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Medicine: PBL wrap-ups > Unit 7 Week 3: Birth > Flashcards

Unit 7 Week 3: Birth Flashcards

1
Q

symptoms 1st trimester of pregnancy, 1-12 weeks

A

fatigue
tender/swollen breasts
mood changes
fodo cravings
headaches
indigestion
need to urinate more
weight changes
constipation
nausea, sometimes with vomiting (morning sickness)

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2
Q

symptoms 2nd trimester, 13-28 weeks

A

abdomen expansion
stretch marks
areola darkens
skin on face may darken
ankles, face, fingers swell
itching
morning sickness may reduce or disappear

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3
Q

itching in second trimeter when to seek help q

A

if occurs with vomiting, yellowing of eyes or skin

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4
Q

symptoms of 3rd trimester
29-40 weeks

A

heartburn
shortness of breath
swelling of ankles face and fingers
insomnia
mood changes
leakage of milk from breasts
other breast/ nipple changes
frequent urination
haemorrhoids
Braxton hicks contractions, doesnt mean labour
real contractions, means labour

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5
Q

non pharmacological pain relief pregnancy

A

breathing techniques and exercises
water therapy
massages
acupuncture

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6
Q

acupuncture

A

thin needles to specific points of Body to manage pain

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7
Q

pharmacological options for pain management

A

gas and air
pethidine injections
epidurals

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8
Q

gas and air

A

mixture of oxygen and nitrous oxide gas
inhaled through mouthpiece
can relieve pain and anxiety
side effects: dizziness, nausea and vomiting

moa:
opioid peptide release to brain stem
activates noradrenergic neurons
modulation of nociceptive process in spinal cord

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9
Q

pethidine injections

A

type of opioid pain medication that can be given as an injection
binds to opioid receptors in the brain and spinal cords
can help to reduce pain
decreases pain for 2-4 hours
side effects: drowsiness, nausea and dizziness in mother and baby, may affect breastfeeding and cause respiratory depression in baby if given too close to deliver y

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10
Q

epidurals

A

regional anaesthesia that involves injecting numbing medication into the epidural space in lower back
help relieve pain in lower body management, one of the most effective pain management
side effects: drop in blood pressure, headache, difficulty urinating

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11
Q

inducing labour

A

is a chice
carried out in a maternity unit or birthing centre
elective labour induction= starting for convenience, no medical need
failed induction= another induction or C section

can take minutes to hours

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12
Q

when is labour induced

A

post term pregnancy
pre labour rupture of membranes
chorioamnionitis
fetal growth restriction
oligohydraminios
gestational diabetes
pre-eclampsia
placental abruption
certain medical conditions

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13
Q

post term pregnancy labour induction

A

1 to 2 weeks beyond the due date

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14
Q

pre labour rupture of membranes PROM labour induction

A

when labour doesn’t begin after waters have broken
hole in amniotic fluid allows fluid to drain

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15
Q

chorioamnionitis labour induction

A

infection in the uterus

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16
Q

fetal growth restriction labour induction

A

baby’s estimated weight is less than 10th percentile for gestational age

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17
Q

oligohydramnios labour induction

A

not enough amniotic fluid surrounding the baby

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18
Q

gestational diabetes labour induction

A

when diabetes develops during pregnancy

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19
Q

pre-eclampsia labour induction

A

developing high blood pressure in combination with signs of damage to organ system

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20
Q

placental abruption labour induction

A

when placenta peels away from inner wall of uterus before delivery

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21
Q

certain medical conditions labour induction

A

heart, lung, kidney disease
obesity

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22
Q

how is labour induced

A

ripen/ soften the cervix
prostaglandins by pessaries/ orally
catheter with inflatable saloon on end filled with saline inserted into cervix
membrane sweep: finger over crossing of amniotic sac, separates sac from cervix and lower uterine wall
amniotomy: rupture amniotic sac so water breaks
IV meds: oxytocin hormone to cause uterine contractions

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23
Q

vaginal pessaries

A

induce labour
tablet/ gel/ device inserted into vagina
contains prostaglandins to prime Cervix to stimulate contractions
before using: monitor the baby’s heart for 30 mins continuously
slow release: progress like a tampon stays in vagina for 24 hours and slowly releases hormones to ripen the cervix
side effects: nauseas, feverish, diarrhoea, sore vagina, pristine contractions, prolonged contraction
prostaglandin gel: given when cervix more favourable

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24
Q

problem with prolonged contractions

A

can affect baby’s heart rate

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25
Q

oxytocin injections

A

Rtocen
hormone produced by hypothalamus: helps start or sustain uterine contractions, reduces bleeding after birth and helps milk secretion
can be used to deliver the placenta: if it isn’tseparating, patient bleeding heavier than normal, patient has induction, epidural, assisted birth, c section
given IV/M
side effects: nausea, vomiting, rash, itching, swelling

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26
Q

antenatal appointments

A

in the 3rd trimester
update the patient history
offer exams and investigations (blood pressure and urine dipstick to test hypertension and pre-eclampsia)
plot symphysis-fundal height on graph
discuss the babies movements
advice not to sleep on back after 28 weeks
discuss and give information on prepping for labour and birth, recognising active labour, post natal periods, physical emotional and relationship changes, support and baby bonding
review bloods from other appointments
update antenatal records

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27
Q

why is it advised not to sleep on your back afte 28 weeks pregnant

A

still birth risk as supine positions causes uterus to put pressure on inferior vena can and abdominal aorta
reduced O2 ti placenta

