Obstetrics & Neonatology Flashcards
(122 cards)
1
Q
Abortion
A
expulsion of the fetus, from any cause, before the 20th week gestation.
2
Q
Abruptio placenta
A
a premature separation of the placenta from the wall of the uterus.
3
Q
Amniotic fluid
A
a watery fluid that provides the fetus with a weightless environment in which to develop.
4
Q
Amniotic sac
A
the fluid-filled, bag-like membrane in which the fetus develops.
5
Q
Antepartum
A
before delivery
6
Q
Atresia
A
the process by which an oocyte (egg) dies
7
Q
Blastocyst
A
the term for an oocyte once it has been fertilized and multiplies into cells.
8
Q
Bloody show
A
a plug of mucus, sometimes mixed with blood, that is expelled from the dilating cervix and discharged from the vagina.
9
Q
Body (context of the uterus)
A
the portion below the fundus that begins to taper and narrow.
10
Q
Breech presentation
A
a delivery in which the buttocks comes out first.
11
Q
Cervical canal
A
the interior of the cervix
12
Q
Cervix
A
the narrowest portion of the uterus that opens into the vagina
13
Q
Cholestasis
A
a common liver disease that only occurs during pregnancy, in which the flow of bile is altered resulting in acids being released into the bloodstream, causing profuse and painful itching.
14
Q
Chronic hypertension
A
a BP that is greater than or equal to 140/90mmHg, which exists prior to pregnancy, occurs before the 20th week of pregnancy, or continually persists postpartum.
15
Q
Complete abortion
A
expulsion of all products of conception from the uterus.
16
Q
Corpus luteum
A
the remains of a follicle after an oocyte has been released, and which secretes progesterone.
17
Q
Crowning
A
the appearance of the infant’s head at the vaginal opening during labour.
18
Q
Ectopic pregnancy
A
an egg that attaches outside the uterus, typically in a fallopian tube.
19
Q
Embryo
A
the fetus in the earliest stages after fertilization
20
Q
Endometrium
A
the innermost layer of tissue in the uterus.
21
Q
Episiotomy
A
an incision in the perineal skin made to prevent tearing during childbirth.
22
Q
External os
A
the junction where the uterus opens into the vagina
23
Q
fallopian tubes
A
the vehicles of transportation of the ova from the ovaries to the uterus; also called ovaducts
24
Q
fetus
A
the developing, unborn infant inside the uterus
25
first stage of labour
the stage of labour that begins with the onset of regular labour pains-crampy abdominal pains- during which the uterus contracts and the cervix effaces
26
follicle-stimulating hormone (FSH)
a hormone produced by the anterior pituitary gland which is important in the menstrual cycle.
27
footling breech
a delivery in which one or both of the feet dangle through the vaginal opening
28
fundus
the dome shaped top of the uterus
29
gestational diabetes
diabetes that develops during pregnancy in women who did not have diabetes prior
30
gestational HTN
high BP that develops after the 20th week of pregnancy, in women with previously normal BP, and resolves spontaneously after birth.
31
gestational period
the time it takes for the infant to develop in utero, normally 40 weeks
32
GnRF
a chemical released by the hypothalamus that stimulates the release of follicle-stimulating hormone
33
gravid
the number of all the pregnancies a woman has had, including those not carried to term
34
gravidity
a term used to refer to a uterus that contains a pregnancy, whatever the outcome.
35
Group B streptococcus
a bacteria that lives in the genitourinary and GI tracts of normal healthy people, but which can cause life-threatening infections in newborn babies.
36
human chorionic gonadotropin hormone
a hormone that sends signals to the corpus luteum that pregnancy has initiated.
