8/27 Lecture

Question 1

For post term pregnancies especially, what is an indirect measure of placenta function. Most important assessment for fetal well-being

Answer 1

BPP (biophysical profile)

Question 2

What does the BPP look at?

Answer 2

Fetal movement
Amniotic fluid
Fetal Tone
Fetal Breathing (diaphragm contracting)

Question 3

What is the first 6 weeks of post partum

Answer 3

Puerperium

Question 4

What is the vaginal discharge 14 days after giving birth?

Answer 4

Lochia

Question 5

If a women isn’t lactating when will ovulation return?

Answer 5

45 days

Question 6

If a women is lactating when will ovulation return?

Answer 6

6 months (189 days)

Question 7

What is the major reason women die from postpartum?

Answer 7

Post partum hemorrhage

Question 8

What are some etiology for peripertum cardiomyopthay?

Answer 8

inflammatory cytokines
myocarditis
abnormal immunity
genetic
hemodynaic factors

Question 9

What are some risks for peripartum cardiomyopathy?

Answer 9

>30 
multiparity
morbid obesity
multigravida 
maternal cocaine abuse

Question 10

What is the test for postpartum thyroiditis?

Answer 10

Antithyroid peroxidase antibody

Question 11

What is postpartum thyroiditis often misdiagnosed as?

Answer 11

Postpartum depression

Question 12

What is normal bleeding for a vaginal birth?

Answer 12

500 mL

Question 13

What is normal bleeding for a C-Section?

Answer 13

1,000 mL

Question 14

What does each 1% drop in HCT about equal?

Answer 14

100 mL blood loss

Question 15

What are some signs of postpartum hemorrhage?

Answer 15

Tachycardia
tachypnea
orthostatic changes
oliguria

Question 16

What is the biggest reason for postpartum hemorrhage?

Answer 16

Uterine atony

Question 17

What are some risk factors of uterine atony?

Answer 17

Over distention of utreus
augmented labor
protracted labor
C-section

Question 18

How do you treat uterine atony?

Answer 18

Empty bladder
Give uterotonic agents (pitocin)
Bimanual uterine massage
Surgical

Question 19

Another reason for postpartum hemorrhage, not as common, involved placenta.

Answer 19

Retained placenta

Question 20

What should you look at the placenta for?

Answer 20

Whole placenta

Look for incomplete separation of placenta

Question 21

How do you treat a retained placenta?

Answer 21

Manual removal

Question 22

When should you give prophylactic antibiotics?

Answer 22

After manual removal of the placenta

Question 23

When is a hematoma of the lower tract acceptable?

Answer 23

<5 cm and stable

treat with ice packs

Question 24

If a hematoma is >5 cm what do you do?

Answer 24

Incision and Drain

Question 25

When can uterine rupture happen?

Answer 25

Protracted/ arrest labor | Previous C/S incision or other surgical procedure

Question 26

A C-section in what section is more likely to result in uterine rupture?

Answer 26

Upper uterine section

Question 27

What puts a mom at risk for amniotic fluid embolism?

Answer 27

PROM

Question 28

What is the prevention of thrombophelbitis and DVT?

Answer 28

Have the mom move around or put compression hose on

Question 29

What is a Homan's sign?

Answer 29

Have them pull back their foot and will have calf pain

Question 30

If a women has a temp x 2 during first 10 days PP, tachy, dyspnea, malodorous Lochi, uterine tenderness what should you suspect?

Answer 30

Postpartum infection

Question 31

How do you treat urinary retention?

Answer 31

Catheterization

Question 32

What is a common post partum problem with the bladder?

Answer 32

Stress incontinence

Question 33

When does stress incontinence usually resolve?

Answer 33

12 weeks PP

Question 34

When does post partum depression occur?

Answer 34

8-20 weeks after | Anorexia, depressed, insomnia, loss of libido, cognitive issues/ lapses

Question 35

What is where women have anxiety, restless, manic w/ paranoia or delusions. Abnormal responses to family. Onset at 1st or 2nd week postpartum.

Answer 35

PP psychosis (need to be admitted)

Question 36

How long should women breast feed?

Answer 36

Exclusively for 1st 6 months | encourage for the first year

Question 37

How do you know a baby is getting enough food?

Answer 37

6-8 wet diapers per day

Question 38

How many times should you breast feed in 24 hours?

Answer 38

8-12 times

Question 39

What causes engorded breasts?

Answer 39

Baby not emptying the milk fully

Question 40

What is reddened/ painful breast, chills, malaise, body aches? caused by S. aureus

Answer 40

Puerperal mastitis

Question 41

How do you treat puerperal mastitis?

Answer 41

Warm soaks Analgesia check breast feeding technique antibiotics PRN

Question 42

What are some contraindications for breast feeding?

Answer 42

Illicit drug use untreated active TB, HIV/ AIDS Chemo Rx radioactive dyes/ contrast dyes