Day 15 - Ob4 Quiz Flashcards Preview

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Flashcards in Day 15 - Ob4 Quiz Deck (13):

Mgt breech presentation > 36 wks GA

Offer external cephalic version


Definition of postpartum hemorrhage

Loss of at least 500 mL w/ vaginal; Loss at least 1 L w/ C-section


Tx woman not wish to breastfeed after pregnancy

Ice packs, tight fitting bras, avoidance of nipple stimulation, analgesia; OCPs, bromocriptine


Postpartum female p/w pain and tenderness of breasts, limited to one region, no redness or warmth



When can OCPs be administered in postpartum pts who do not wish to breastfeed

Wait at least 6 wks before OCPs (Risk of DVT)


Within immediate postpartum, pt develops sudden onset hypoxia, cardiogenic shock, DIC

Amniotic fluid emobolism (during labor or immediate postpartum, within 48 hrs of labor)


Pt loses more than 500 cc postpartum of blood & now has anemia, attempts at breastfeeding unsuccessful, as it appears she's unable to generate any milk

Sheehan's syndrome (pituitary infarction, absence of prolactin)


Meds used to control postpartum hemorrhage

Uterine massage; Oxytocin; Methergine (ergot), Hemabate (carbaprost tromethamine?, prostaglandin F2alpha); Surgical options


Definition of prolonged latent phase

Labor not progress to active phase after 20 hrs in nulliparous; or after 14 hrs in multiparous


Definition of prolonged active phase

Active phase > 12 hr; Nulliparous not dilating by 1.2 cm per hr, Multiparous pt not dilating by > 1.5 cm per hr


Tx prolonged latent or active phase

3 P's (passage, passenger, power?) - Augment power; If still not working, C-section


Definition of arrest of descent

Epidural: Multip should not take longer than 2 hr in stage 2, Primip not take longer than 3 hr in stage 2; 1 hr less for ea w/ general (i.e., no epidural)


First steps mgt in fetal hyperstimulation or non-reassuring fetal heart tones

Maternal O2; Remove uterine stimulating (oxytocin or dinoprostone=cervadil); Left lateral decubitus; Increase monitoring (fetal scalp electrode, IUPC)

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