37
hyperemesis gravidarum
a condition of persistent N/V during pregnancy
38
incomplete abortion
expulsion of the fetus which results in some products of conception remaining in the uterus
39
induced abortion
intentional expulsion of the fetus
40
inevitable abortion
a spontaneous abortion that cannot be prevented
41
internal mucosa
the inner layer of tissue in the fallopian tubes
42
labour
the mechanism by which the baby and placenta are expelled form the uterus
43
luteinizing hormone
a hormone released by the anterior pituitary gland that stimulates the process of ovulation
44
meconium
a dark green material in the amniotic fluid that can indicate disease in the newborn; meconium can be aspirated into the infant's lungs during delivery; the baby's first BM
45
missed abortion
a situation in which the fetus has died during the first 20 weeks gestation but has remained in utero
46
molar pregnancy
occurs at the fertilization stage in pregnancy during which a malfunction of the egg or sperm results in an abnormal placenta and a fetus with an abnormal chromosome count, or which results in an empty egg
47
multigravida
a woman who has had two or more pregnancies, irrespective of the outcome
48
multipara
a woman who has had two or more deliveries
49
muscularis
the middle layer of tissue int he fallopian tubes
50
myometrium
the middle layer of tissue in the uterus
51
nullipara
a woman who has never delivered
52
oocyte
an egg produced from the female ovary
53
para
the number of pregnancies a woman has carried to more than 28 weeks, regardless of whether the fetus was delivered dead or alive
54
parity
number of live births a woman has had
55
perimetrium
the outer layer of protective tissue in the uterus
56
placenta
the tissue attached to the uterine wall that nourishes the fetus through the umbilical cord
57
placenta previa
a condition in which the placenta develops over and covers the cervix
58
postpartum
after birth
59
preeclampsia
a condition of late pregnancy that involves gradual onset of HTN, headache, visual changes, and swelling of the hands and feet; also called pregnancy induced HTN or toxemia of pregnancy
60
prenatal
the state of the pregnant woman before childbirth
61
primigravida
a woman who is pregnant for the first time
62
primipara
a woman who has had only one delivery
63
progesterone
a hormone that influences the second phase of the menstrual cycle, when the oocyte is either fertilized or dies
64
prolapsed umbilical cord
a situation in which the umbilical cord comes out of the vagina before the infant
65
pseudocyesis
a false pregnancy that develops all of the typical S/S of true pregnancy, but in which no actual pregnancy exists
66
Rh factor
a protein found on the RBC of most people
when a woman without this protein is impregnated by a man with this protein, the woman's body can create antibodies against the protein and attack future pregnancies
67
second stage of labour
the stage of labour in which the baby's head enters the birth canal, during which contractions become more intense and frequent
68
secretory stage
the second stage of the menstrual cycle
69
septic abortion
a life-threatening emergency in which the uterus becomes infected following any kind of abortion
70
serosa
the outermost layer of tissue in the fallopian tubes
71
shoulder dystocia
a condition in which the infant becomes trapped between the symphysis pubis and sacrum because its shoulders are larger than its head
72
spontaneous abortion
expulsion of the fetus that occurs naturally; also called miscarriage
73
stratum basalis
a permanent mucous membrane that makes up part of the outer endometrium
74
stratum functionalis
an inner mucous membrane that makes up part of the endometrium, and which is renewed following menstruation
75
supine hypotensive syndrome
low BP resulting from compression of the inferior vena cava by the weight of the pregnant uterus when the mother is supine
76
third stage of labour
the stage of labour in which the placenta is expelled
77
threatened abortion
expulsion of the fetus that is attempting to take place but has not occurred yet; usually occurs in the first trimester
78
tocolytics
drugs used to delay preterm labour
79
transverse presentation
a delivery in which the fetus lies crosswise in the uterus; one hand may protrude through the vagina
80
umbilical cord
the conduit connecting the mother to the infant via the placenta; contains two arteries and one vein
81
uterine cavity
the interior of the body of the uterus
82
uterine inversion
a potentially fatal complication of childbirth in which the placenta fails to detach properly and results in the uterus turning inside-out
83
uterus
a muscular inverted pear-shaped organ, that lies situated between the urinary bladder and the rectum
84
vagina
a tubular organ lined with mucous membranes, which is the lower portion of the birth canal.
85
acrocyanosis
a decrease in the amount of oxygen delivered to the extremities. The hands and feet turn blue because of narrowing of small arterioles toward the end of the arms and legs.
86
Apgar (appearance)
completely pink: 2
body pink, extremities blue: 1
centrally blue, pale: 0
87
Apgar (pulse)
>100: 2
<100, >0: 1
absent: 0
88
Apgar (grimace)
cries: 2
grimaces: 1
no response: 0
89
Apgar (activity)
active motion: 2
some flexion in the extremities: 1
limp: 0
90
Apgar (respiratory)
strong cry: 2
slow and irregular: 1
absent: 0
91
choanal atresia
a narrowing or blockage of the nasal airway by membranous or bony tissue; a congenital condition.
Often bilateral and because neonates are obligatory nasal breathers, it is life-threatening.
92
cleft lip
an abnormal defect or fissure in the upper lip that failed to close during development.
