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Reproductive > Pregancy, Labor, and Delivery: Young > Flashcards

Pregancy, Labor, and Delivery: Young Flashcards

1
Q

What are the 2 things to do in medicine?

A
  1. maintain your composure

2. ease the babies head out

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2
Q

What not to do?

A

NEVER FORCE BABY OUT… easy it along

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3
Q

When is a fetus viable?

A

~24 weeks

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4
Q

When is preterm defined as?

A

viable 24 wks to 37 weeks

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5
Q

What is early term?

A

37-38

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6
Q

What is term?

A

39-40

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7
Q

What is late term?

A

41

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8
Q

What is post term?

A

42

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9
Q

What is total term pregnancy?

A

40 weeks from date of last menstrual period

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10
Q

What is the goal of the first visit of a pregnant mother?

A

identify problems or potential problems

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11
Q

What do you assess in initial visit?

A 
Risks
Discuss chromosome assessment: age based
Monitor: 
   wt gain
   bp
   Rh
   diabetes
   anemia
   stds
   Group B strep
   plan for delivery
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12
Q

What is the medical definition of abortion?

A

Pregnancy doesn’t make it 20 weeks=aborted

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13
Q

What are the risks of chromosome abnormality at 18? 45?

A

18: 1/1500
45: 1/50

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14
Q

What is defined as advanced maternal age?

A

age 35… really more like 37, 38

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15
Q

What is the risk of fetal loss in amniocentesis?

A

1/250

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16
Q

What % of US population has group B strep?

A

20%… pretty much from diet and life

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17
Q

What does GBS screening decrease the risk of fetal loss by?

A

2 orders of magnitude

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18
Q

What nutrition is necessary?

A

Wight gain
Obesity is a form of malnutrition
Essential amino acids: eat meat/soy

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19
Q

What are the BP things we look at?

A

Pre-exisiting
Hypertension of pregnancy:
gestational hypertension
pre-ecclampsia

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20
Q

EXAM/TEST: What HTN drug is ABSOLUTELY CONTRAINDICATED IN pregnancy?

A

ACE inhibitors: take them off of it even if they are thinking or at the age to possibly get pregnant

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21
Q

EXAM: When is organogenesis complete?

A

12 weeks… so first trimester ACEinh. will do damge

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22
Q

What is gestational hypertension?

A

Benign hypertension

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23
Q

What is pre ecclampsia?

A

HTN

Proteinuria (edema): 500 mg protein per day

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24
Q

What is the natural history of pre ecclampsia?

A

Death

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25
Q

What is strange about pre ecclampsia?

A

Only seen in humans, no animal models

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26
Q

What is eclampsia?

A

Convulsions

27
Q

How do you know someone is pre-ecclampsia?

A

Clinical judgememt

28
Q

When does pre eclampsia not show up before?

A

20 weeks

29
Q

TEST: what is THE major complication of pregnancy?

A

Pre eclampsia

30
Q

What is Rh factor?

A

Rhesus monkey D antigen
Prior pregnancy event
Mom Rh neg., baby positive, possibly sensitize mom develops antigens and rejects next pregnancy

31
Q

Is Rh A or B type?

A

No… just Rh factor on either type gets attacked in baby

32
Q

What do you do to prevent Rh attack?

A

RhoGam: Coat fetal red cells which contain Rh antigens using IgG so mom doesn’t see antigen (72 hours)

33
Q

If mom is Rh negative, what happens?

A

RhoGam either way. Baby has 50/50 chance of being Rh positive.

34
Q

What is high risk for diabetes?

A

Prior DM in pregancy
Multiple gestation
AMA
Obese

35
Q

What percent with gestational DM develop overt DM later in life?

A

40-50%

36
Q

BOARDS/not this test: hCG is elevated in pregnany. What is it similar to?

A

TSH
Insulin
So: thyroid, insulin, hCG

37
Q

When do you do a ultrasound to check organ size?

A

18-20 weeks

38
Q

If a patient has a cyst in the brain, or calcification of heart, how do you consul?

A

It will go away!

39
Q

What does ultrasound tell us?

A

Structure (where and how many)

Blood flow

40
Q

What does ultrasound not tell us?

A

if the baby is okay…

41
Q

What is the strict criteria of fetal heart rate?

A

110-160 bpm
with accelerations
with decelerations

42
Q

When someone comes into the exam, what do you do with them?

A

Talk with them! OB is medicine and sociology

43
Q

What are social considerations of pregnancy?

A

Finances
Work
Other Children=a job
Delivery planning

44
Q

Fibroid is what?

A

Leiomyomyoma

45
Q

A subtotal hysterectomy?

A

Cervix is left behind

46
Q

What is viability?

A

Ability to live outside the uterus

NOT a “viable baby at 6 weeks”, this is just a healthy fetus

47
Q

What is premature?

A

After 24 weeks… death before 20 weeks is an abortion

48
Q

Premature and Preterm are two different words. What do they mean?

A

Premature=baby

Preterm= timeline

49
Q

Membranes break. What does not break?

A

Water!

50
Q

What % of pregnancy are normal?

A

75%

25% have a major complication

51
Q

What are the main complications?

A 
infection
preterm labor
per eclampsia
prior CS
not vertex
52
Q

What are the phases of labor?

A

Latent phase “pre labor” <4 cm
Active phase 1st 4-10 cm
Pushing 2nd
Delivery of placenta 3rd

53
Q

What are the dilation of first stage?

A

4-10 cm (1st stage0

54
Q

How do we measure contractions?

A

Intrauterine pressure catheter

55
Q

What are the duration of labor definitions?

A

Latent: no limits
Active: friendman curve, actually 1-2 cm/hr
2nd stage: 3 hr. primip, or 2 hour multi
3rd stage: 1 hour

56
Q

BOARDS, not this test: What are the 7 cardinal movements of delivery?

A
  1. engagement: head into pelvis
  2. descent: chin to chest
  3. flexion : chin back up
  4. internal rotaion: turn
  5. extension: head up
  6. external rotation/restitution: back to straight
  7. expulsion-delivery of anterior shoulder, delivery of posterior shoulder under symphysis
57
Q

What are the notable characteristics of the cord?

A

Is it intact?
3 vessels?
Bleeding?

58
Q

How do you pull the cord out?

A

Gentle traction: do not avulse cord… put your hand in there and scoop out, antibiotics and sepsis risk.
Twist the rope

59
Q

What do you do to mom after birth?

A

Assess for damage

60
Q

What are the definitions of perineum lacerations?

A

1st degree: skin only

2nd: defect in underlying, but not anal sph.
3rd: into or through anal sphincter
4th: defect of rectum

61
Q

What percent of babies are delivered CS?

A

30-33%

62
Q

What percent of babies in puerto rico are delivered CS?

A

70%

63
Q

What is VBAC?

A

Vaginal birth after C section: risk of ruptured uterus/bleeding/scarring

64
Q

TEST: If you have a prior CS, and placenta is low anterior, what is the risk?

A

Placenta accreta

Reproductive (31 decks)

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