UW OB 4 Flashcards
how long should stage 2 of labor last?
3h null2h muli*anything -1 is protracted(2h null, 1h multi)
managment of ROM & PROM?
delivery! they are at term so induce PROM and deliver be sure ot test PROM for GBS and give Ampicillin if needed
Transverse vs longitudinal cephalic v breech
Transverse = perpendicular to momlongitudinal = parallel with moncephalic = head @ cervixbreech = ass @ cervix
what should you always do when you find a prego women with HTN?
urinalysis for protein + if actual HTN and not transient = do U/S for IUGR
Preeclampsia
> 140/90 + protinuria = >37 deliver if <37 rest!*eclampsia, severe preeclampsia, HELLP deliver all these!
what causes hypercoagulability in prego?
increase clotting factors, decrease PC/S and INCREASED FIBRINOGEN*if you ever see normal fibrinogen in prego especially close to term think DIC.
complete breech
baby cris-cross apple sauce folded in a ball!
Post date baby date?
> 42wks
what do you give for seizure in a prego women with epilepsy?
phenobarbitol
what happens to TV, FEV1, FRC in prego?
tidal volume increases, FEV1 doesnt change, Functional residual capacity decreases
define premature rupture of membranes
ROM w/o contraction between 37-42 wks
what is required for an adequate CST?
3 contractions every 10 min
Precutaneous Umbilical Blood Sampling(PUBS)/Cordocentesis. why do you do this? when?
anytime between 20-32 wks to confirm fetal anemia & treat w/transfusion.*if >32 wks = deliver baby!
when do you check for anemia during pregnancy? what is normal? how do you F/U & tx?
1st and 3rd!28-30 wks = nadir of Hg/Hct: 10/30*if less than this do iron studies and tx w/iron supplimentation!
define preterm premature rupture of membranesManagement?
ROM w/o contractions between 24-36 wks>34 wks deliver<24 wks deliver/abort*24-26wks = steroids + expected managment –>risk for prolonged rupture of membranes
CST late decelerations
utero-placental insufficiency
how long shoudl stage 3 of labor last?
30 min. no matter how long the other stages were its always 30 min!
What are the rules for a reactive NST?
> 32wks = 15x15; 2x20*increase via 15 bpm for 15 sec w/2 of these occuring within 20 min<32wks = 10x10; 2x20
what bonds are broken when cervix dilates?
DISULFIDE BONDS
tx of hyperthyroid in prego? what will you see for TSH & T4:?
dec TSH, inc T4tx: CANNOT DO RADIO I! tx w/PTU and if needed can do surgery in 2nd trimester
incomplete breech
aka footling = one leg curled up the other leg sticking out!
what defines arrested active labor?
stage 1 active labor….>4h w/good contractions>6h w/o contractions
what do you do to check for Mg tox?
check DTR! these will go before respiratory depression!
Tx of epilepsy in prego?
all epilepsy drugs are teratogens!tx: L drugs are safest!*Leviteracetan & Lemotriginednt forget to add FOLIC ACID
tx of GBS?
ampicillin or Clindamycin if pcn allergy
tx of diabetes in prego?
insulin > metformin > glyburide
How long till active labor? nulli v multi?
20h in null; 14 multi*active labor is 6cm
how long should it take to progress through active stage 1 labor?
1.2 cm/h null1.5 cm/h multi*if slower = protracted labor
Misoprostole vs Mifepristone?
Misoprostole(PGE1) = causes uterus to contract ad expel productsMifepristone(–|PG) = causes trophoblast to be removed from the decidua = terminates prego
what do you test for in the 3rd trimester?
as you begin 3rd u check for 3 big things!1. Gestational Diabetes2. Alloimmunizatoin3. Anemia
tx of hypothyroid in prego? what labs will you see for tsh and t4?
dec T4 & inc TSHtx: frequent TSH assesment and give levothyroxine**if already on levo you will need to increase the dose for prego
Whats Cell-Free DNA screen? when can this be done?
ID genetic shit from babys cells that are in moms blood as early as 10 wks!