Obstetrics Part 1 Vega edition

Question 1

What is the placenta and what does it do?

Answer 1

A disk-shaped organ that provides fetal nourishment and waste removal.

Question 2

Do women always have a placenta?

Answer 2

No, it is a temporary organ of pregnancy.

Question 3

What happens to the placenta after birth?

Answer 3

It separates from the uterus after delivery and is expelled.

Question 4

What is true about the blood of the mother and the fetus?

Answer 4

They do not mix; unless during birth or miscarriage.

Question 5

What is the umbilical cord?

Answer 5

The unborn infant’s lifeline. It attaches the fetus to the placenta.

Question 6

What does the umbilical cord do?

Answer 6

Delivers the nutrients/nourishment 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.

Question 7

Physiology changes to the vascular system/circulatory/cardiovascular?

Answer 7

Cardiac output increases

Maternal blood volume increases by 45%

There is also an increase in red blood cell (RBC) content and plasma; however, the plasma volume increase is greater than the RBCs, causing a relative anemia. The pregnant patient is given iron supplements to increase oxygen binding on the RBC.

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

Question 8

What is spontaneous abortion?

Answer 8

Delivery of the fetus and placenta before the fetus is viable (20 weeks of gestation) (miscarriage) (most often before 12 weeks of gestation)

Question 9

When does spontaneous abortion most often occur?

Answer 9

before 12 weeks of gestation.

Question 10

What causes spontaneous abortion?

Answer 10

Genetics (50% of all cases), uterine abnormality, infection, drugs, or maternal disease.

Question 11

With spontaneous abortion what is normally present at 8-12 weeks?

Answer 11

Cramping and vaginal bleeding.

Question 12

What is ectopic pregnancy?

Answer 12

A fertilized ovum is implanted outside the uterus, usually in a fallopian tube.

Question 13

What happens to the tissue surrounding the embryo during ectopic pregnancy?

Answer 13

It ruptures.

Question 14

What causes ectopic pregnancy?

Answer 14

Previous ectopic pregnancies, pelvic inflammatory disease, adhesions from surgery, tubal surgery including elective tubal ligation, or intrauterine device (IUD).

Question 15

Locations of ectopic pregnancy? (include %’s)

Answer 15

Fallopian tubes (90%), Abdomen (6%), ovary, cervix and outside wall of uterus

Question 16

Emergency care for ectopic pregnancy?

Answer 16

The primary treatment is to administer a high concentration of oxygen, regardless of the SpO2 reading and oxygenation status of the pregnant patient, via a nonrebreather mask at 15 lpm to maximize oxygenation of the fetus. Transport the patient to a facility that can manage a surgical emergency.

Question 17

What is placenta previa?

Answer 17

A misplaced placenta near or over the cervix.

Question 18

Where is the placenta normally placed?

Answer 18

Normally implanted in the fundus (top).

Question 19

Why does the placenta prematurely tear?

Answer 19

When the fetus changes position in the uterus, or the cervix begins to efface and dilate.

Question 20

What are the three types of placenta previa?

Answer 20

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

Question 21

What causes placenta previa?

Answer 21

Multiparity (more than 2 deliveries), greater than 35 yrs old, bleeding after intercourse during pregnancy, and history of early vaginal bleeding.

Question 22

Major concerns for placenta previa and what should you do?

Answer 22

blood loss for the mother and hypoxia and distress for the fetus. This is a situation in which, regardless of the SpO2 reading and oxygenation status of the pregnant woman, a high concentration of oxygen is administered via a nonrebreather mask at 15 lpm to maximize oxygenation of the fetus.

Question 23

What is abruptio placentae?

Answer 23

Abnormal separation of the placenta from the uterine walls.

Question 24

Patho of abruptio placentae?

Answer 24

Small arteries located in the lining between placenta and uterus are prone to rupture. When this happens, the accumulating blood begins to separate the placenta from the uterus in till it tears away disrupting the function of the placenta.

Question 25

what does fetal abruptio placentae cause?

Answer 25

A reduction in fetal blood flow causes fetal hypoxia, inadequate nutrient delivery, and poor elimination of carbon dioxide and other waste products

Question 26

What does maternal abruptio placentae cause?

Answer 26

Severe hemorrhage and hypovolemic shock.

Question 27

predispositions for abruptio placentae?

Answer 27

Hypertension, use of cocaine, preeclampsia, multiparity, previous abruption, smoking, short umbilical cord, premature rupture of the amniotic sac, diabetes, and trauma involving the abdomen during pregnancy.

Question 28

The two types of abruptio placentae? (also what is the morality rate)

Answer 28

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.

Question 29

Emergency medical care for abruptio placentae?

Answer 29

Administer the same care as the placenta previa

Administer high concentrations of oxygen regardless of the mother’s SpO2

Treat for hypovolemic shock

Question 30

Patho of a ruptured uterus?

Answer 30

As the uterus enlarges during pregnancy, the uterine wall becomes extremely thin, especially around the cervix.

Question 31

Where can the fetus possibly go in the case of a ruptured uterus?

Answer 31

The abdomen.

Question 32

Emergency medical care for ruptured uterus?

Answer 32

-The primary treatment is to administer a high concentration of oxygen, regardless of the SpO2 reading and oxygenation status of the pregnant patient, via a nonrebreather mask at 15 lpm to maximize oxygenation of the fetus.

-Transport the patient to a facility that can manage a surgical obstetric emergency

Question 33

What does gravida and para mean?

Answer 33

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.