OB

Question 1

Definition of preterm delivery

Answer 1

Delivery after 20 but before 37 weeks

Question 2

Definition of preterm labor

Answer 2

Active uterine contractions with cervical change after 20 but before 37 weeks

Question 3

Incidence of pruritis with neuraxial opioids

Answer 3

60-80%

Question 4

Treatment of pruritis from neuraxial opioids

Answer 4

Nalbuphine > naloxone
Diphenhydramine doesn’t works, causes sedation
Maybe zofran or nsaids or propofol

Question 5

In pregnant or peripartum patients, when is the ideal time to have non-obstetric surgery

Answer 5

Second trimester, or 2-6 weeks after delivery

Question 6

Definition of miscarriage vs abortion

Answer 6

< 20 wks miscarriage

> 20 weeks abortion

Question 7

Where does pudendal nerve originate, what does it innervate, and what can a block be used for

Answer 7

S2-S4, clitoris, perineal muscles, labia, external anal sphincter, perineal skin, can block for second stage of labor

Question 8

Define stages of labor

Answer 8

1st (active and latent), 2nd, 3rd
Latent: onset of contractions to cervical change or regular q2-3 min ctxs.
Active: above to fully dilated
2nd: fully dilated to delivery of fetus
3rd: delivery of fetus to delivery of placenta

Question 9

Nerve roots involved in each stage of labor, organs innervated, and analgesic techniques

Answer 9

1st stage: T10-L1 via inferior hypogastric plexus, uterus and cervix.
Spinal, epidural, CSE, paracervical, remifentanyl
2nd stage: T12-L1, S2-S4 (pudendal), vaginal wall, perineum
Spinal, epidural, CSE, pudendal block

Question 10

What is paracervical block used for and what does it block

Answer 10

First stage of labor pain, blocks T10-L1, uterine innervation, doesn’t block vaginal wall or perineum, bad for second stage

Question 11

Drugs for reversal on nondepolarizing NMBs in pregnant patients?

Answer 11

Atropine and neostigmine - Gyco will not cross placenta and neostigmine will, causing fetal bradycardia. Atropine crosses and will prevent bradycardia