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REPRO II Exam 2 > Dunn OB/GYN I > Flashcards

Dunn OB/GYN I Flashcards

(63 cards)

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1
Q

prenatal care recommendations

A

office visit at 8-10 weeks of pregnancy

every 4 weeks - first 28 weeks
every 2-3 weeks - 28-36 weeks
every week - after 36 weeks

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2
Q

goal of prenatal care

A

coordination of care for detected medical and psychosocial risk factor

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3
Q

postpartum care

A

on or between 21 days and 56 days after delivery

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4
Q

quad screen test

A

maternal blood screen

AFP
hCG
estriol
inhibinA

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5
Q

AFP

A

produced by fetus

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6
Q

hCG

A

produced by placenta

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7
Q

estriol

A

produced fetus and placenta

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8
Q

inhibin A

A

produced by placenta and ovaries

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9
Q

decreased AFP and estriol

increased beta-hCG and inhibin A

A

trisomy 21

ultrasound - nuchal translucency

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10
Q

most likely chromosomal disorder compatible with life

A

trisomy 21

life expectance 60yo

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11
Q

most common genetic cause of mental retardation

A

trisomy 21

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12
Q

flat facies, epicanthial folds, duodenal atresia, congenital heart defects, alzheimers and leukemia risk

A

trisomy 21

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13
Q

decreased AFP, beta-hCG, and estriol

increased inhibin A

A

trisomy 18

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14
Q

edwards syndrome

A

trisomy 18

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15
Q

severe mental retardation, rocker bottom feet, micrognathia, low set ears, clenched hands, prominent occiput

A

trisomy 18

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16
Q

life of trisomy 18

A

most 5 - 15 days

only 8 % live beyond year

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17
Q

trisomy 13

A

pataus syndrome

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18
Q

pataus syndrome

A

US nuchal tranlucency

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19
Q

normal quad scree, possible beta-hCG decreased

A

trisomy 13

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20
Q

mental retardation, rocker bottom feet, microcephaly, cleft lip, cleft palate, holoprosencephaly, polydactyly

A

trisomy 13

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21
Q

life of trisomy 13

A

50% babies live a week

5% live a year

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22
Q

risk of quad screen

A

no known risks or side effects

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23
Q

when to perform quad screen

A

16-18 week of pregnancy
-all should be offered

indications:

  • family hx
  • > 35yo
  • harmful med/drug use
  • diabetes and insulin **
  • viral infection
  • exposed high radiation
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24
Q

diabetes and insulin pregnant mother

A

indication for quad screen

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25
high levels of AFP
suggest neural tube defect -spina bifida or anencephaly most common reason for elevated AFP - inaccurate dating of pregnancyf
26
most common reason for elevated AFP
inaccurate dating of pregnancy
27
early gestation heart
sympathetic control as develops - responds to parasympathetic
28
fetal heart tracing
``` baseline rate baseline variability accelerations decelerations changes over time frequency/intensity of contractions ```
29
baseline FHR
HR during 2 minute segment | -minimum 2 minutes
30
bradycardia
FHR <110 not usually sign of compromise heart block, occiput posterior or transverse position
31
tachycardia
FHR >160 not sign of fetal distress maternal fever, fetal hypoxia, fetal anemia, amnionitis, fetal heart failure
32
baseline change
decrease or increase in HR lasting longer than 10 minutes
33
baseline variability
fluctuations in rate of more than 2 cycles per minute based on amplitude range
34
minimal variability
<5bpm
35
moderate variability
6-25bpm
36
marked
>25bpm
37
sinusoidal pattern
no variability smooth undulating pattern lasting at least 10 minutes with fixed period of 3-5 cycles per minute and amplitude of 5-15bpm
38
most significant intrapartum sign of fetal compromise
persistently minimal or absent FHR
39
decreased variability
``` fetal metabolic acidosis CNS depressants sleep cycles congenital anomalies fetal tachy betamethasone ```
40
acceleration
abrupt in crease in FHR above baseline -onset to peak acceleration <2min duration time from initial change in HR to time of return to baseline
41
accelerations <32 weeks
>10bpm above baseline for >10 seconds
42
accelerations >32 weeks
>15bpm above baseline for >15 seconds
43
prolonged accelerations
increase in HR lasts 2-10 minutes
44
absent accelerations for more than 80 minutes
increased infant morbidity
45
to induce accelerations
fetal scalp stimulation fail to respond - acidosis 50% chance
46
reactivity
increase of 15bpm above baseline for 15 seconds twice in 20 minute period** 34 weeks - 95% fetus reactive
47
episodic patterns deceleration
not associated with contractions
48
periodic patterns deceleration
associated with contractions
49
gradual
decrease and return to baseline from time of onset of dceleration to low point >30 seconds
50
abrupt
decrease in baseline of 15bpm with onset of decelerations to low point <30 seconds
51
early deceleration
decrease in FHR and onset of decelerations >30s low point occurs with peak of contraction
52
late deceleration
onset of deceleration to low point >30s occurs after beginning of contraction low point after peak of contraction
53
variable deceleration
abrupt decrease in FHR of >15bpm per minute measured from most recently determined baseline rate onset of deceleration to low point is 15s and <2 min
54
recurrent deceleration
occur with >50% of uterine contractions in any 20 minute segment
55
prolonged deceleration
decrease in FHR >15 bpm from mast recently determined baseline deceleartion >2 minutes but less than 10 minutes
56
deceleration causes
maternal hypotension, uterine hyperactivity, cord prolapse, cord compression, abruption, artifact, maternal seizure
57
umbilical cord compression
prolonged deceleration pelvic exam should be performed - to rule out umbilical cord prolapse or rapid descent of fetal head
58
late decelerations with preservation of beat to beat variability
mediated by arterial chemo receptors in mild hypoxia low O2 in feta blood - fetal vasoconstriction - HTN -HTN stimulate broreceptor - slow HR
59
late decelerations with no variability
hypoxia - lactic acid - suppress fetal nervous system -decreased variability myocardial depression - shallow decelerations
60
causes of late decelerations
uterine contractions, maternal hypotension, maternal hypoxemia reduced placental exchange
61
management of late decelerations
patient on side - less IVC compression discontinue oxytocin IV hydration scalp pH - >7.25 good
62
recurrent late decelerations
consideration of expeditious delivery unless reversible maternal condition - diabetic ketoacidosis, pneumonia
63
acceleration shoulders
partial cord occlusion

REPRO II Exam 2 (21 decks)

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