93
cleft palate
a fissure or hole in the palate that forms a communicating pathway between the mouth and nasal cavities.
94
diaphragmatic hernia
a defect in the muscle of the diaphragm more common on the left side which results in passage of loops of bowel with or without other abdominal organs, through the diaphragm muscle into the chest cavity.
95
Erb palsy
lack of movement in the shoulder due to nerve injury resulting from the stretching of the cervical nerve roots ( C5 and C6 most commonly) during delivery of the newborn's head during birth. The effect is usually transient, but can be permanent.
96
free-flow oxygen
oxygen administration via oxygen tube and a cupped hand on patient's face
97
bradycardia (newborn)
<100bpm
98
hypoglycemia (newborn)
<2.6mmol
99
hypotonia
low or poor muscle tone
100
hypoxic ischemic encephalopathy
damage to cells in the CNS from inadequate oxygen resulting in abnormal neurological examination.
101
intercostal retractions
skin sucking in between the ribs, seen when a patient creates increased negative intrathorax pressure to breathe
102
intussusception
an event where one part of the intestine telescopes into another part of the intestines and leads to a blockage in the intestine and potential for bowel ischemia
103
Klumpke paralysis
an injury of childbirth affecting the spinal nerves C7, C8, and T1 of the brachial plexus.
104
malrotation
a congenital anomaly of rotation of the midgut, the small bowel is found predominantly on the right side of the abdomen
105
oligohydramnios
decreased volume of amniotic fluid during a pregnancy; a risk factor associated with abnormalities of the urinary tract, postmaturity (birth after a prolonged pregnancy), and intrauterine growth retardation.
106
persistent pulmonary hypertension
delayed transition from fetal to adult circulation from high pulmonary vascular resistance.
107
Pierre Robin sequence
a condition present at birth marked by a very small lower jaw (micrognathia). The tongue tends to fall back and downward (glossoptosis), and there is a soft cleft palate.
108
polycythemia
abnormally high RBC count
109
polyhydramnios
an excessive amount of amniotic fluid that can cause preterm labour. It may be associated with disorders of swallowing or intestinal blockage.
110
premature
underdeveloped; the condition of an infant born too soon. Refers to infants delivered before 37 weeks
111
primary apnea
apnea caused by oxygen deprivation; usually corrected with stimulation, such as drying or gently slapping the newborn's feet.
Usually preceded by an initial period of rapid breathing.
112
pulmonary hypertension
elevated BP in the pulmonary arteries from constriction; causes problems with blood flow to the lungs.
113
retinopathy of prematurity
a disease of the eye that affects prematurely born infants, thought to be caused by disorganized growth of retinal blood vessels resulting in scarring and retinal detachment; can lead to blindness in serious cases.
114
secondary apnea
when asphyxia continues after primary apnea, infant responds with a period of gasping respirations, falling pulse rate, and falling BP
115
small for gestational age
an infant whose weight is considerably less than 90% of infants of the same age
116
What questions should you ask of a third trimester pregnant woman with vaginal bleeding?
when did it start?
what activity were you doing when it began?
how much blood loss?
do you have abdominal pain?
117
What is the treatment for vaginal bleeding in a third trimester pregnant woman?
```
lay her on her left side
15lpm O2 NRB
RTC
NS IV large bore
ECG
loosely placed trauma pads over the vagina
```
118
What is the treatment for hyperemesis gravidarium?
```
15lpm O2 NRB
IV NS 250ml
Gravol, if indicated
check BGL
ECG
Transport
```
119
What special considerations are there for pregnant women and their BP levels?
a pregnant woman may have a lot of blood loss before she shows signs of shock. Suspect shock from the MOI, not the presentation
120
How do you cut the cord?
clamp the cord at 20 cm from the infant's naval, and another one 5 cm further.
cut between the clamps
121
How do you treat a prolapsed umbilical cord?
supine position with hips elevated as much as possible
100% supplemental O2 via NRB
instruct the woman to pant with each contraction, which will prevent her from bearing down
with two fingers, gently push the baby (not the cord) back up into the vagina until the presenting part no longer pushes on the cord.
while you maintain pressure on the baby, have your partner cover the presenting cord with dressings moistened with NS
Maintain that position and RTC
122
what are the indications for artificial ventilation of a newborn?
apnea
pulse < 100bpm
persistent central cyanosis despite breathing 100% O2
