Routine Prenatal Care, Labor and Delivery Flashcards
Early Symptoms of Pregnancy
Breast Tenderness, Morning Nausea, Vaginal Discharge, Bleeding or Fatigue, Headaches or edema
Factors that increase the likelihood of twins
Advancing age Increased parity Family history from either parent Obese and tall women greater chance Fertility drugs
Acute Cystitis Treatment in Pregnancy
Augmentin
Nitrofurantoin
Cephalexin
Avoid fluroquinolones
Indications for Rhogam
28 weeks gestation Spontaneous abortion, induced abortion ectopic pregnancy invasive procedures fetal death blunt trauma external cephalic version (breech position to head down) antepartum hemorrhage (ex. placenta previa)
Chorionic Villous Sampling
A procedure to get fetal DNA for testing for Down syndrome & other abnormalities
Should not be done before 10 weeks gestation because of increased pregnancy loss
Maternal Serum Alpha Fetal Protein (MSAFP)
Measurement can be used to detect abnormalities in the fetus: Neural tube defects: MSAFP is high Down Syndrome: MSAFP is low*** Anencephaly: MSAFP is high Multiple gestation: MSAFP is high
How often to do Maternal Visits
Prenatal visits every 4 wks until 28wks then every 2wks until 34-36 wks then every wk
When the Mother begins to feel the fetus move
18 -20 weeks (quickening)
screening for gestational diabetes
Random serum glucose > 200 mg/dL
Fasting serum glucose > 126 mg/dL
Glucose challenge test: 50-g oral glucose load given:
1 hour later serum glucose measured
Abnormal > 130**
To confirm gestational diabetes do three hour oral GTT
Braxton Hicks contractions
false labor, contractions without a change in cervical dilatation or effacement
Exam for delivery
Determine presenting part (Head down!)
Digital vaginal exam—cervix:
Consistency—hard vs. soft
Effacement—shortening of the cervical canal from 2 cm to paper thin
Dilation—cervix opens from closed to 10 cm being fully dilated
Fetal Station—position of the fetal head in the birth canal in relation to the ischial spines
Stages of Labor
1st Stage:
Latent phase—cervical effacement and early dilatation
Active phase—begins when cervix is 3-4 cm dilated
Onset of contractions to complete dilatation and effacement of cervix
2nd Stage—Delivery of the infant
3rd Stage—Delivery of the placenta
4th Stage—Hour immediately after delivery
Fetal Heart rate
Range 110-160
Good variability, accelerations with movement
Warning signs: late decelerations, bradycardia, decreased variability
Variable Decelerations
Usually associated w/ umbilical cord compression…but baby is NOT in distress!
Late Decelerations
decreased oxygen to fetus…BAD! May need a C-section
