week 2 Flashcards
relaxation in pelvic joints results from _____
hormonal changes
sacrum to top of symphysis
true conjugate
sacrum to middle of symphysis
obstetrical conjugate
sacrum to bottom of symphysis
diagonal conjugate
how is OC calculated?
DC- 1.5 to 2= OC
what is normal OC?
10cm or more
which is the shortest ap diameter of the inlet? OC, DC, or TC?
OC
what is normal DC?
12cm
Going from TC to OC to DC what are the normal measurements?
11, 10, 12
How is TC calculated?
DC-1.2=TC
What is the normal measurement of transverse diameter of outlet? inlet?
outlet=11
inlet=13.5
What is the transverse diameter referring to?
the distance between the linea terminalis
What is the normal interspinous diameter
10cm
What is the normal anteroposterior diameter of the midlplane?
11.5
What is the posterior sagittal diameter of the midpane measuring?
between the sacrum and the line created by the interspious diameter
what is the normal measurement of the post. sagittal diameter of the midplane?
4.5cm
If thoms rule is _____then the bony outlet is adequate
> 15cm
Size of non pregnant uterus?
mango, pear
Size of 12 week uterus
grapefruit or softball
size of 20 week uterus
size of cantelope
three denominators
occiput, mentum, sacrum
3 fetal lies
transverse, longitudinal, oblique
presenting part
part of the fetus that is nearest the cervix
attitude
relationship of one fetal part to another
presentation
part of fetus over the inlet
position
relationship o the denominator to the maternal pelvis
Which pelvis is the best for vaginal delivery?
gynecoid
which pelvis has a roomy outlet and a round inlet?
gynecoid
which pelvis is more prominent in black women?
anthropoid
which pelvis has an oval inlet?
anthropoid
which pelvis I wider front to back rather then side to side?
anthropoid
which pelvis is comparable to a males
android
which pelvis is heart shaped?
android
which pelvis has reduced posterior segments?
android
which pelvis is flat, narrow, and wide?
platypelloid
which pelvis has a shallow cavity but widens at the outlet?
platypelloid
Which pelvis is common in native American women?
platypelloid
suprapubic arch should be at least ___degrees
90
three presentation
cephalic, breech, shoulder
three types of attitude
flexion, extension, military
anterior fontanels are ____shaped
diamond
post fontanels are ___shaped
triangle
bregma
anterior fontanels
lambda
post fontanels
when do you perform TOC for GC/C?
4 weeks and then at the end of pregnancy
gbs screen good for ___weeks
4
what labs do you obtain at 24-28 weeks?
glucose, HH, repeat antibody screen if rh-
underweight BMI
<18.5
normal BMI
18.5-24.9
overweight BMI
25-29.9
obese BMI
> 30
weight gain for underweight BMI
28-40
weight gain for normal BMI
25-35
weight gain for overweight BMI
15-25
weight gain for obese BMI
11-20
why does a pregnant person in second trimester appear more hemodiluted?
big surge in blood volume that comes in the form of plasma
what is evident of iron deficiency?
low MCV
criteria for iron deficiency in 1st and 3rd trimesters?
hgb <33%
criteria for iron deficiency in 2nd trimester
hgb<32%
take iron with ____to help absorption
vit c
take iron separate from ___and ____ to help in absorption
PNV and Ca
important factors to monitor in vegitarians bc there is not much of these in veggies
vit b and folic acid
moderate caffeine consumption
<300mg per day
best sweeteners in pregnancy bc they are natural
splenda or truvia
when are the greatest iron needs for the fetus?
3rd trimester
which trimester should herbs be avoided?
1st
abortifactant herbs to avoid
rue, tansy, pennyroyal, high vit c with rose hips
uterine and nervous system herbs to avoid
blue/blach cohosh prior to term, ma huang or Chinese ephedra
teratogen herbs to avoid
caffeine infusions, excess sucrose and quinine
hormonal herbs to avoid
estrogens: licorice, black cohosh, dong quai
progesterones: chaste tree berry and wild yam
toxic herbs
chaparral, comfrey, germander, jin bu haun, lobelia, ma huang, stephania, magnolia, yohimbe
st johns wart should be ____
avoided
placental transport of drugs to the fetus starts at ___
5 weeks
from 31-71 days, exposure to teratogens is _____
organ specific
before day 31, exposure to teratogen is _____
all or none…usually results in SAB
most drugs have a shorter __ ____ in pregnancy
half life
what four tests make up the quad screen?
AFP, estriol, HCG, Inhibin A
what causes an abnormally HIGH AFP?
leaking from open NTD, wrong gestational age, multiples,
what causes a LOW AFP?
trisomy 21, 18
where is AFP produced?
yolk sac then the fetal liver
decreased estriol is associated with
trisomy 21,18, inaccurate gestational age
increased estriol is______
normal
decreased HCG seen in
trisomy 18
increased HCG seen in
trisomy 21, multiples, inaccurate GA, other anomalies
inhibin A follows same abnormals as ___
HCG
four positions of leapolds
- feel fundus
- feel sides of uterus
- pawlicks
- feel fundus and pawlicks together