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ENRP > Obstetrical Complications > Flashcards

Obstetrical Complications Flashcards

1
Q

What defines Preterm Labor (PTL)?

A

Between 20 and 36 weeks and 6 days

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2
Q

What is the general way to diagnose Preterm Labor?

A

Uterine contractions and cervical change

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3
Q

What is the very specific way to diagnose PTL?

A

Cervical dilation of at least 2 cm
AND/OR
80% effaced

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4
Q

What is the very specific way to diagnose Preterm Labor?

A

Cervical dilation of at least 2 cm
AND/OR
80% effaced

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5
Q

What are the 4 main pathways that are aimed at preventing PTL?

A
  1. Infection
  2. Placental-vascular
  3. Pyschosocial stress
  4. Uterine stretch
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6
Q

What are 4 infections that can increase the risk for PTL?

A

Bacterial Vaginosis
Group B strep
Gonorrhea
Chlamydia

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7
Q

Alterations in the placental-vascular flow can lead to what 2 things that are risk factors for PTL?

A

Preeclampsia

Poor fetal growth

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8
Q

What molecules that are increased with psychosocial stress can be a risk factor for PTL?

A

Cortisol

Catecholamines

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9
Q

In what race is PTL more common due to socioeconomic reasons?

A

Black people

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10
Q

The risk of PTL is INCREASED as cervical length is _____

A

DECREASED

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11
Q

As the cervical length is decreased, the risk for preterm labor is?

A

Increased

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12
Q

What are some symptoms of PTL?

A

Cramping/contractions
Backache
Discharge

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13
Q

With the evaluation of PTL, what may resolve the contractions?

A

Hydration and rest

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14
Q

With the evaluation of PTL, you should evaluate for infection and then what?

A

Hydrate

–> check cervix again in 1 hour

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15
Q

What are 3 drugs that can be used for Tocolysis if the patient is < 34 weeks?

A

Magnesium Sulfate
Nifedipine
Prostaglandin Synthetase inhibitors

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16
Q

What are 3 drugs that can be used for Tocolysis of PTL and how they are given?

A

Magnesium Sulfate (IV)
Nifedipine (oral)
Prostaglandin Synthetase Inhibitors – for extreme prematurity

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17
Q

What can be given between 24-34 weeks to help the fetal lungs mature?

A

Glucocorticoids

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18
Q

If a patient is at risk of PTL in the next 7 days and she is between 34-36 and 6, what can be given?

A

Single course of Betamethasone

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19
Q

What is the lower limit of Viability with a premie?

A

22-24 weeks

< 500 gms

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20
Q

What is PROM (premature rupture of membranes)?

A

Rupture of membranes before the onset of labor at any gestation

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21
Q

What is diagnosis of PROM made off of?

A

HISTORY

22
Q

What will the patient say in their history with PROM?

A

Loss of amniotic fluid in the vagina

23
Q

What should you NOT do with a presumed PROM patient?

A

Do NOT check the cervix!!!!

24
Q

Why should you not check the cervix of a presumed PROM patient?

A

Increased risk of infection since the amniotic sac may not be intact

25
Q

What are 3 tests to confirm PROM?

A
  1. Pooling
  2. Nitrazine paper
  3. Ferning
26
Q

What are 3 tests to confirm PROM?

A
  1. Pooling
  2. Nitrazine paper
  3. Ferning
27
Q

With PROM, the nitrazine paper should turn what color?

A

Blue

28
Q

What are some false (+)s and (-)s with the Nitrazine paper test for PROM?

A

False (+)s = urine, blood, semen

False (-)s = Minimal leakage or none remaining

29
Q

Management of PROM depends on gestational age, amniotic fluid index and the status of mother/baby. When do most PROM patients deliver?

A

34 weeks

30
Q

When do most PROM patients deliver and what should you monitor for?

A

34 weeks

– monitor for chorioamionitis

31
Q

IUGR

A

Intrauterine Growth Restriction

32
Q

What defines IUGR?

A

Estimated fetal weight or abdominal circumference is below 10% for gestational age

33
Q

What defines IUGR?

A

Estimated fetal weight or abdominal circumference is below 10% for gestational age

34
Q

What are some maternal causes of IUGR?

A

Poor nutrition/low weight

Smoking and drugs

35
Q

What is a placental cause of IUGR?

A

Insufficient substrate transfer through placenta or poor invasion

36
Q

What are the TORCH infections of the fetus that can cause IUGR, amongst other things?

A

Toxoplasmosis
Rubella
CMV
Herpes

37
Q

What are the 2 main ways to diagnose IUGR?

A

Fundal height

Ultrasound

38
Q

What are the 2 main ways to diagnose IUGR?

A

Fundal height

Ultrasound

39
Q

How do you measure fundal height and when does it indicate IUGR?

A

Top of uterine fundus to pubic bone

= If the height lags more than 3cm behind what is expected for gestational age

40
Q

Once IUGR is identified, what should be done weekly?

A

Nonstress test twice a week
BPP
Doppler of Umbilical A.

41
Q

What finding on doppler of the Umbilical A. can signify IUGR?

A

Decreased diastolic flow

42
Q

What defines Postterm Pregnancy?

A

Gestation > 42 weeks

43
Q

Post - Maturity Syndrome is due to?

A
  • due to aging/infarcts of the placenta especially near 42 weeks
44
Q

What are the signs a baby had Post-Maturity Syndrome?

A

Decreased subcutaneous fat
Long fingernails
Dry and peeling skin
Increased hair

45
Q

What are the signs a baby had post-maturity syndrome?

A

Decreased subcutaneous fat
Long fingernails
Dry and peeling skin
Increased hair

46
Q

When is induction preferred with a Post-term pregnancy?

A

41 weeks preferred

– Definitely induce by 42 weeks

47
Q

IUFD

A

Intrauterine Fetal Demise

48
Q

What defines IUFD?

A

Death after 20 weeks gestation but before labor onset

49
Q

How do you diagnose IUFD?

A

Ultrasound with no fetal cardiac activity

50
Q

What causes IUFD?

A

Usually known

ENRP (45 decks)

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