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28
Q

further antenatal appointments

A
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29
Q

mat b1 form

A

confirms pregnant woman is expected week of childbirth EWC
and confirms pregnancy
usually around week 20 pregnant given to employer so employee can claim statutory maternity pay

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30
Q

mother post natal care before discharge

A

perineum inspection for trauma
pain management
vital signs: includes lochia assessment, uterine inoculation, uterine volume
mothers mental well-being

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31
Q

child post natal care before discharge

A

crying
skin to skin contact and breastfeeding
APGAR score
physical exam: eyes, heart, hips and testicles

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32
Q

6 weeks postnatal check up

A

physical symptoms
psychological symptoms
social problems
examination
sex and contraception
pelvic floor exercises

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33
Q

how should a baby present at birth if healthy

A

tongue and lips= pink
rest cyanosed/ blue as lower O2 sats in utero, when they take first few breaths will become well perfused

crying/ coughing
RR: 30-60
HR: 100-160
umbilical stays on (falls off in 1/52)
fontanelles
vernix
2/52 eyes following you
swelling/ head bruising
blood shot eyes
jaundice
sucking reflex

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34
Q

vernix

A

sticky white substance
fights infection

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35
Q

APGAR score

A
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36
Q

functional anatomy of the breast

A
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37
Q

six key hormones in pregnancy

A

HCG
progesterone
oestrogen
prolactin
relaxin
oxytocin

38
Q

HCG pregnancy

A

produced by placenta after implantation
support function of corpus leuteum
detected by pregnancy tests

39
Q

progesterone pregnancy

A

helps establish placenta
stimulates growth of blood vessels that support the womb
inhibits contraction of the uterus so it grows as baby does
strengthens pelvic wall muscles fo labour

40
Q

oestrogen pregnancy

A

helps uterus grow
maintains lining
helps foetal organs develop
activates and regulates production of other hormones
with progesterone will stimulate breast growth and milk duct development

41
Q

prolactin pregnancy

A

main hormone needed to produce breast milk
contributes to enlargement of mamamary glands and prepares them for milk production
inhibits lactation during pregnancy

42
Q

relaxin pregnancy

A

inhibits uterine contraction to prevent premature birth
relaxes blood vessels
increasing blood flow to placenta and kidneys
relaxes joints of pelvis and softens and length cervix during birth

43
Q

oxytocin pregnancy

A

rise at start of labour
stimulating contractions of uterine muscle
triggers production of prostaglandins
increase contractions further
if labour doesnt start naturally can be used to induce it

44
Q

lactogenesis

A

cellular changes by which mammary epithelial cell switches from growing non-secretory tissue to secretory non-growing tissue

45
Q

stage 1 lacotgenesis

A

breast development and colostrum production from 16 weeks gestation
differentiation of alveolar epithelial cells to lactocytes
secrete colostrum

46
Q

stage 2 lactogenesis

A

onset of increased milk secretion 32-96 hours post birth
in response to rise in prolactin
decrease in pregnancy hormones
milk will “come in” regardless

47
Q

stage 3 lactogenesis

A

maintenance of milk production approx 10 days post natal

48
Q

prolactin in breast feeding

A
49
Q

oxytocin in breast feeding

A
50
Q

breast milk composition

A
51
Q

prolactin receptor theory

A
52
Q

controlling lactation, feedback inhibitor of lactation role

A
53
Q

normal physiological changes to mother in pregnancy

A

cardiovascular
hematological
urinary
respiratory
gastorintestinal
dermatological
immune tolerance
endocrine

54
Q

cardiovascular normal physiological changes

A
55
Q

haematological normal physiological changes

A
56
Q

urinary normal physiological changes

A
57
Q

respiratory normal physiological changes

A
58
Q

gastrointestinal normal physiological changes

A
59
Q

dermatological normal physiological changes

A
60
Q

stages of labour

A
61
Q

stage 1 labour

A
62
Q

stage 2 Labour

A
63
Q

stage 3 labour

A
64
Q

initation of labour

A
65
Q

cervical ripening

A
66
Q

myometrial excitability

A
67
Q

oxytocin role in labour

A
68
Q

vaginal changes in labour

A

muscle layer thickens, more elastic= vaginal dilatation in 2nd phase of labour
number of squamous cells increases due to glycogen
does predispose to thrust

69
Q

stages of delivery

A

descent
engagement
neck flexion
internal rotation
crowing
extension of presenting part
restitution
external rotation
lateral flexion

70
Q

descent

A
71
Q

engagement

A
72
Q

flexion

A
73
Q

internal rotation

A
74
Q

Crowning

A
75
Q

extension of presenting part

A
76
Q

external rotation and restitution

A
77
Q

delivery of shoulders and body

A
78
Q

degrees of perineal tears

A

1st to 4th

79
Q

1st degree tear

A
80
Q

2nd degree tear

A
81
Q

3rd degree tear

A
82
Q

4th degree tear

A
83
Q

episiotomy

A
84
Q

support in labour

A

praise
reassurance
encouragement
eye contact
breathing
relaxation
massages
TENS machine

85
Q

different birthing

A

hypnobirthing
hydrotherapy
touch therapy
aromatherapy

86
Q

maternal bonding in utero

A
87
Q

how do babies bond

A
88
Q

factors that may affect bonding

A
89
Q

paternal bonding

A
90
Q

same sex parents and adoptive parents

A

Medicine: PBL wrap-ups (21 decks)

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