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Flashcards in L&D Postpartum - Hill Deck (19):
1

What kinds of variability are there for FHR monitoring?

1) minimal: 0-5 bpm
2) moderate: 6-25 bpm
3) maximal: > 25 bpm

2

What is the baseline HR for the fetus?

110-160 bpm

3

What is NIH Category I or "normal"?

1) predictive of normal acid-base balance
2) follow in a routine manner
3) must include ALL of the following:
a) baseline FHR 110-160
b) moderate variability (6-25)
c) No late or variable decels
d) early decels present or absent
e) accels present or absent

4

What is NIH category III "abnormal"?

1) predictive of abnormal acid-base status
2) requires prompt evaluation - prepare for delivery and intrauterine resuscitative measures

5

What are the criteria for NIH category III?

Must meet (1) or (2)
1) absent baseline FHR variability AND any
of the following:
a) recurrent late decels
b) recurrent variable decels
c) bradycardia
2) sinusoidal pattern for > 20 min

6

What are early decelerations?

1) gradual decrease in FHR
2) onset to nadir > 30 seconds
3) Nadir occurs with peak contraction

7

What causes early decels?

head compression

8

What causes variable decels?

cord compression

9

What are variable decelerations?

1) abrupt decrease in FHR of > 15 bpm
2) onset to nadir < 30 sec
3) lasts > 15 sec and > 2 min

10

What causes late decels?

Placental Insufficiency

11

What are late decelerations?

1) gradual decrease in FHR
2) onset to nadir > 30 sec
3) onset after start of contractions
4) FHR returns to baseline after ctxn ended

12

What are the different pelvic shapes and which are good for delivery?

1) Gynecoid - circle - good
2) platypelloid - flat oval - good
3) anthropoid - tall oval - bad
4) android - heart - bad

13

What are the changes in position for the baby during delivery?

1) engagement
2) descent
3) flexion
4) internal rotation
5) extension
6) external rotation
7) restitution

14

What makes up the first stage of the labor curve?

A) latent labor
B) acceleration
C) maximum slope
D) deceleration

15

What makes up the second stage of the labor curve?

E) after fully dilated

16

What is the third stage of the labor curve?

from delivery of fetus to delivery of placenta

17

When do you treat for GBS?

1) GBS+ from vagina or rectum
2) positive history of birth of infant with early onset GBS disease
3) GBS bacteriuria in current pregnancy
4) GBS unknown AND
a) intrapartum fever OR
b) preterm labor OR
c) prolonged rupture of membranes
> 18 hours

18

What would you use broad spectrum intrapartum antibiotics for?

The treatment (not prophylaxis) of the febrile woman in labor with clinical etiology of chorioamnionitis

19

What is chorioamnionitis?

1) maternal temp > 38 C (+ ONE of...)
a) fetal tachycardia
b) maternal tachycardia
c) abdominal tenderness
d) foul smelling AF
e) +AF cx = fold standard