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EOR - Women's Health > Prenatal Care and Normal Pregnancy > Flashcards

Prenatal Care and Normal Pregnancy Flashcards

1
Q

normal APGAR range

A

7-10

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2
Q

APGAR score is recorded at _
and _ minutes after birth

A

1 and 5

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3
Q

an infant w. an APGAR score of _ to _ needs further eval and possible resuscitation

A

4-6

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4
Q

what does APGAR stand for

A

appearance
pulse
grimace
activity
respiration

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5
Q

normals for APGAR

A

a: 2 = active movement
p: 2 = pulse > 100
g: 2 = pulls away, sneeze
a: 2 = pink
r: 2 = crying

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6
Q

apgar score > _ = good
apgar score of _ indicates resuscitation

A

6
4

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7
Q

4 components of fetal position

A

size
attitude
lie
presentation

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8
Q

most critical component of fetal size

A

head size

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9
Q

_ disproportion is concerning for labor dystocia

A

cephalopelvic

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10
Q

what is macrosomia

A

birth weight > 90th %ile for gestational age or > 4500 g

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11
Q

macrosomia is associated w.

A

shoulder dystocia
birth injuries

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12
Q

what is fetal attitude

A

relationship of fetal parts to one another

i wish it were how bossy/spicy/feisty your fetus is

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13
Q

2 classifications of fetal attitude

A

fully flexed -> normal
not flexed

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14
Q

describe full flexion

A

chin on chest
rounded back
flexed arms/legs
smallest diameter of head presents at pelvic inlet

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15
Q

what is fetal lie

A

relationship of fetal cephalocaudal axis (spinal column) to maternal cephalocaudal axis

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16
Q

3 types of fetal lie

A

longitudinal -> ideal
transverse
oblique

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17
Q

fetal spine lies along maternal spine

A

longitudinal

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18
Q

fetal spine is perpendicular to maternal spine

A

transverse

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19
Q

fetal spine is at a slight angle to maternal spine

A

oblique

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20
Q

what is fetal presentation

A

fetal part that enters the pelvic inlet first

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21
Q

3 types of fetal presentation

A

cephalic
breech - bottom first
breech - shoulder first

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22
Q

3 types of cephalic fetal presentation

A

vertex
brow
face

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23
Q

mc type of cephalic presentation

A

vertex:
head completely fixed onto chest
occiput is presenting

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24
Q

-fetal head partially extended
-sinciput (frontal bone) is presenting part

A

brow presentation

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25
Q

-fetal head hyperextended
-fetal face from forehead to chin is presenting part

A

face presentation

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26
Q

-head up
-bottom, feet, knees present first

A

breech

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27
Q

what are the 4 types of breech

A

frank
complete
incomplete
shoulder

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28
Q

hips flexed
knees extended
bottom presents

A

frank breech

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29
Q

hips, knees flexed
bottom presents

A

complete breech

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30
Q

-one/both hips not completely flexed
-feet present

A

incomplete breech

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31
Q

-transverse lie
-shoulders present first

A

shoulder breech

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32
Q

prevalence of breech birth decreases w.

A

increasing gestational age

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33
Q

25% of fetuses under _ weeks old are breech

A

28

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34
Q

dx for breech presentation

A

PE
US if unclear

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35
Q

tx for breech presentation

A
  1. external cephalic version at or near term
  2. followed by trial of vaginal delivery if version is successful
  3. planned cesarean if persistent
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36
Q

24 yo G2P1 f in for 13 week office visit - fundal height and alpha fetoprotein are greater than expected for due date

A

multiple gestations

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37
Q

terms used for multiple births or the genetic relationship of their offspring

A

monozygotic
dizygotic
polyzygotic

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38
Q

multiple fetuses produced by the splitting of a single zygote

A

monozygotic (identical)

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39
Q

multiple fetuses produced by 2 zygotes

A

dizygotic (fraternal)

40
Q

multiple fetuses produced by 2 or more zygotes

A

polyzygotic

41
Q

3 clues for multiple gestation pregnancy

A

fundal height > than dates
extra fetal heart tones
elevated maternal AFP

42
Q

management of multiple gestation pregnancy

A

more frequent prenatal visits
diet
induction vs c section at > 34 weeks

43
Q

2 mc complication of multiple gestation pregnancy

A

spontaneous abortion
preterm birth

also:
preeclampsia
anemia

44
Q

fancy word for labor

A

parturition

45
Q

labor begins w. _
and ends w. _

A

uterine contractions
delivery of baby/placenta

46
Q

term delivery is between _ and _ weeks gestation

A

37-42

47
Q

_ is associated w. longer labor

A

nulliparas

48
Q

premonitory signs of labor

A

cervical changes:
remoderling of cervix
cervical softening
spontaneous rupture of membranes (ROM)

49
Q

what is the “blood show”

A

cervical softening -> expulsion of mucus plug -> pink tinged mucus

50
Q

false labor is associated w.

