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Z. PATH 2 > Outcome 5 Late Pregnancy and Delivery > Flashcards

Outcome 5 Late Pregnancy and Delivery Flashcards

1
Q

Premature detachment of a normally positioned placenta during pregnancy

A

abruptio placentae

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2
Q

Placenta covering the opening of the cervix

A

placenta previa

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3
Q

What are 2 types of placenta previa?

A
  1. partial

2. complete or central

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4
Q

Type of placenta previa where majority of the placenta is away from the opening

A

partial previa

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5
Q

Type of placenta previa where the more central portion of the placenta covers the opening

A

complete or central previa

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6
Q

Low implantation of the ____ in the uterine cavity causes placenta previa

A

blastocyst

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7
Q

Is vaginal delivery allowed when there is placenta previa present?

A

no

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8
Q

T or F. Immediate C-section is warranted when there is a massive hemorrhage in placenta previa

A

T

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9
Q

Contractions leading to cervical change before 37 weeks of pregnancy

A

premature labor

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10
Q

What IM injections are given to mother in premature labor to reduce complications?

A

betamethasone

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11
Q

What IM injections reduce incidence of premature birth by 30%?

A

progesterone

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12
Q

Spontaneous break in the amniotic sac before onset of regular uterine contractions

A

premature rupture of membranes (PROM)

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13
Q

When the infant is full term, the period between membrane rupture and the onset of labor is ____

A

brief

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14
Q

When infant is pre-term, the period between membrane rupture and onset of labor is ____, which increases risk of fetal death

A

prolonged

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15
Q

A cause for PROM is increased intrauterine tension due to ____ or ____

A

hydramnios or multiple pregnancies

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16
Q

PROM in pre-term pregnancy (28 to 34 weeks) is treated with hospitalization and ____ if there is evidence of infection

A

induction of labor

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17
Q

PROM in term pregnancy when vaginal delivery isn’t achieved within 24 hours following prom, induction of labor with ____ is usually done

A

oxytocin

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18
Q

Pregnancy that persists for 41 weeks or more

A

prolonged post-term pregnancy

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19
Q

T or F. Prolonged pregnancies are not induced because dates may be wrong, inducing comes at a higher risk, hard on mom and baby

A

T

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20
Q

What are the 3 phases of the first stage of labor?

A
  1. early labor (0-4cm)
  2. active labor (4-8cm)
  3. hard labor or transition (8-10cm)
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21
Q

Which stage of labor is the longest?

A

first

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22
Q

Stage of labor that begins at full cervic dilation (10cm) and baby’s head has begun to press into the birth canal

A

second stage of labor

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23
Q

Stage two ends with the ____

A

birth of the baby

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24
Q

Stage of labor where the uterus rests for 15 minutes, placenta detaches from the uterine wall, and is delivered by expulsion by the birth canal

