Labor and Delivery (Young)

Question 1

a term pregnancy is 40 weeks from …

Answer 1

last menstrual period

Question 2

viability is at ___ weeks

Answer 2

24 weeks

Question 3

pre term is at ___ weeks

Answer 3

37 weeks

Question 4

early term is at ___ weeks

Answer 4

37, 38

Question 5

term is at ___ weeks

Answer 5

39, 40

Question 6

post term is at ___ weeks

Answer 6

42

Question 7

goal of initial visit when pregnant?

Answer 7

screen, ID high risk factors, and anticipate problems

Question 8

what age is considered advanced or at high risk

Answer 8

35

*but really its 37

Question 9

What is monitored as the pregnancy progreses

Answer 9

diabetes, anemia, STD, weight gain, BP, GBS,

Question 10

how much weight should a women gain for a healthy pregnancy?

Answer 10

25-30 lbs (+5 for each additional fetus)

Question 11

is a form of malnutrition

Answer 11

obestiy

Question 12

What are the 9 essential aa? Where do we get them?

Answer 12

histidine, isoleucine, leucine, lysine, methionine, cysteine, phenylalanine, thyrosine, threonine, tryptophan, valine

meat, fish, soy

Question 13

What are the 3 types of HTN in pregnancy?

Answer 13

pre-existing
gestational
pre-eclampsia

Question 14

HTN med that should never be taken while preggers? why?

Answer 14

ACEi bc it causes malformation of organs during the first trimester

Question 15

2 characteristic findings in pre-eclampsia

Answer 15

htn and proteinuria (nephrotic syndrome)

Question 16

pre-eclampsia is only seen ____ weeks

Answer 16

after 20 weeks

Question 17

why “pre-“ eclampsia

Answer 17

eclampsia means convulsions so it is the syndrome before it gets to that point

Question 18

what is the Rh factor?

Answer 18

rhesus D Ag

Question 19

what is the significance of Rh factor and prenancy?

Answer 19

mom is Rh- and baby is Rh+ –> mom makes Ab to the fetal Ag –> mom become sensitized – > mom gets pregant with 2nd Rh+ babt –> she “rejects” pregnancy

Question 20

how is Rh factor “treated”

Answer 20

give mom rhogam shot… this is IgGs that coat fetal RBCs so that mom cannot see the Ag. given prior to birth (have 72 hrs where it is affected) when the blood can mix

Question 21

if you get gestational diabetes, do you have an increased risk to get DM later in life?

Answer 21

yes (40-50% do)

Question 22

is gestation diabetes like type I or II DM

Answer 22

type II = insulin independent

Question 23

what is the most important risk factor for gestational diabetes

Answer 23

obesity

Question 24

the alpha structure of hCG is very similar to the alpha structure of …

Answer 24

TSH and insulin

Question 25

when are the fetal organs surveyed for anatomic abnormalities

Answer 25

18-20 weeks (this is when they are big enough to see on ultrasound, even though they were developed at 12 weeks)

Question 26

what are the 3 things ultrasounds can give you info on

Answer 26

structure (where and how many) blood flow amniotic fluid volume

Question 27

what is the range for baseline fetal HR

Answer 27

110-160 BPM

Question 28

what is viability?

Answer 28

ability to live outside the uterus

Question 29

What is preterm vs pre-mature

Answer 29

an birth/delivery is pre-term and baby is pre-mature

Question 30

what 3 things signal the onset of labor

Answer 30

contractions, bleeding, and rupture of membranes

Question 31

what is the % of normal pregnancies?

Answer 31

75%

Question 32

what are the major complications of pregnancy

Answer 32

infection, preterm labor, pre-eclampsia, prior C.S, not vertex

Question 33

what are the phases of labor

Answer 33

latent = <4 cm dilated active (1st) = 4-10 cm dilated pushing (2nd) delivery of placents (3rd) **also can throw in transitional at 7-8 cm dilated

Question 34

what is the definition of labor

Answer 34

regular, phasic contractions sufficient to cause progressive dilation of the cervix

Question 35

why are uterine contractions phasic?

Answer 35

fetus is perfused during the uterine diastole

Question 36

what is the duration of each phase of labor?

Answer 36

latent has no limits active: friedman curve (1-2cm/hr) pushing: 3 hr or 2 hr placental delivery: 1 hr

Question 37

what are the 7 cardinal movements for delivery

Answer 37

``` engagement descent flexion internal rotation extension restitution (external rotation) expulsion ```

Question 38

how to determin if the placenta was delivered correctly

Answer 38

is it intact are there 3 vessels is there bleeding

Question 39

what can be lacerated during birth?

Answer 39

cervix, vaginal wall, perineum, vulva

Question 40

what are the degress of perineum lacerations

Answer 40

1st: skin only 2nd: defect in underlying tissue but NOT thru anal sphincter 3rd: into or through the sphincter 4th: defect of rectum

Question 41

What are the 2 toold for assisted vaginal delivery

Answer 41

forceps and vacuum

Question 42

term used for managin pre-term labor (it stops preterm labor)

Answer 42

tocolytic

Question 43

what is the C/S rate in the US

Answer 43

30-35%

Question 44

What are the complications for a vaginal birth after C/S

Answer 44

``` ruptured uterus (scar is weaker) repeat C/S ```

Question 45

can you have a vaginal birth after C/S

Answer 45

yes

Question 46

what are the risks assc with a C/S

Answer 46

bleeding, infections, intra-abd scarring, uterine rupture, placenta accreata (next pregnancy)