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