A

braxton hicks contractions

51
Q

describe true labor contractions (5)

A

regular
increase in frequency/duration/intensity
produce cervical changes
pain begins at lower back -> radiates to abdomen
pain not relieved w. ambulation

52
Q

decribe braxton hicks contractions (4)

A

irregular/intermittent
no cervical changes
pain in abdomen
walking relieves pain

53
Q

how many stages of labor are there

A

4

54
Q

first stage of labor begins w. _
and ends w. _

A

onset
full dilation (10 cm)

55
Q

3 stages of the first stage of labor including timeline

A

early: 8-12 hr
active: 3-5 hr
transition: 30 min -2 hr

56
Q

describe early/latent phase of labor

A

8-12 hr
contractions: q 5-30 min, 30 sec each
gradually increase
cervical dilation: 0-3 cm
effeacement: 0-30%
spontaneous ROM

57
Q

describe active phase of labor

A

3-5 hr
contractions: q 3-5 min, >/= 1 min each
cervical dilation: 3-7 cm
effacement: 80%
progressive fetal descent

58
Q

describe transition phase of labor

A

30 min - 2 hr
contractions: q 1.5-2 min, 60-90 sec each
cervical dilation: 7-10 cm
effacement: 100%

59
Q

second stage of labor lasts from _
to _

A

full dilation
birth of infant

60
Q

second stage is aka

A

pushing stage

61
Q

navigation of fetus thru maternal pelvis during the second stage of labor is dicatated by

A

3 p’s:
power
passenger
passage

62
Q

frequency, duration, and intensity of uterine contractions

A

power -> physiologic contractions

63
Q

physiology of uterine contractions involves
stimulation of the uterine _ and _ receptors (2)

A

myometrium
alpha and oxytocin

64
Q

stimulation of _ receptor stimulates uterine contractions

A

alpha

65
Q

steps of a uterine contraction

A
  1. wave begins in fundus and proceeds downward
  2. muscle shortens
  3. increment (build up)
  4. acme (peak)
  5. decrement (gradual letting up)
  6. fetal descent, effacement, dilation
66
Q

the amt of pressure exerted by uterine contractions (intrauterine pressure) is measured in

A

mmHg

67
Q

passenger portion of stage 2 of labor is affected by

A

fetal size, attitude, lie, presentation, breech

68
Q

4 types of pelvis

A

gynecoid
android
anthropoid
platypelloid

69
Q

-rounded pelvic inlet, midpelvis
-outlet capacity adequate
-optimal for vaginal delivery

A

gynecoid pelvis

70
Q

-heart shaped pelvic inlet
-decreased midpelvis diameters/outlet capacity
-associated w. labor dystocia

A

android pelvis

71
Q

-oval shaped pelvic inlet, midpelvis diameters
-outlet capacity adequate
-favorable for vaginal delivery

A

anthropoid pelvis

72
Q

-oval shaped pelvic inlet, decreased midpelvis diameters
-outlet capacity adequate
-not favorable for vaginal delivery

A

platypelloid pelvis

73
Q

which 2 types of pelvis are ideal/favorable for vaginal delivery

A

gynecoid
anthropoid

74
Q

mechanisms of labor are called _ movements

A

cardinal

75
Q

what are the 6 cardinal movements

A

descent
flexion
internal rotation
extension
restitution
expulsion

76
Q

presenting part reaches pelvic inlet (engagement) before onset of labor

A

descent

77
Q

fetal chin presses against chest, head meets resistance from pelvic floor

A

flexion

78
Q

fetal shoulders internally rotate 45 degrees, widest part of shoulders in line w. widest part of pelvic inlet

A

internal rotation

79
Q

fetal head passes under symphysis pubis and emerges from vagina

A

extension

80
Q

head externally rotates as shoulders pass thru pelvic outlet under symphysis pubis and turns to align with back

A

restitution

81
Q

anterior shouler slips under symphysis pubis, followed by posterior shoulder and rest of body - marks end of second stage of labor

A

expulsion

82
Q

third stage lasts from _
to _

A

delivery of infant to delivery of placenta

83
Q

what happens during the third stage of labor

A

-delivery of placenta, umbilical cord, fetal membranes
-uterus contracts firmly
-placenta begins to separate from uterine wall

84
Q

what happens during the fourth stage of labor

A

-physiological adaptation to blood loss
-initiation of uterine involution

85
Q

norma HR in newborn

A

120-160 bpm

86
Q

fetal monitoring marker of fetal distress

A

consistent decelerations after contractions

87
Q

2 types of fetal monitors
where is each one placed

A

external: maternal abdomen
internal: infant head

88
Q

4 types of fetal HR changes

A

accelerations
early decelerations
variable decelerations
late decelerations

89
Q

which type of fetal heart rate change is a normal response to fetal movement and is reassuring

A

accelerations

90
Q

benign fetal HR change that mirrors images of contractions and indicates fetal head compression

A

early decelerations

91
Q

-rapid FHR drop w. a return to baseline w. variable shape that indicates cord compression

A

variable decelerations

92
Q

t/f: variable decelerations can be benign if mild or mod

A

t!

worrisome if severe

93
Q

which fetal HR change is always worrisome

A

late decelerations

94
Q

describe late FHR decelerations

A

drop at the end of the contraction

95
Q

what do late FHR decelerations indicate

A

uteroplacental insufficiency

EOR - Women's Health (15 decks)

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