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OBGYN Flashcards

(60 cards)

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1
Q

Perineum

A

Skin between anus and vagina that may tear during childbirth.

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2
Q

Urethra

A

Opening to urinary tract.

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3
Q

Labia Majora

A

External skin of female genitalia.

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4
Q

Labia Menora

A

Internal mucosal skin of female genitalia.

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5
Q

Vagina

A

Opening into the cervix.

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6
Q

Cervix

A

Narrow opening in uterus from vagina.

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7
Q

Ovaries

A

Produce estrogen, ova, and hCG hormone in pregnancy.

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8
Q

Menstrual Cycle

A

Menstrual Phase: 1-4 (shed lining)
Follicular: 5-13 (thickening, ovum matures)
Ovulation: 14 (ovum release)
Luteal: 15-26 (egg leaves fallopian tube)
Ischemic: 27-28 (blood flow to uterine wall slows)

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9
Q

Menarche

A

Age of first menstruation (8-16)

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10
Q

Pregnancy Full Term

A

280 days (40 weeks)
39 weeks to 40 weeks & 6 days
Three trimesters

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11
Q

Late Term

A

41 weeks through 6 days later

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12
Q

Post Term

A

After 42 weeks

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13
Q

Early Term

A

37 weeks through 38 weeks and 6 days

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14
Q

Stages of Labor

A

1) Dilation (first pregnancy 16 hrs, 7-8 second)
2) Expulsion
3) Placental

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15
Q

Dilation

A

First contraction to full dilation of cervix.
“Bloody show” - mucous plug breakdown
Rupture of amniotic sac.
Contractions increase in frequency and intensity.

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16
Q

Expulsion

A

Full cervical dilation to delivery.
Urge to push.
Crowning.
Perineum may tear.

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17
Q

Placental

A

Delivery to Placental expulsion.
Placenta delivered 5 to 20 min after
Gush of blood, uterus smaller, umbilical cord exits.
Urge to push.

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18
Q

Changes in Pregnancy

A

At risk for bleeding and uterus displaced from pelvis.

RR increases 2nd trimester
Reduced ability to compensate
HR increases up to 20%, more blood produced.
Weight gain.

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19
Q

Index of Suspicion: Pregnancy

A

Female of childbearing age.
Appears pregnant.

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20
Q

Imminent Labor Questions

A

Do after ABCDs

1) Has water broken? If so when and was there any color to it?
2) Do you have contractions? If so, how far apart and for how long?
3) Do you feel a need to push?

If yes to any perform a genital exam.

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21
Q

History: Pregnancy

A

1) Last menstrual period or how far along?
2) Gravida (total number of pregnancies) Para (Deliveries after 20 weeks pregnancy) Abortus (number of miscarriages or abortions)
3) Taking any prenatal care?

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22
Q

Transport

A

If delivery imminent remain on scene.
Contraction under 2 minutes apart lasting 60 to 90 seconds, crowning, strong urge to push.

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23
Q

Vaginal Bleeding

A

Treat for hypoperfusion and provide obstetric pads.

