contains the developing fetus.
The three sections of the uterus?
The fundus (top), corpus (body), and the Isthmus (cervix).
What is the plug of mucus?
A plug that seals the uterine opening; preventing contamination from entering the uterus. The plug is discharged when the cervix begins to dilate. Signaling the first stage of labor, the “bloody show”.
The three layers of the uterus?
Endometrium (innermost lining), Myometrium (thick middle layer), and Perimetrium (outer layer)
What is the placenta and what does it do?
A disk-shaped organ that provides fetal nourishment and waste removal.
What does the umbilical cord do?
Delivers the nutrients and oxygen to the fetus. The umbilical vein carries oxygen and nutrients to the fetus. 2 umbilical arteries carry deoxygenated blood from the fetus to the placenta.
What is the amniotic sac?
A sac filled with amniotic fluid in which the baby floats, insulating and protecting the baby.
How much amniotic fluid is in the amniotic sac?
500-1000 ml of amniotic fluid.
What is the vagina?
An opening to the outside for the baby. Extends from the cervix to an external opening of the body.
What is crowning?
When the top of the baby’s head appears at the vaginal opening. This means the baby is coming, no matter what; you will be giving birth very very soon.
Stages of the menstrual cycle?
Throughout 28 days, the menstruation cycle occurs. The first day begins with menstruation (bleeding due to the endometrium shedding). On day 14 ovulation occurs (release of the ovum) and the endometrium thickens. The egg is either fertilized or not.
What is gestation?
Pregnancy.
What is gestational age?
The age of the fetus in weeks.
Pre-embryonic phase
For the first 14 days of pregnancy.
Embryonic phase
15 days to 8 weeks of pregnancy.
Fetal stage
8 weeks of pregnancy to birth.
At birth what is the baby called?
A neonate
How long is a trimester?
3 months.
Physiological changes in the reproductive system?
Uterus increases in size from 2oz to 2lbs
A mucus plug forms
The breasts enlarge to prepare for lactation
Physiological changes in the respiratory system?
Mother’s oxygen demand increases
Respiratory tract resistance decreases
Tidal volume increases by 40%
Respiratory rate increases slightly
Oxygen consumption increases by 20%
Physiological changes in the cardiovascular system?
Cardiac output increases
Maternal blood volume increases by 45%
There is an increase in plasma and RBC’s. However the plasma volume increase is greater than the RBC increase; causing a relative anemia.
The blood volume delays the signs and symptoms of shock in the patient
Maternal HR increases by 10-15 BPM
BP decreases slightly in the first and second trimesters and returns to normal in the third trimester
Physiological changes in the gastrointestinal system?
Nausea and vomiting commonly occur during the first trimester
Bloating and constipation may occur from a decrease in peristalsis
Physiological changes in the urinary system?
Renal blood flow increases
Glomerular filtration increases by 50% during the second trimester and remains elevated
The urinary bladder is displaced superiorly and anteriorly
An increase in urinary frequency is common in the 1st and 3rd trimester because of the uterus compressing the bladder
Physiological changes in the musculoskeletal system?
Pelvic joints loosen due to hormone changes
The center of gravity changes due to the heavy uterus
What is and what causes hyperemesis gravidarum?
Increased hormone levels may cause this severe nausea and vomiting.
When does hyperemesis gravidarum occur and peak?
Symptoms occur between 4 and 6 weeks and can peak between 9 and 13 weeks.
What is spontaneous abortion?
Delivery of the fetus and placenta before the fetus is viable (20 weeks of gestation) (miscarriage)
What causes spontaneous abortion?
Genetics, uterine abnormality, infection, drugs, or maternal disease.
What is ectopic pregnancy?
A fertilized ovum is implanted outside the uterus, usually in a fallopian tube.
What causes ectopic pregnancy?
Previous ectopic pregnancies, pelvic inflammatory disease, adhesions from surgery, tubal surgery, or intrauterine device.
What is placenta previa?
A misplaced placenta near or over the cervix.
What are the three types of placenta previa?
Total: the placenta completely covers the opening of the cervix
Partial: the placenta partially covers the opening of the cervix
Marginal: the placenta is near the opening of the cervix
What causes placenta previa?
Multiparity (more than 2 deliveries), greater than 35 yrs old, bleeding after intercourse during pregnancy, and history of early vaginal bleeding.
What is abruptio placentae?
Abnormal separation of the placenta from the uterine walls.
Patho of abruptio placentae?
Small arteries located in the lining between the placenta and uterus are prone to rupture.
what does fetal abruptio placentae cause?
A reduction in fetal blood flow causes fetal hypoxia, inadequate nutrient delivery, and poor elimination of carbon dioxide and other waste products
What does maternal abruptio placentae cause?
Severe hemorrhage and hypovolemic shock.
What causes abruptio placentae?
Hypertension, use of cocaine, preeclampsia, multiparity, previous abruption, smoking, short umbilical cord, premature rupture of the amniotic sac, diabetes, and trauma involving the abdomen.
The two types of abruptio placentae? (also what is the morality rate)
Complete: the placenta completely separates from the uterine wall. 100% mortality rate.
Partial: the placenta is torn from the uterine wall and it has a 30-60% mortality rate.
Patho of a ruptured uterus?
As the uterus enlarges during pregnancy, the uterine wall becomes extremely thin; so this is how it ruptures. Releasing the fetus into the abdominal cavity.
How to transport pregnant patients? and why?
Transport on their left side or at least with their right hip elevated 15 degrees to the left if they are at 20 weeks of gestation or more. To avoid supine hypotension syndrome.
Pregnancy-induced hypertension is considered greater than what?
140/90
What is eclampsia?
Hypertension (high bp)
What is preeclampsia?
A more severe eclampsia and can include seizures or comas.
What causes eclampsia/preeclampsia?
hypertension, diabetes, kidney disease, liver disease, or heart disease, obesity, connective tissue disorder, no previous pregnancies, poor nutrition, and sudden weight gain.
What is supine hypotensive syndrome?
When the weight of the fetus compresses the inferior vena cava when the patient is supine (laying down), reducing blood flow to the right atrium.
What does gravida and para mean?
Gravida is each pregnancy and para is each birth of a fetus after 20 weeks of gestation; dead or alive. twins count for one para because it was only one delivery emergency.
Emergency care for pregnant patients?
Be supportive, treat for hypovolemic shock, and ensure adequate airway, ventilation, and oxygenation. regardless of the mothers spo2 levels, oxygenate. And place them on their left or lean their right hip 15 degrees to the left at least.
Ask questions such as…
Have you ever been pregnant before?
If so, how many pregnancies?
How many pregnancies have resulted in live births?
Have there been any previous complications?
When was your last normal menstrual cycle?
What is the quality of pain?
How intense is the pain?
Did the pain have a sudden or a gradual onset?
Does the pain radiate?
Can you point to the pain with one finger?
Is the pain constant? Does it come in regular or irregular intervals?
What is the duration of the pain or cramps?
How often do the cramps occur?
Are you nauseated? Have you thrown up?
Is the pain related to a menstrual cycle or sexual intercourse?
Was the volume and the color of blood normal? (last period)
Have there been any episodes of bleeding between menstrual periods?
Have your periods been regular?
Have you missed a menstrual period?
Is there any chance of pregnancy? Have you had any unprotected intercourse? what form of contraception do you use?
Is there breast tenderness, or increase in urination, nausea, or vomiting?
Any unusual discharge?
Did your discharge smell abnormal?
how much was discharged?
When is your due date?
Have you had any prenatal care?
How many pregnancies have you had?
how many children do you have?
Did you have any complications with previous pregnancies?
