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Flashcards in Labor and Delivery (Young) Deck (46):
1

a term pregnancy is 40 weeks from ...

last menstrual period

2

viability is at ___ weeks

24 weeks

3

pre term is at ___ weeks

37 weeks

4

early term is at ___ weeks

37, 38

5

term is at ___ weeks

39, 40

6

post term is at ___ weeks

42

7

goal of initial visit when pregnant?

screen, ID high risk factors, and anticipate problems

8

what age is considered advanced or at high risk

35
*but really its 37

9

What is monitored as the pregnancy progreses

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

10

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

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

11

is a form of malnutrition

obestiy

12

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

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

meat, fish, soy

13

What are the 3 types of HTN in pregnancy?

pre-existing
gestational
pre-eclampsia

14

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

ACEi bc it causes malformation of organs during the first trimester

15

2 characteristic findings in pre-eclampsia

htn and proteinuria (nephrotic syndrome)

16

pre-eclampsia is only seen ____ weeks

after 20 weeks

17

why "pre-" eclampsia

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

18

what is the Rh factor?

rhesus D Ag

19

what is the significance of Rh factor and prenancy?

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

20

how is Rh factor "treated"

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

21

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

yes (40-50% do)

22

is gestation diabetes like type I or II DM

type II = insulin independent

23

what is the most important risk factor for gestational diabetes

obesity

24

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

TSH and insulin

25

when are the fetal organs surveyed for anatomic abnormalities

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

26

what are the 3 things ultrasounds can give you info on

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

27

what is the range for baseline fetal HR

110-160 BPM

28

what is viability?

ability to live outside the uterus

29

What is preterm vs pre-mature

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

30

what 3 things signal the onset of labor

contractions, bleeding, and rupture of membranes

31

what is the % of normal pregnancies?

75%

32

what are the major complications of pregnancy

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

33

what are the phases of labor

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

34

what is the definition of labor

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

35

why are uterine contractions phasic?

fetus is perfused during the uterine diastole

36

what is the duration of each phase of labor?

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

37

what are the 7 cardinal movements for delivery

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

38

how to determin if the placenta was delivered correctly

is it intact
are there 3 vessels
is there bleeding

39

what can be lacerated during birth?

cervix, vaginal wall, perineum, vulva

40

what are the degress of perineum lacerations

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

41

What are the 2 toold for assisted vaginal delivery

forceps and vacuum

42

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

tocolytic

43

what is the C/S rate in the US

30-35%

44

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

ruptured uterus (scar is weaker)
repeat C/S

45

can you have a vaginal birth after C/S

yes

46

what are the risks assc with a C/S

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