Lacerations, labor, and delivery Flashcards Preview

Repro II > Lacerations, labor, and delivery > Flashcards

Flashcards in Lacerations, labor, and delivery Deck (25):
1

1st degree tears

least severe
only skin around vaginal opeing
mild burning with urination
heal on their own in a few weeks

2

2nd degree tears

vaginal tissue and perineal mm
the mm btwn vagina and ansu that help support uterus, bladder, and rectum
typically require closure, but heal with in a few weeks

3

3rd degree tear

involve post vaginal tissues, perineal mm, and capsule of anal spinchter

4

4th degree tears

most severe
perineal mm and anal sphincter
tissue lining rectum
surgical repair
complications include fecal incontinence and painful intercourse

5

breastfeeding

bonding
nutrition
immunity
benefits mothers health
benefits society

6

30-50% of maternal deaths is d/t what

labor difficulties

7

morbidity in survivors of complicated delivery

fistulas
anaemia
infertility

8

antenatal risk factors

young and old nulliparas
short
previous difficult birth
previous c-section
previous stillbirth or neonatal death
multiple pregnancy
nutritional deficiency, severe anaemia
LGA
obvious pelvic deformity
malpresentation
high parity

9

when should you induce labor

41+ wks
w/in 96hrs of ruptured membranes at term
preeclampsia at term
maternal DM or GD at term
IUGR at term
macrosomia ?
multiple pregnancy?
previous precipitate delivery?
unstable lie?
cholestasis of pregnancy?

10

how to induce labor for ruptured membranes

oxytocin by IV infusion
or vaginal PGs

11

to induce labor in other pts

vag PGs
amniotomy wtih oxy infusion 3-12 hours later

12

who do you NOT use PGs in

previous C-section pt

13

oxy infusion

single standard dilution in NS
IV by infusion pump
1-2 mU/min
increase at 30 min intervals
review at 16-20mU/min
discontinue after 5 units
monitor fetus

14

evaluate Ps

powers
pasenger, presentation, position
passages
psychology

15

powers

uterine contractions
oxy augmentation?

16

passenger, presentation, and position

estimating fetal weight
beware the multipara

17

passages

is labor obstructed?

18

psychology

pain relief
hydration

19

who should NOT push

cardiac disease
aneurisms

20

what is more likely with vag birth

perineal pain
urinary incontinence
uterovaginal prolapse

21

more likely with c-section

longer hospital stay
ICU
death
bladder or ureter damage
hyseterectomy
thromboembolism
placenta previa in next prego
still birth in next prego
placenta accreta

22

passive second stage

from time of full dilatio to commencement of involuntary expulsive effort

23

active second stage

commencement of expulsive effort
plus
symptoms of full dilation or baby visible

24

length of second stage for nullipara

2.5hrs w/o epi
3hrs w/epi

25

length of second stage for parous pt

1hr w/o epi
2hr w/epi