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Women's health trigger > Labor Trigger > Flashcards

Labor Trigger Flashcards

1
Q

if there is risk of hypoxia to mother and fetus, what type of anesthesia is used for delivery

A

general anesthesia

used in any emergent event as well as in the risk of materla aspiration or maternal/fetal hypoxia

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2
Q

what is fetal attitude

A

the degree of flexion or extension of the fetal head

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3
Q

what fetal positioning indicates immediately switching from vaginal birth to c section

A

funic

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4
Q

what 4 things can be determined from teh leopold maneuver

A
  • fetal lie
  • estimation of fetal weight
  • fetal positioning
  • fetal presentation
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5
Q

what pelvic shape is ideal for delivering babies

A

gynecoid

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6
Q

what are the complications of episiotomy

A
  • increase vaginal bleeding
  • increased postpartum pain
  • unsatisfactory anatomic results
  • sexual dysfunction
  • increase risk of infection
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7
Q

what are the two types of episiotomy

A

midline and mediolateral

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8
Q

what are the complications of shoulder dystocia

A
  • fracture of humerus and clavicle
  • brachial plexus injury
  • phrenic nerve palsy
  • hypoxic brain injury
  • death
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9
Q

what is the management for shoulder dystocia

A
  • call for help
  • episiotomy
  • “McRoberts Maneuver” sharp flexion of maternal hips
  • suprapubic pressure
  • delivery of posterior shoulder
  • symphisiotomy
  • “zavanelli” (replace infants head back into pelvis and do a c section)
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10
Q

what is the typical time from fetal delivery to the delivery of the placenta

A

30 minutes

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11
Q

How is the placenta delivered

A

one hand on umbilical cord with gentle downward traction
other hand on abdomen supporting uterine fundus

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12
Q

what is the biggest risk factor for aggressive traction during delivery of the placena

A

uterine inversion

Obstetrical emergency!!!
immediate replacement of the fundus must be done manually or surgically!

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13
Q

what are causes for postpartum hemorrhage

A
  • uterine atony (MCC)
  • retained placental fragments
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14
Q

what is the treatment for postpartum hemorrhage

A
  • removal of placental fragments or repair of lacerations
  • Additional IV access
  • type and cross match for blood
  • meds for uterine atony (pitocin, methergine, cytotec, hemabate)
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15
Q

what is fetal HR baseline

A

mean bpm over a 10 minute window

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16
Q

what is considered absent, minimal, moderate and marked fetal HR variability

A

absent - 0 bpm of variation (worry)
minimal 1-5 bpm of variation (sleeping/inactive)
moderate 5-25 bpm variation
marked >24 bpm variation (worry)

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17
Q

this describes length of cervix (thickness/difference between internal and external os)

A

effacement

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18
Q

this describes Degree of descent of presenting part of fetus (cm from ischial spine, measured in 3rds)

A

station

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19
Q

contractions in the absence of what indicates braxton hicks contractions

A

in the absence of cervical change

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20
Q

what are the 5 categories of the bishop score?

A

Dilation
effacement
station
cervical consistency
position of cervix

21
Q

ferning, nitrazine, cervical leakage, and AFI are all ways to assess what?

A

membrane status during labor

22
Q

Contraindications include maternal bleeding disorder or use of LMWH within the past 12 hours

A

epidural

23
Q

complications include maternal hypotension and respiratory depression

A

epidural

also spinal HA!!

24
Q

what anesthetic type would be likely used in a C section

A

spinal anesthesia

25
Q

this causes dissolution of collagen bundles and increases water uptake

A

cervidil (PGE1) and cytotex (PGE2)

26
Q

SE of this are fever, V/D

A

cervidil (PGE1) and cytotex (PGE2)

also tachysystole and uterine rupture.

27
Q

CI of this are hx of c section, myomectomy, or hysterotomy

A

cervidil (PGE1) and cytotex (PGE2)

28
Q

SE includes hypotension, hyponatremia, and amniotic fluid rupture

A

pitocin

also tachysystole and uterine rupture

29
Q

the CI to this are fetal distress and hypersensitivity reactions

A

pitocin

30
Q

the 3 Ps effect which phase of labor

A

active phase of stage one of labor

31
Q

what does external tocodynamometry measure

A

uterine contraction force (can also be measured w IUCP)

31
Q

cranial bones getting compressed temporarily to the pelvis is known as what

A

molding

31
Q

localized edema on the scalp due to cervix is known as what

A

caput

32
Q

If a mom delivers a baby and she suffers a tear through her external anal sphincter, what degree of tear is it?

A

1st degree: injury to perineal skin and vaginal mucosa only
2nd degree: Injury to perineal body
3rd degree: Injury through external anal sphincter
4th degree: Injury through rectal mucosa

33
Q

what positioning is used when attempting to deliver a baby with shoulder dystocia

A

mcroberts position

34
Q

Passage of widest diameter fetal part below plane of pelvic inlet

which part of labor

A

engagament

35
Q

what is the smallest diameter of a babies head

A

suboccipitobregmatic diameter

36
Q

Fetal head rotates from occiput transverse to occiput anterior or posterior

what portion of the labor process is this

A

internal rotation

37
Q

what type of movement must be performed to aid in the final expulsion of the fetus

A

downward traction to release the shoulder

38
Q

Fundus becoming globular and more anteverted against abdominal hand is a sign of what

A

the 3rd stage of labor

39
Q

if a mother is 28 weeks pregnant, how high and how long are fetal HR accelerations expected to be?

A

> 32 weeks = 15 BPM for 15s
< 32 weeks = 10 BPM for 10s

40
Q

these occur during labor and are considered a vasovagal response of the fetus to head compression

A

early decelerations (occuring at the same time as contractions)

no intervention needed-> normal4

41
Q

these occur during labor as a result of uteroplacental insufficiency

A

late decelerations (beginning at peak of contraction)

requires positioning, O2, stop pitocin and fluid bolus. consider c section

42
Q

these occur during labor and are considered a result of cord compression

A

variable decelerations

occur at anytime, consider intervention via amnioinfusion (NS into sac via IUPC)

43
Q

what suggests fetal anemia on IUCP

A

sinusoidal waveform (Smooth sine wave)

44
Q

if a patient has early decelerations, normal FHR and accelerations of 15 bpm, what FHR tracing category.

A

category 1

45
Q

if a patient has recurrent variable decelerations, absent FHR variability what FHR tracing category.

A

category 3

46
Q

if a patient has early decelerations, normal FHR and accelerations of 29 bpm, what FHR tracing category.

A

category 2

47
Q

Evaluate fetal response via pitocin to achieve 3 contractions in 10 minutes.

what is this process called

A

contraction stress test

Women's health trigger (23 decks)

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