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Flashcards in OB Deck (42):
1

Nullipara

had no deliveries

2

nullgravida

never pregnant

3

Primipara

one delivery

4

Multipara

multiple deliveries

5

Grand multipara

> 5 births; more likely to have complications

6

TPAL

T= term (>/= 37 wks)
P= preterm (

7

G3 P 0202

3rd pregnancy
0 term babies
2 preterm babies
0 abortions
2 living

8

Gravidity

current or completed pregnancies

9

cutpoint for abortions in TPAL

> 2

10

G = ?

T+P+A

11

What do you do with adoptions?

some ppl add them into L

12

Term vs preterm

37 weeks

i.e. 36 wks 6 days still preterm

13

G5 P2110

5 pregnancies
2 terms
1 preterm
1 abortion
0 living

14

Braxton-Hicks contractions

False Labor
- may be present first trimester
- irregular, nonrhythmic-- cervix not changing
- Some ppl get them, some don't

15

3 things to ask every pregnant woman

bleeding, contractions, leaking fluid

+ baby moving?

16

True Labor

Regular contractions with cervical change

17

2 main hormones

Prostaglandins
Oxytocin

18

What do prostaglandins do

make cervix soft

19

what does oxytocin do

from posterior pituitary and helps with uterine contractions

20

3 Stages of labor

Stage I: 2 phases (latent vs active) - cervix dilating
Stage II: from when 10 cm to when baby is out
Stage III: from when baby is out until placenta delivered

21

Latent Phase

NOW 0-6 cm but used to be 0-4
SLOW

22

Active Phase

Officially starts at 6 cm
FAST

23

What is effacement vs dilation

Dilation = enlargening cervix
Effacement = thinning of cervix

In woman with first pregnancy will effacement first then dilate
Multiparous- usually dilate then efface

24

Laboring down

way for mom to get uterus to move baby down naturally to get ready for birth

25

Cardinal movements

- Engagement, descent, flexion
- Internal rotation
- Complete rotation with beginning of excision
- Complete extension (restitution)
- Deliver anterior shoulder

26

signs of Third stage of labor

uterus becomes firmer, gush of blood, uterus rises in abdomen as placenta passes into lower segment, lengthening of umbilical cord
- usually takes a half an hr

27

Lacerations classifications

1st degree: tears into vaginal mucosa/skin
2nd deg: into submucosa and can involve muscles of perineal body
3rd deg: involves anal sphincter
4th: involves rectal mucosa

28

3 Factors of labor

Passage (bony pelvis, soft tissue)
Power
Passenger

29

Caldwell-Moloy Classification

Classifies pelvic shape
- Gynecoid most common
- Anthropoid more common in African American (taller, not wider)

30

Assessment of Mid-pelvis

Feel for ischial spines

31

Big reason babies get stuck

not coming through the canal in the right way

32

What to consider on fetal heads

Bones in face fused but movable bones
Sutures
Fontanelle- spaces between bones

33

5 terms for describing baby in mom

- Fetal Lie- axis of mom to axis of baby (longitudinal vs transverse)
- Fetal Presentation **: what is presenting to cervix first
- Attitiude
Fetal Station**
Fetal position

34

Fetal presentation types

Cephalic/Vertex
Breech
Transverse
Compound - 2 things coming out at a time
Face
Brow

35

Types of Breech

- Complete (crossing legs)
- incomplete (partial up/down)
- Frank (Feet up by head)

36

How to diagnose fetal presentation

Abdominal palpation (Leopold's Maneuvers)
Vaginal Examination
Auscultation (where is heart beat? high = breech)
Sonography

37

Fetal attitude

Degree of flexion a fetus assumes during labor

- Flexed,
- sinciput/military
- brow
- face

38

Station

relationship of part of baby presenting to ischial spine levels

(-5 to +5); ischial spines = 0
+5 = crowning and about to deliver

39

Fetal Position

relation of arbirarily chosen portion of fetal presenting part to right or left side of maternal birth canal

Reference points:
- fetal occiput :babies coming head first
- Fetal chin (mentum): face first babies
- Fetal sacrum: breech babies

40

OP vs OA

occiput posterior vs anterior compared to mom

most of time babies face posterior = occiput anterior
- everything relative to mom

41

What parameters can you change in shock

1. CO (heart rate---children more HR dependent;
SV- increase preload, contractility, alter afterload

2. CAO2- Increase oxygenation

42

first thing to give in shock

isotonic fliud

Saline, surgeons may be like LR