pregnancy and birth Flashcards
when should miscarriage in first trimester be transported to ED
if pain is severe, or
The nature or location of the pain is different to that of menstrual pain, or
Bleeding is significantly more than a heavy menstrual period.
After 20 weeks gestation, hypotension may occur in the supine position because
the uterus can impede venous return through the inferior vena cava.
To prevent supine hypotension
always tilt the patient 30 degrees (or more) to their left by placing a rolled towel or pillow under their right hip. If this cannot be achieved, manually displace the uterus to the left if feasible.
define pre term labour
onset of labour prior to 37 weeks of pregnancy.
how to clamp the cord
Clamp and cut the cord 5 cm from the baby 2-3 minutes after birth, unless this is required earlier to facilitate resuscitation.
define shoulder dystocia
Shoulder dystocia (when the baby’s head appears but birth does not occur after two contractions with pushing) is a life-threatening emergency for the baby.
first manoeuvre to manage shoulder dystocia
Legs up. Ask the patient to grab her knees, pull them to her chest and push as hard as she can with the next two contractions.
second manœuvre for management of shoulder dystocia
Pressure. With the legs still up (as above), place the heel of your hand directly above the patient’s pubic bone and push slowly but firmly straight back toward the patient’s lower back. This is designed to reposition the baby’s shoulder, which is usually what is preventing delivery.
third step of management of shoulder dystocia
consult and manœuvres, if unsuccessful, roll mum onto all fours and try again
management of cord wrapped around baby’s neck
This is quite common and is not an emergency.
If the cord is loose and is easy to slip over the baby’s head, then do so.
If you cannot easily slip it over the head, allow birth to continue
what is a prolapsed umbilical cord
when the umbilical cord appears in the vagina ahead of the baby.
management of prolapsed umbilical cord
Instruct the patient not to push.
If possible position the mother tilted to the left with pillows/blankets under her pelvis, so that her head is below her pelvis. This is designed to take the weight of the baby off the cord and delay delivery until an LMC is available.
Transport urgently to a hospital with obstetric facilities.
Encourage delivery to occur if the baby appears at the vaginal opening or the patient wants to push.
management of breech birth
Seek immediate help from an LMC if possible.
Instruct the patient not to push.
If possible, position the mother tilted to the left with pillows/blankets under her pelvis, so that her head is below her pelvis. This is designed to take the weight of the baby off the cord and delay delivery until an LMC is available.
Transport urgently to a hospital with obstetric facilities.
Encourage delivery to occur if the baby appears at the vaginal opening or the patient wants to push.
define retained placenta
This is when the placenta has not been delivered within 60 minutes of the baby.
management of retained placenta
- transport
-prep for PPH
define an ectopic pregnancy
An ectopic pregnancy is a pregnancy in which a fertilized egg implants and grows outside the uterus, most commonly in the fallopian tube.
sx usually occur 4 weeks post LMP, shoulder pain
define gravity
The number of times a woman has been pregnant, regardless of the outcome (live birth, miscarriage, stillbirth, etc.). This includes the current pregnancy if she is pregnant.
define parity
The number of pregnancies that have progressed to a viable gestational age
define gestation
The period of time between conception and birth during which the baby develops in the uterus. A full-term gestation is usually around 37 to 42 weeks.
