Chapter 32 Obstetric and Gynecologic Emergencies Flashcards

1
Q

Key Terms

spontaneous (miscarriage) or induced termination of pregnancy

A

Abortion

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2
Q

Key Terms

a condition in which the placenta separates from the uterine wall; a cause of prebirth bleeding

A

Abruptio Placentae

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3
Q

Key Terms

the placenta, membrane of the amniotic sac, part of the umbilical cord, and some tissues from the lining of the uterus that are delivered after the birth of the baby

A

Afterbirth

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4
Q

Key Terms

the “bag of waters” that surrounds the developing fetus

A

Amniotic Sac

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5
Q

Key Terms

irregular prelabor contractions of the uterus

A

Braxton-Hicks Contractions

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6
Q

Key Terms

when the baby’s buttocks or both legs appear first during birth

A

Breech Presentation

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7
Q

Key Terms

when the baby appears headfirst during birth. This is the normal presentation

A

Cephalic Presentation

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8
Q

Key Terms

the neck of the uterus at the entrance to the birth canal

A

Cervix

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9
Q

Key Terms

when part of the baby is visible through the vaginal opening

A

Crowning

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10
Q

Key Terms

a severe complication of pregnancy that produces seizures and coma

A

Eclampsia

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11
Q

Key Terms

when implantation of the fertilized egg is not in the body of the uterus, occurring instead in the fallopian tube (oviduct), cervix, or abdominopelvic cavity

A

Ectopic Pregnancy

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12
Q

Key Terms

the baby from fertilization to 8 weeks of development

A

Embryo

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13
Q

Key Terms

the narrow tube that connects the ovary to the uterus. Also called the “oviduct”

A

Fallopian Tube

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14
Q

Key Terms

the baby from 8 weeks of development to birth

A

Fetus

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15
Q

Key Terms

expulsion of a fetus as a result of deliberate actions taken to stop the pregnancy

A

Induced Abortion

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16
Q

Key Terms

soft tissues that protect the entrance to the vagina

A

Labia

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17
Q

Key Terms

the three stages of the delivery of a baby that begin with the contractions of the uterus and end with the expulsion of the placenta

A

Labor

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18
Q

Key Terms

the sensation of the fetus moving from high in the abdomen to low in the birth canal

A

Lightening

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19
Q

Key Terms

when an infant’s limb protrudes from the vagina before the appearance of any other body part

A

Limb Presentation

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20
Q

Key Terms

amniotic fluid that is greenish or brownish-yellow rather than clear as a result of fetal defecation; an indication of possible maternal or fetal distress during labor

A

Meconium Staining

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21
Q

Key Terms

spontaneous abortion

A

Miscarriage

22
Q

Key Terms

soft tissue that covers the pubic symphysis; area where hair grows when a woman reaches puberty

A

Mons Pubis

23
Q

Key Terms

when more than one baby is born during a single delivery

A

Multiple Birth

24
Q

Key Terms

a newly born infant or an infant less than one month old

A

Neonate

25
Q

Key Terms

the female reproductive organ that produces ova

A

Ovary

26
Q

Key Terms

the phase of the female reproductive cycle in which an ovum is released from the ovary

A

Ovulation

27
Q

Key Terms

the surface area between the vagina and anus

A

Perineum

28
Q

Key Terms

the organ of pregnancy where exchange of oxygen, nutrients, and wastes occurs between a mother and fetus

A

Placenta

29
Q

Key Terms

a condition in which the placenta is formed in an abnormal location (low in the uterus and close to or over the cervical opening) that will not allow for a normal delivery of the fetus; a cause of excessive prebirth bleeding

A

Placenta Previa

30
Q

Key Terms

a complication of pregnancy in which the woman retains large amounts of fluid and has hypertension. She may also experience seizures and/or coma during birth, which is very dangerous to the infant

A

Preeclampsia

31
Q

Key Terms

any newborn weighing less than 5.5 pounds or born before the 37th week of pregnancy

A

Premature Infant

32
Q

Key Terms

when the umbilical cord presents first and is squeezed between the vaginal wall and the baby’s head

A

Prolapsed Umbilical Cord

33
Q

Key Terms

when the fetus and placenta deliver before the 28th week of pregnancy; commonly called a “miscarriage”

A

Spontaneous Abortion

34
Q

Key Terms

born dead

A

Stillborn

35
Q

Key Terms

dizziness and a drop in blood pressure caused when the mother is in a supine position and the weight of the uterus, infant, placenta, and amniotic fluid compress the inferior vena cava, reducing return of blood to the heart and cardiac output

A

Supine Hypotensive Syndrome

36
Q

Key Terms

the fetal structure containing the blood vessels that carry blood to and from the placenta

A

Umbilical Cord

37
Q

Key Terms

the muscular abdominal organ where the fetus develops; the womb

A

Uterus

38
Q

Key Terms

the birth canal

A

Vagina

39
Q

Critical Decision Making

Childbirth in the field is a rare but very exciting call. For every baby you deliver, you may have dozens of maternity calls in which the mother is transported to the hospital before the baby is delivered. Being able to determine whether the birth is imminent is an important skill for an EMT. For each of the scenarios presented, determine if you should stay and prepare for delivery or transport the patient to the hospital.

