Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro 2 > Obstetric Complications - Wootton > Flashcards

Obstetric Complications - Wootton Flashcards

1
Q

Pre-term labor is between weeks ___ and ___

A

20 - 37

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Preterm labor is defined by what 2 things?

A
  • Uterine contractions

- Cervical change/dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of preterm labor

A
  • Spontaneous
  • Multiple gestations
  • PPROM
  • Pregnancy HTN
  • Cervical incompetence
  • Uterine anomalies
  • Antepartum hemorrhage
  • Intrauterine growth restriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Does previous history of pre-term labor play a risk for the next pregnancy?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Infections that can cause PTL

A

BV, B strep, gonorrhea, chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cervical length and PTL

How to screen for this?

A

Shorter cervical length (2.5 cm) is a 6x risk for PTL compared to a normal (4 cm) length

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is fetal fibronectin?

A

Released from BM of fetal membranes, means that PTL could happen for some reason

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Placenta and PTL

Sign in mom?

A

Abnormal placental connection to mom for some reason, increases risk of PTL

Mom may get HTN, trying to push more blood through the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Stress and PTL

Modifiers of this

A

Hight stress = high cortisol = high CRH from placenta = increased contractions

Stress reduction, good nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Uterine stretch and PTL

Risk factors for this pathway

A

Uterine stretch via increasing volume –> contraction

Polyhydramnios, twins/triplets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Symptoms of PTL

A

Menstrual-like cramping, low/dull backache, pelvic pressure, increased discharge, uterine contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Managing PTL (4)

A
  • Assess cervix
  • Look for underlying causes
  • Monitor uterus and fetal HR
  • Re-evaluate after hydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What main underlying cause for PTL is looked for?

Treat?

A

Group B strep (and other infections)

Empirical treatment = Penicillin (until negative culture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If uterine contractions cannot be stopped with hydration and rest, and PTL is definitely happening, do what? (3)

A

Tocolytics

  • MgSO4 + steroids
  • Nifedipine
  • Indomethicin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Benefit of MgSO4 outside of tocolytic effect

A

Prevents from cerebral palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mom gets MgSO4 as tocolytic for PTL, develops warmth, flushing, N/V, respiratory depression. How to correct?

A

Calcium gluconate

17
Q

Baby - side effects of MgSO4

A
  • Lost muscle tone
  • Drowsiness
  • Lower Apgar scores
18
Q

Nifedipine - MoA

A

Inhibits slow inward Ca++ flow during phase 2 of AP

19
Q

Indomethacin - used usually when?

Side effects? (baby)

A

Extreme PTL (2nd trimester)

  • Oligohydramnios (decreased baby’s renal function)
  • Premature DA closure (3rd trimester)
20
Q

When are glucocorticoids given for fetal lung maturation?

Give what?

Reduces what?

A

23-34 weeks

Betamethasone or Dexamethasone

RDS

21
Q

Lowest limit of viability for PTL

A

23-24 weeks

22
Q

Most recent intervention for preventing PTL

Used in who?

A

IM Progesterone (Makena) and Vaginal Progesterone (Prometrium)

Spontaneous PTL/PPROM

23
Q

Arabin pessary - used when?

A

Women w/ shortened cervix

24
Q

Risk factors for PROM

A
  • Infections
  • Abnormal membranes
  • Incompetent cervix
  • Nutritional deficiencies
25
Q

Diagnosing PROM (history)

What NOT to do?

A

Loss of fluid, amniotic fluid in vagina

Touch the cervix w/ hands (prevent infection)

26
Q

4 things to confirm PROM

A
  • Pooling of amniotic fluid in vagina
  • Nitrazine paper (turns blue)
  • Ferning
  • Ultrasound for fluid level
27
Q

PPROM before 24 weeks…

- Complication?

A

Pulmonary hypoplasia (no fluid to breathe in and help lungs develop)

28
Q

Oligohydramnios - AFI

A

Less than 5 cm

29
Q

Diagnosing chorioamnionitis (4)

A
  • Maternal fever ( >100.4)
  • Fetal/maternal tachycardia
  • Tender uterus
  • Foul-smelling amniotic fluid
30
Q

Traditional testing for fetal lung maturity

Mature lung – L:S?
If PG is present?

A
  • Lecithin:sphingomyelin ratio
  • Phosphatidylglycerol (PG)

L:S > 2
Considered mature

31
Q

NEW testing for fetal lung maturity

A

Lamellar body number density (> 46,000)

32
Q

What is IUGR? Definition?

A

Intrauterine growth restriction – birth weight of newborn is below 10% for given age

33
Q

Maternal causes of IUGR

A

Anything that affects placental blood flow

  • INFECTION (TORCH, etc.)
  • Smoking
  • Drugs
  • Alcohol
  • Heart disease
  • Pulmonary insufficiency
  • APA syndrome
  • Thrombophilias
  • Collagen vascular disease
34
Q

IUGR – fundal height

Do what?

A

More than 3 cm behind gestational age

Order ultrasound - check for HTN, renal disease, DM, drugs, APA, SLE, etc.

Repro 2 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions