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Emma Repro > Prenatal Care, Labor and Delivery > Flashcards

Prenatal Care, Labor and Delivery Flashcards

1
Q

human gestation lasts _ days from LMP

A

280

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2
Q

objective findings of preg

A
  • Chadwick sign (blueish)
  • Hegar sign
  • Goodell’s (cervix softening)
  • Melasma/cholasma
  • linea nigra
  • inc in basal bod temp
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3
Q

fetal heart detected w. doppler at

A

10 wk

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4
Q

fetal heart by auscultation at

A

20 wk

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5
Q

uterus rises to umbilicus at

A

20 wk

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6
Q

McDonald’s Measurements

A

top of mother’s uterus to pubic bone in cm

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7
Q

fetal movements at

A

18-20 wk (nullipara)

16-28 (multipara)

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8
Q

Why does the belly fall at 40nk

A

amniotic fluid diminishes

uterus = smaller, lower

baby drops, “lightening”

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9
Q

prevention of toxoplasmosis

A
  • no raw meat, no seafood, no hand washing, gloves when changing cat litter or gardening
  • wash produce/cutting boards w/ bleach
  • cook/freeze meats
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10
Q

rule of thumb for weight gain during preg

A

10% of body weight +15lbs

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11
Q

hyperemesis gravidium is associated w/ high

A

hCG

  • mult preg
  • chorioCA
  • hypERthyroid
  • mult preg
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12
Q

pre-eclampsia

A
  • alt in angiogenesis
  • incomplete remodeling of uterine spiral arterioles
  • abnml placental vascular development
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13
Q

proteins implicated in pre-eclampsia

A
  • sFlt-1
  • VEGF
  • PIGF
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14
Q

sFLT-1 and NO in preeclampsia

A

inversely related

(xs sFLT-1 receptor binds up VEGF, can’t stim NO)

–> reduced placental blood vessel growth

–> preeclampsia

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15
Q

diabetes and pregnancy

A

insulin resistance increases in pregnancy

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16
Q

criteria for pregestational diabetes

A

-for 1st trimester or early 2nd trimester…
HbA1c > 6.5%
fasting plasma glucose >126 mg/dL
2-hr glucose > 200 mg/dL

17
Q

circulating cell free DNA

A

NOT pt of routine prenatal lab assessment

screens for common trisomies and possibly sex

18
Q

group __ strep should be done between 35-37 weeks

A

B

retest if negative

19
Q

cervical ripening - process

A
  • inc collagen solubility
  • alt in ground substance
  • ripening in cervix and corpus
20
Q

cervical ripening hormonal methods

A
  • oxytocin
  • PGE2,1
  • progesterone antagonist
21
Q

role of calcium in labor

A

when Ca++ is removed, phosphorylation ceases and m. relaxes

labor INHIBITED

22
Q

oxytocin role in labor

A

inc in number and sensitivity by term

-raises intracellular free Ca levels –> stim actomyosin formation and musc contractio

23
Q

If ________ occurs early, spontaneous preterm labor will ensue

A

dysregulation of decimal inflammatory signaling

24
Q

risk fx for spontaneous preterm birth

A
  • cervical shortening
  • lower GI infection
  • undernutrition
  • anemia
  • cigarette smoking
25
Q

role of CRH in labor

A
  • derived from placenta in lg amounts
  • secreted into maternal circulation in 3rd trimester

-rises EXPONENTIALLY during pregnancy, peaks at END

26
Q

-high CRH delivery early or late?

A

early

27
Q
  • low CRH delivery early or late?
A

late

28
Q

release of _____ from decide can result in preterm labor

A

prostaglandins, cytokines, chemokine, ROS from decidua

29
Q

preterm labor risk fx

A
  • prior preterm birth
  • # of prior preterm births and gestational age
  • prior preterm twin birth
  • SHORT cervical length
  • smoking
  • hx of cervical surgery (LEEP)
30
Q

the ___ the cervical length, the greater the risk of preterm birth

A

the SHORTER the cervical length, the greater the risk of preterm birth

31
Q

first stage of labor

A

between onset of labor and full cervical dilation

latent and active phase

32
Q

second stage of labor

A

between full cervical dilation and delivery

  • descent/expulsio
  • active role of pushing
33
Q

third stage of labor

A

fetal delivery to placenta delivery

34
Q

4 signs of placental separation

A
  • lengthening of umbilical cord
  • gush of blood
  • fundus –> globular, more anteverted against abd
  • fundus rises as placenta moves down
35
Q

cardinal movements of labor (7 distinct)

A 
engagement
descent
flexion
internal rotation
extension
external rotation/restitution 
expulsion

Emma Repro (23 decks)

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