A

third stage of labor

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25
The third stage is managed by administering ____ and ____ which when given at time of birth, can reduce severe bleeding
oxytocin and ergonovine
26
Lie
position of baby in relation to mom
27
Lie: fetus is lying lengthwise (vertically) in the uterus
longitudinal fetal lie
28
Lie: fetus is lying crosswise or horizontally in the uterus
transverse fetal lie
29
T or F. Caesarean is always performed when fetus is at a transverse lie
T
30
Lie: maternal axes cross at a 45 degree angle, forming an unstable lie that'll always become either longitudinal or transverse during the course of labor
oblique fetal lie
31
direction of baby in relation to mom's pelvis
position
32
part of baby that passes through the pelvis first
presentation
33
Presentation: back part of skull (occiput) is the point of direction
vertex presentation
34
Presentation: chin is the point of direction
face presentation
35
Presentation: brow is the point of direction
brow presentation
36
Presentation: sacrum is the point of direction and the feet are crossed and the thighs are flexed on the abdomen
complete breech presentation
37
__% of breech babies are delivered by cesarean section
85%
38
Presentation: thighs flexed on the abdomen, legs upon the thighs and one or both feet may be lowermost
incomplete (footling) breech presentation
39
Presentation: thighs flexed; legs extended over the anterior surfaces of the body
frank breech presentation
40
Presentation: prolapsed limb is alongside the presenting part
compound presentation
41
Where the fetal head is delivered but one of the shoulders gets stuck behind the pelvic bone, if not managed appropriately, could lead to the fetus suffering serious trauma from the delivery
shoulder dystocia
42
How is shoulder dystocia treated?
1. McRoberts maneuver | 2. Wood screw maneuver
43
Extremely rapid labor and delivery, which may occur without professional assistance (labor of less than three hours)
precipitate labor
44
Term used when fetus is believed to be in jeopardy, most often due to decrease oxygen flow.
fetal distress
45
Condition of a very large fetus; serious dystocia may arise when large head attempts to pass through a normal pelvis.
fetal macrosomia
46
Excessive accumulation of cerebrospinal fluid in ventricles of the brain with consequent enlargement of the cranium.
fetal hydrocephalus
47
Normal circumference: 32-38cm. Hydrocephalic babies: ___ cm
50-80 cm
48
Result of greatly distended urinary bladder, ascites, or enlargement of kidney or liver; spontaneous delivery may be impossible due to large amount of fetal swelling.
large fetal abdomen
49
"Siamese twins" May be diagnosed antenatally, but not always identified until difficulty at delivery
conjoined twins
50
Umbilical cord can wrap around baby’s neck during pregnancy and cut off fetal blood supply; knot is deadly
umbilical cord entanglement
51
Umbilical cord slipping through the cervix and into the vaginal canal before arrival of the fetus
prolapsed umbilical cord
52
Prolapsed umbilical cord is due to _____ before the descent.
amniotic membrane rupture
53
Condition in which a newborn does not breathe spontaneously.
asphyxia neonatorum or perinatal asphyxia
54
Dark green material in intestine of a full-term infant, often called the first stool of the newborn
meconium
55
Newborn inhales (aspirates) a mixture of meconium and amniotic fluid, which can partially or completely block the baby’s airways.
meconium aspiration
56
Excess of amniotic fluid. Associated with maternal disorders such as eclampsia and DM.
polyhydramnios
57
Placenta that has not been expelled within 30 mins after delivery of baby
retained placenta
58
Spontaneous traumatic rupture of the uterus. If fetus is alive at time of rupture, only chance of survival is immediate delivery.
ruptured uterus
59
Inverted uterus occurs during the delivery of placenta due to _____ on umbilical cord when placenta is firmly attached to uterine wall
excessive traction
60
Perineal lacerations are classified as:
1st, 2nd, 3rd, or 4th degree
61
Major cause in the majority of maternal deaths: excessive bleeding from the placental implantation site and/or trauma to the genital tract and adjacent structures.
maternal hemorrhage
62
Loss of more than 500ml in vaginal delivery, or more than 1000ml in cesarean
Postpartum hemorrhage defined as
63
Amniotic fluid travelling into the bloodstream of the mother through the highly vascular uterine wall due to the pressure generated during labor and delivery; affects lungs and kidneys
amniotic fluid embolism
64
Delivered through a device similar to a suction cup, where vacuum is placed on head of fetus and traction is applied; lower risk and less postpartum pain for mother than forceps.
vacuum assisted delivery
65
Forceps application is classified according to the position of the fetal head when forceps are applied
forceps delivery
66
Performed in stage 2 of labor in order to substitute a straight surgical incision in place of a possible laceration of the perineum.
episiotomy
67
Removal of baby from the uterus through an incision in the abdominal wall and uterus.
Cesarean section
68
What are the 3 types of c-section?
1. low segment 2. classical 3. intraperitoneal or extraperitoneal cesarean
69
Type of cesarean: transverse incision in lower segment of uterus
low segment
70
Type of cesarean: Vertical incision into the wall of the body of the uterus
classical
71
Type of cesarean: Tissue around urinary bladder dissected providing access to lower uterine segment without entering peritoneal cavity
intraperitoneal or extraperitoneal
72
Procedure involving the removal of uterus immediately following cesarean
cesarean hysterectomy
73
Another name for cesarean hysterectomy
porro operation
74
Usual forms: support persons (birth coaches, doulas), behavioral modifications and breathing, hypnotherapy, massages and showers to manage pain
psychoprophylaxis
75
Often used if mother has very short time before the second stage as estimated by nature of contraction and dilation of cervix
inhaled agents and injections
76
Preferred method of analgesia because it is extremely effective
epidural infusion
77
Allow pain relief without ability of patients to push during second stage of labor
continuous options
78
Anesthesia used for c-section and non-emergency (planned) cases where pt does not have an epidural, and is the preferred method of anesthesia because of reduced mortality and morbidity.
spinal anesthesia
79
Death after 20 weeks gestational age and/or a fetus weighing >500g
intrauterine death or stillbirth
80
___ weeks is the difference between a spontaneous abortion and intrauterine death.
20 weeks
81
Intrauterine death is linked to what?
1. eclampsia 2. preexisting type 1/2 DM 3. APLA syndrome
82
Half of intrauterine deaths are unknown. T or F
T
83
Body does not produce adequate amounts of insulin to deal with increased demand during pregnancy.
gestational diabetes
84
Serious disease of pregnancy characterized by HTN and proteinuria
pre-eclampsia or toxemia
85
Pre-eclampsia is most common in the ___ trimester but can occur anytime after __ weeks
third, 20
86
When a seizure occurs in a pt with preeclampsia Not all pt with preeclampsia will have this
eclampsia
87
What is given to reduce the possibility of a seizure?
magnesium sulfate
88
Inflammation of birth canal during the puerperium. Common cause of childbirth related deaths.
infection
89
What is the cause for pregnancy ifnections?
1. normal vaginal flora that become overgrown
90
When are infections diagnosed?
Fever for 48 hours after delivery with elevation of WBC count and erythrocyte sedimentation rate
91
All breast-feeding mothers experience some degree of this (more severe in primiparas) a few days after giving birth
breast engorgement
92
Sudden drop of estrogen and progesterone after childbirth triggering deep, ongoing depression that begins in postpartum period.
postpartum depression
93
True postpartum depression persists up to ___ months or longer, and can become chronic depression.
six

Z. PATH 2 (17 decks)

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