CNM Purple Big Book: Pregnancy Flashcards Preview

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Flashcards in CNM Purple Big Book: Pregnancy Deck (18):
1

Indomethacin for polyhydramnios

Impairs production of lung liquid, increases fluid movement through fetal membranes or decreases fetal urine production

2

etiology of polyhodramnios

CNS or GI tract anomalies (anencephaly, atresia)

3

probable signs of pregnancy

Enlargement of abdomen
Enlargement of uterus
Palpation of fetal outline
Ballottement
change in the shape of the uterus
Piskacek's sign
Hegar's sign
Goodell's sign
Palpation of Braxton Hicks
+pregnancy test

4

Accuracy of USG by trimester

3-5 days in first trimester
7-10 days in second trimester
14-21 days in third trimester

5

why can pregnancy be considered a hypercoagulable state?

Because fibrinogen (Factor I) and Factors VII-X increase during pregnancy

6

diagonal conjugate

should be more than 11.5

7

interspinous diameter

distance between ischial spines, normally 10 cm; is midplane

8

intertuberous diameter

11 cm

9

Morning sickness rx

Pyridoxine (vit B6): 25 mg PO BID or TID
Doxylamine 12.5 mg PO BID or QID w B6
Metoclopramide 5-10 mg PO q6-8 hr
Promethazine 25 mg q4h per rectal suppository

10

indications for NST

decreased fetal movement
postdates
DM, HTN, IUGR

11

Contraction Stress Test

acceptable: 3 ctxn lasting 40-60 sec & palpable
Results: Negative: no late or variable decels (good)
Equivocal/suspictious: non-repetitive or nonnpersistect decels, or long-term variability is absent
Positive: persistent late decels with 50%+ of ctxns

12

c/i to CST

Absolute: previous classical c/s or myomectomy, placenta previa, at risk for preterm labor
Relative: GA <37 wks, multiple gestation

13

BPP scoring

Breathing movement (1/+ episodes in 30 min)
Body movement (3/+ episodes in 30 min)
Tone (1/+ extension/flexion in 30 min)
Qualitative AFV: at lest one pocket of fluid at least 2 cm in 2 perpendicular planes
Reactivity (reactive NST)
8-10 is normal if absence of oligo
6 is equivocal; repeat testing
4 or less considered abnormal

14

L/S ratio for lung maturity

ratio of 2:1 or greater is indicative of fetal lung maturity except in diabetes

15

phosphatidylglyceral (PG)

appears after 35 wks when lungs are mature; along with favorable L/S ratio, confirms lung maturity;
If PG present even with L/S ratio <2, risk of RDS is minimal

16

Shake test

Amniotic fluid shaken in tube with saline and 95% ethanol for 15 sec. complete ring of bubbles on surface = fetal lung maturity
Low false positive rate
High false negative rate

17

Sensitized pregnancy: Rh neg mother with posiitve antibody titer

>1:4

18

Tx of residual iron depletion after blood loss (Hbg 7 or higher)

oral iron x 3 months as long as woman is afebrile and able to ambulate