Your patient states her contractions are severe and about 30 seconds apart. She feels the need to push and suspects she has accidentally moved her bowels. There is significant bulging, and you can see the baby’s head crowning. This is her fourth child.

A

This baby is coming—and quickly. Prepare for delivery at the scene.

40
Q

Critical Decision Making

Childbirth in the field is a rare but very exciting call. For every baby you deliver, you may have dozens of maternity calls in which the mother is transported to the hospital before the baby is delivered. Being able to determine whether the birth is imminent is an important skill for an EMT. For each of the scenarios presented, determine if you should stay and prepare for delivery or transport the patient to the hospital.

Your patient reports contractions are about 5-10 minutes apart but feel strong. This is her first child. You do not observe any crowning or bulging. She is not sure if her water has broken.

A

This baby will likely wait. Ask the mother about feeling the need to push and if she feels as if she must move her bowels. In the absence of either of these, you should make it to the hospital.

41
Q

Critical Decision Making

Childbirth in the field is a rare but very exciting call. For every baby you deliver, you may have dozens of maternity calls in which the mother is transported to the hospital before the baby is delivered. Being able to determine whether the birth is imminent is an important skill for an EMT. For each of the scenarios presented, determine if you should stay and prepare for delivery or transport the patient to the hospital.

Your patient reports contractions that are about 2 minutes apart. They have been this way for about 8 hours. Her water broke when the contractions started. She doesn’t feel she is progressing through labor and is concerned for her body.

A

Transport this patient. Since there has been no significant change over 8 hours and there are no signs of imminent delivery, transport is the correct decision.

42
Q

Short Answer

Name and describe the anatomical structures of a woman’s body that are associated with pregnancy.

A

The anatomical structures associated with pregnancy are:

  • The ovaries: produce the ova.
  • The fallopian tubes: transport the ova to the uterus and are the site of fertilization.
  • The uterus: the muscular structure that houses the fetus during pregnancy.
  • The placenta: the vascular organ that perfuses and nourishes the fetus during pregnancy.
  • The vagina: the birth canal.
43
Q

Short Answer

Describe the three stages of labor.

A

The three stages of labor are:

Stage 1: start of contractions to full dilation of the cervix.
Stage 2: full dilation of the cervix to birth of the fetus.
Stage 3: birth to expulsion of the placenta.

44
Q

Short Answer

Explain how to evaluate and to prepare the mother for delivery.

A

Prepare the mother for delivery by controlling the scene and the mother’s privacy. Ask bystanders to leave. In addition to gloves, put on a gown, cap, mask, and eye protection. Place the mother on the floor, elevate the buttocks with a blanket or pillow, and have the mother lie with her knees drawn up and spread apart. Use sterile sheets or towels to drape the area and position the obstetric kit within easy reach.

45
Q

Short Answer

Name, in the order of the inverted pyramid, the steps that may be taken to resuscitate a newly born infant.

A

To resuscitate a newly born infant, the baby should initially be dried, warmed, and stimulated. If that is not enough, administer supplemental oxygen. Positive pressure ventilation and chest compressions follow immediately if other initial measures are unsuccessful.

46
Q

Short Answer

Name and describe several possible complications of delivery.

A

Complications of delivery include breech presentations such as a food, hand, or buttocks presenting first. Prolapsed cord occurs when the umbilical cord presents prior to the baby. Placenta previa occurs when the placenta blocks the birth canal and can be harmed by the presenting fetus.

47
Q

Short Answer

Name and describe several possible predelivery emergencies.

A

Predelivery emergencies include eclampsia, where seizures occur, and placental abruptions, where the placenta prematurely detaches from the uterine wall, causing massive internal bleeding.

48
Q

Pathophysiology to Practice

How would you expect the vital signs to change in a late-term pregnant female as a result of the pregnancy?

A

Vital sign changes that occur with pregnancy include the following: respirations typically increases slightly, blood pressure drops slightly (but can be high), and pulse generally increases.

49
Q

Pathophysiology to Practice

How would the changes in pregnancy alter your ability to recognize shock?

A

Shock may be more difficult to recognize as vital signs that typically indicate compensation (fast pulse and increased respirations) may already be present under normal circumstances.

50
Q

Pathophysiology to Practice

How should you assess the severity of a vaginal bleed? Why should you assume the worst?

A

The severity of vaginal bleeding may be assessed by asking the patient how many pads she has needed to use. The chief concern with vaginal bleeding is not external hemorrhage, but rather the bleeding that is occurring internally.

51
Q

Pathophysiology to Practice

What are your priorities in assessing and treating a neonate?

A

The priorities of assessing and treating a neonate include maintaining warmth while assuring airway, breathing, and circulation.