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24
Q

STIs

A

Signs/Sx: lower abdominal pain, low fever, urinary Sx, pain during sex

Complications: Pelvic Inflammatory Disease

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25
Bacterial Vaginosis
Outside bacteria overgrow normal bacteria inside vagina.
26
Chlamydia
Caused by bacteria.
27
Gonorrhea
Caused by bacteria. Occurs in any mucosal surface of sexual contact.
28
Pelvic Inflammatory
Infection spread from vagina to uterus, fallopian tubes, and possibly pelvis. Signs / Sx: Peritonitis, fever, hisotry of vaginal discharge, recent STI, urinary Sx Treatment: rapid transport
29
Sexual Assault
Privacy. Do not examine genitalia unless profuse or life threatening hemorrhage. Preserve all evidence. Advice against washing or eating. Try to accommodate with same gender EMT. Treatment: treat vaginal bleeding or any other concern.
30
Maternal Cardiac Arrest
Treatment: Resuscitation and transport. Displace uterus to enhance venous return.
31
Pre-Eclampsia
High blood pressure (induced hypertension) typically after 30th week of pregnancy. Sx: Swelling, headache, visual disturbance.
32
Eclampsia
Severe pre-eclampsia with seizure activity. Complications: pre-mature labor, abruptio placenta, life threat to fetus Treatment: provide oxygen and transport unless life threat like seizure
33
Supine Hypotensive Syndrome
Pressure of enlarged uterus compresses vena cava. Treatment: left or right lateral recumbent position.
34
Ectopic Pregnancy
Fertilized egg implants in area other than uterus, usually fallopian tube. Leads to rupture of tissue and hemorrhage. (2-12 weeks) Signs/Sx: sharp abdominal pain, vaginal bleeding, bloated/tender abdomen, weakness, dizziness, shock, urge to defecate Treatment: Care as for pre-delivery patient. Treat hypoperfusion.
35
Cullen's Sign
Ecchymosis and edema around navel if rupture from ectopic pregnancy occurs hours before.
36
Miscarriage (Spontaneous Abortion)
Delivery of fetus before it can survive on its own. (before 20th week typically) Signs/Sx: cramping, vaginal bleeding, passage of tissue or clot Treatment: Transport clots and tissue with patient control bleeding with obstetric pad.
37
Gestational Diabetes
Pregnancy hormones impair mother's insulin causing high fetal blood sugar and high fetal insulin production. Complications: Increased birth weight and more difficult delivery.
38
Braxton-Hicks
Non-rhythmic contractions that do not increase. Taper off. Not associated with dilation. "False labor"
39
Placenta Previa
Placenta abnormally implanted at bottom of uterus over cervix. Sx: PAINLESS vaginal bleeding in third trimester. Predisposal: Over 2 other deliveries, over 35 years old, previous condition, rapid succession of pregnancy
40
Abruptio Placenta
Abnormal separation of placenta from the uterine wall prior to birth. Complication: Inadequate gas exchange between mother and fetus. Hypovolemic shock due to blood loss. Sx: Intense pain to mid to lower back, contractions, tenderness of abdomen, vaginal bleeding. Predisposal: hypertension, use of vasoconstrictive drugs, pre-eclampsia, several births, previous abruption, smoking, short umbilical cord, premature amniotic sac rupture, diabetes mellitus
41
Ruptured Uterus
Uterine wall can become thing and cause spontaneous rupture, releasing fetus into abdominal cavity. Signs/Sx: tearing or shearing sensation in abdomen, nausea, vomiting, vaginal bleeding, cessation of contractions, ability to palpate fetus Predisposal: previous rupture, abdominal trauma, large fetus, history of more than 2 births, previous surgery or caesarean Treatment: Treat for shock and transport.
42
Field Delivery
BSI: gloves, gown, mask, eye protection + OB kit Do not permit use of bathroom. Partner at head to communicate. Prepare sterile environment. Assess for crowning, tear amniotic sac if not ruptured, place fingers against bony part of infant skull, determine position of cord.
43
Initial Care: Newborn
Tilt shoulders to assist passing pubic symphysis. Dry, wrap, and warm. Suction mouth with bulge syringe if necessary (gurgling or distress) Obtain APGAR. Position level with placenta. Clamp, tie, and cut umbilical cord. (7 + 3 inches from umbilicus)
44
Placental Delivery
May take up to 30 minutes after birth. Place placenta in plastic bag to take to hospital. Place one or two sanitary napkins over vaginal opening. Record time of delivery and transport to hospital. Emergency if: over 30 minutes, over 500 mL blood lost before delivery, significant bleeding
45
Care for Mother
Allow to breastfeed. Knead lower abdomen to stimulate uterine contraction and control bleeding.
46
Prolapsed Uterus
May be replaced with gloved hand with one attempt and gentile pressure. Otherwise cover with moist sterile dressing.
47
Prolapsed Cord
Umbilical cord presenting. May be compressed between baby and vaginal wall, cutting of oxygen supply. Treatment: Use Trendelenburg with hips elevated. Insert sterile glove hand and lift presenting part off umbilical cord. Cover with moist sterile towel. Transport ASAP.
48
Breeched Birth
Fetal buttocks or lower extremities present. Treatment: If buttocks out of vagina deliver in field. Once body delivered insert two fingers palm toward baby's face on maxillae and press wall of vagina away from face. If head does not deliver in 10 minutes transport ASAP. (3 min MA)
49
Limb Presentation
One limb (arm or leg) protrudes first from birth canal. Treatment: High flow oxygen. Supine. DO NOT ATTEMPT DELIVERY.
50
Spinal Bifida
Spinal cord or meninges protrude outside vertebrae and possibly body. Treatment: Cover with moist, sterile dressing. Hold newborn against skin to maintain temperature.
51
Multiple Births
Strong contractions still continue. Abdomen still large. Contractions start again 10 minutes after delivery. If second baby not delivered within ten minutes of first TRANSPORT.
52
Post-Partum Hemorrhage
Over 1L of blood loss. Over 500 mL is excessive. Save soaked pads. Do not pack vagina.
53
Nuchal Cord
Umbilical cord around neck. Treatment: slack cord to remove from baby's neck. clamp as far apart as possible and cut.
54
Shoulder Dystocia
Shoulder stuck behind pubic symphysis or sacrum. Treatment: Gentle downward pressure to free shoulder.
55
Prolonged Delivery
Contractions 2-3 minutes apart for over 20 minutes with no progression. Transport
56
Inverted Uterus
Signs / Sx : Post Partum hemorrhage with sudden and severe abdominal pain. Hypovolemic shock may develop rapidly. Treatment: Treat for shock. Make one attempt to reposition the uterus and cover with moist sterile dressing for transport.
57
Delivery: Infant Exposed to Drugs in Utero
Low birth weight, severe respiratory depression, or fetal alcohol syndrome. Treatment: Oxygen and ventilations.
58
Post-Partum Embolism
Increased risk for pulmonary embolism. Signs / Sx: Sudden SOB or difficulty breathing.
59
APGAR
Perform: 1, 5, and 10 minutes after birth. Appearance (Pink 2, Acrocyanosis 1, Entire body blue 0) Pulse (Over 100 HR 2, Under 100 HR 1, No Pulse 0) Grimace (Grimace, Sneeze, Cough, or Cry 2 ; Some facial grimace 1, No reflex 0) Activity (Strong 2, Minimal 1, None 0) Respirations (30-60 RR or strong cry 2, <30 RR or weak irregular cry 1, no respiratory effort 0) 1 min scores should be 7-8, at 5/10 9-10. 0-3 : Extensive resuscitation 4-6: provide stimulation and oxygen. 7-10: provide routine care
60
Newborn Resuscitation
40-60 Breaths per min If slow, inadequate, under 100 HR, or cyanotic after blow by oxygen. Reassess color, respiratory effort, and HR after 90 seconds of ventilation on room air. If HR < 60 begin compressions. Ventilate for 30 seconds with BVM and 100% oxygen.

EMT (12 decks)

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