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REPRO II Exam 2 > Dunn OB/GYN I > Flashcards

Dunn OB/GYN I Flashcards

1
Q

prenatal care recommendations

A

office visit at 8-10 weeks of pregnancy

every 4 weeks - first 28 weeks
every 2-3 weeks - 28-36 weeks
every week - after 36 weeks

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2
Q

goal of prenatal care

A

coordination of care for detected medical and psychosocial risk factor

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3
Q

postpartum care

A

on or between 21 days and 56 days after delivery

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4
Q

quad screen test

A

maternal blood screen

AFP
hCG
estriol
inhibinA

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5
Q

AFP

A

produced by fetus

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6
Q

hCG

A

produced by placenta

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7
Q

estriol

A

produced fetus and placenta

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8
Q

inhibin A

A

produced by placenta and ovaries

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9
Q

decreased AFP and estriol

increased beta-hCG and inhibin A

A

trisomy 21

ultrasound - nuchal translucency

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10
Q

most likely chromosomal disorder compatible with life

A

trisomy 21

life expectance 60yo

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11
Q

most common genetic cause of mental retardation

A

trisomy 21

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12
Q

flat facies, epicanthial folds, duodenal atresia, congenital heart defects, alzheimers and leukemia risk

A

trisomy 21

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13
Q

decreased AFP, beta-hCG, and estriol

increased inhibin A

A

trisomy 18

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14
Q

edwards syndrome

A

trisomy 18

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15
Q

severe mental retardation, rocker bottom feet, micrognathia, low set ears, clenched hands, prominent occiput

A

trisomy 18

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16
Q

life of trisomy 18

A

most 5 - 15 days

only 8 % live beyond year

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17
Q

trisomy 13

A

pataus syndrome

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18
Q

pataus syndrome

A

US nuchal tranlucency

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19
Q

normal quad scree, possible beta-hCG decreased

A

trisomy 13

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20
Q

mental retardation, rocker bottom feet, microcephaly, cleft lip, cleft palate, holoprosencephaly, polydactyly

A

trisomy 13

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21
Q

life of trisomy 13

A

50% babies live a week

5% live a year

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22
Q

risk of quad screen

A

no known risks or side effects

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23
Q

when to perform quad screen

A

16-18 week of pregnancy
-all should be offered

indications:

  • family hx
  • > 35yo
  • harmful med/drug use
  • diabetes and insulin **
  • viral infection
  • exposed high radiation
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24
Q

diabetes and insulin pregnant mother

A

indication for quad screen

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25
Q

high levels of AFP

A

suggest neural tube defect
-spina bifida or anencephaly

most common reason for elevated AFP - inaccurate dating of pregnancyf

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26
Q

most common reason for elevated AFP

A

inaccurate dating of pregnancy

27
Q

early gestation heart

A

sympathetic control

as develops - responds to parasympathetic

28
Q

fetal heart tracing

A 
baseline rate
baseline variability
accelerations
decelerations
changes over time
frequency/intensity of contractions
29
Q

baseline FHR

A

HR during 2 minute segment

-minimum 2 minutes

30
Q

bradycardia

A

FHR <110

not usually sign of compromise

heart block, occiput posterior or transverse position

31
Q

tachycardia

A

FHR >160

not sign of fetal distress

maternal fever, fetal hypoxia, fetal anemia, amnionitis, fetal heart failure

32
Q

baseline change

A

decrease or increase in HR lasting longer than 10 minutes

33
Q

baseline variability

A

fluctuations in rate of more than 2 cycles per minute

based on amplitude range

34
Q

minimal variability

A

<5bpm

35
Q

moderate variability

A

6-25bpm

36
Q

marked

A

> 25bpm

37
Q

sinusoidal pattern

A

no variability

smooth undulating pattern lasting at least 10 minutes with fixed period of 3-5 cycles per minute and amplitude of 5-15bpm

38
Q

most significant intrapartum sign of fetal compromise

A

persistently minimal or absent FHR

39
Q

decreased variability

A 
fetal metabolic acidosis
CNS depressants
sleep cycles
congenital anomalies
fetal tachy
betamethasone
40
Q

acceleration

A

abrupt in crease in FHR above baseline
-onset to peak acceleration <2min duration

time from initial change in HR to time of return to baseline

41
Q

accelerations <32 weeks

A

> 10bpm above baseline for >10 seconds

42
Q

accelerations >32 weeks

A

> 15bpm above baseline for >15 seconds

43
Q

prolonged accelerations

A

increase in HR lasts 2-10 minutes

44
Q

absent accelerations for more than 80 minutes

A

increased infant morbidity

45
Q

to induce accelerations

A

fetal scalp stimulation

fail to respond - acidosis 50% chance

46
Q

reactivity

A

increase of 15bpm above baseline for 15 seconds

twice in 20 minute period**

34 weeks - 95% fetus reactive

47
Q

episodic patterns deceleration

A

not associated with contractions

48
Q

periodic patterns deceleration

A

associated with contractions

49
Q

gradual

A

decrease and return to baseline from time of onset of dceleration to low point >30 seconds

50
Q

abrupt

A

decrease in baseline of 15bpm with onset of decelerations to low point <30 seconds

51
Q

early deceleration

A

decrease in FHR and onset of decelerations >30s

low point occurs with peak of contraction

52
Q

late deceleration

A

onset of deceleration to low point >30s

occurs after beginning of contraction

low point after peak of contraction

53
Q

variable deceleration

A

abrupt decrease in FHR of >15bpm per minute measured from most recently determined baseline rate

onset of deceleration to low point is 15s and <2 min

54
Q

recurrent deceleration

A

occur with >50% of uterine contractions in any 20 minute segment

55
Q

prolonged deceleration

A

decrease in FHR >15 bpm from mast recently determined baseline

deceleartion >2 minutes but less than 10 minutes

56
Q

deceleration causes

A

maternal hypotension, uterine hyperactivity, cord prolapse, cord compression, abruption, artifact, maternal seizure

57
Q

umbilical cord compression

A

prolonged deceleration

pelvic exam should be performed - to rule out umbilical cord prolapse or rapid descent of fetal head

58
Q

late decelerations with preservation of beat to beat variability

A

mediated by arterial chemo receptors in mild hypoxia

low O2 in feta blood - fetal vasoconstriction - HTN
-HTN stimulate broreceptor - slow HR

59
Q

late decelerations with no variability

A

hypoxia - lactic acid - suppress fetal nervous system
-decreased variability

myocardial depression - shallow decelerations

60
Q

causes of late decelerations

A

uterine contractions, maternal hypotension, maternal hypoxemia

reduced placental exchange

61
Q

management of late decelerations

A

patient on side - less IVC compression
discontinue oxytocin
IV hydration
scalp pH - >7.25 good

62
Q

recurrent late decelerations

A

consideration of expeditious delivery

unless reversible maternal condition - diabetic ketoacidosis, pneumonia

63
Q

acceleration shoulders

A

partial cord occlusion

REPRO II Exam 2 (21 decks)

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