Obstetrics Weeks 1-2 Flashcards
3 trimesters of pregnancy weeks?
1st: 1-12
2nd: 13-27
3rd: 28-birth (37-42)
what is the most accurate way of determining a due date?
ultrasound in first trimester
miscarriage definition?
loss of pregnancy before 20 weeks gestation
What symptoms during pregnancy require emergency medical care?
large clots heavy bleeding severe abdo pain fever dizziness diarrhea
What hormonal changes occur during pregnancy?
Human chorionic gonadotrophin
Progesterone
Estrogen
Relaxin
morning sickness can be related to a rise i which hormone during pregnancy?
Human chorionic gonadotrophin (hCG)
doubles every 2 days during first 10 weeks
what effect does a rise in progesterone have during pregnancy?
- inhibits smooth muscle and increases ligament laxity
- bowel muscles to relax and cartilage to soften
- fatigue
what effect does a rise in estrogen have during pregnancy?
enables uterus and placenta to improve vascularisation
- milk duct development
what effect does a rise in relaxin have during pregnancy?
relaxes ligaments of cervix for birth
What are some key CV and respiratory changes that occur during pregnancy?
increase in:
- plasma volume
- cardiac output
- metabolic rate
- O2 consumption
- glucose and insulin changes
What are the routine tests during pregnancy?
- U/S at 11-13 and 20 weeks
- BP
- Blood tests
- Urinalysis
- GTT
- Group B Streptococcus at 36 weeks
(BBUUGG)
Serious conditions not to be missed during pregnancy?
3 x P, M and E
- Preeclampsia
- Premature rupture of membranes
- Placental abruption
- Miscarriage
- Ectopic pregnancy
What is an ectopic pregnancy?
when a fertilised egg implants itself outside the womb, usually in one of the fallopian tubes
key SSx of ectopic pregnancy?
unilateral abdo pain vaginal bleeding bowel pain shoulder tip pain vomiting and diarrhea
key SSx of preeclampsia?
- High BP
- Protein in urine
sudden face, hand or feet swelling - persistent HA, blurred vision
key signs of gestational diabetes?
increased thirst, urination and fatigue
What nutrient when taken before conception can prevent 70% of neural tube defects?
folate: vegetables, fruit, nuts, seafood, meat and dairy
foods to avoid during pregnancy?
Lysteria risk: deli meat, cheese, uncooked seafood
Salmonella
Mercury: certain types of fish
what hormone inhibits uterine contractions?
Relaxin
what hormone suppresses immune system of mother?
hCG
when is a pregnancy considered a full term?
after 37 weeks
what are the options for birth?
public maternity hospital
private obstetrician
private midwife
hone birth
1st stage of labour?
first onset of contractions at 3 cm dilation to full dilation of cervix
2nd stage of labour?
from full dilation (10cm) to birth
3rd stage of labour?
delivery of placenta
what is the optimal position of the baby for birth?
left occiput anterior
Types of breech presentations?
Breech: head is superior
Frank
complete
footling
non-medical pain relief during birth?
Tens
acupressure/massage
intradermal water injections
medical pain relief during birth?
gas (nitrous oxide)
pethidine
epidural
epidural?
An anesthetic injected into the epidural space surrounding the fluid-filled sac (the dura) around the spinal cord. It partially numbs the abdomen and legs and is most commonly used during childbirth
induction of labour may involve?
administration of prostaglandins or oxytocin OR manual rupturing the amniotic membranes OR cervical balloon catheter
Episiotomy?
cut made into the perineum an posterior vaginal wall
assisted delivery?
vaccum
forceps
typical recovery time for C-section patients?
will need major abdo surgery
~ 6-8 weeks
when can pelvic floor exercise be performed after delivery?
1-2 days after delivery
diastasis recti:
2 or more finger spaces
abdominal separation
what are the milestones needed for an infant to be allowed to go home from a neonatal nursery?
breathe without oxygen outgrow bradcardia/apnea feed by mouth maintain stable temp hearing, car seat safety, heart disease screening
