Outcome 5 Late Pregnancy and Delivery Flashcards Preview

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Flashcards in Outcome 5 Late Pregnancy and Delivery Deck (93):
1

Premature detachment of a normally positioned placenta during pregnancy

abruptio placentae

2

Placenta covering the opening of the cervix

placenta previa

3

What are 2 types of placenta previa?

1. partial
2. complete or central

4

Type of placenta previa where majority of the placenta is away from the opening

partial previa

5

Type of placenta previa where the more central portion of the placenta covers the opening

complete or central previa

6

Low implantation of the ____ in the uterine cavity causes placenta previa

blastocyst

7

Is vaginal delivery allowed when there is placenta previa present?

no

8

T or F. Immediate C-section is warranted when there is a massive hemorrhage in placenta previa

T

9

Contractions leading to cervical change before 37 weeks of pregnancy

premature labor

10

What IM injections are given to mother in premature labor to reduce complications?

betamethasone

11

What IM injections reduce incidence of premature birth by 30%?

progesterone

12

Spontaneous break in the amniotic sac before onset of regular uterine contractions

premature rupture of membranes (PROM)

13

When the infant is full term, the period between membrane rupture and the onset of labor is ____

brief

14

When infant is pre-term, the period between membrane rupture and onset of labor is ____, which increases risk of fetal death

prolonged

15

A cause for PROM is increased intrauterine tension due to ____ or ____

hydramnios or multiple pregnancies

16

PROM in pre-term pregnancy (28 to 34 weeks) is treated with hospitalization and ____ if there is evidence of infection

induction of labor

17

PROM in term pregnancy when vaginal delivery isn't achieved within 24 hours following prom, induction of labor with ____ is usually done

oxytocin

18

Pregnancy that persists for 41 weeks or more

prolonged post-term pregnancy

19

T or F. Prolonged pregnancies are not induced because dates may be wrong, inducing comes at a higher risk, hard on mom and baby

T

20

What are the 3 phases of the first stage of labor?

1. early labor (0-4cm)
2. active labor (4-8cm)
3. hard labor or transition (8-10cm)

21

Which stage of labor is the longest?

first

22

Stage of labor that begins at full cervic dilation (10cm) and baby's head has begun to press into the birth canal

second stage of labor

23

Stage two ends with the ____

birth of the baby

24

Stage of labor where the uterus rests for 15 minutes, placenta detaches from the uterine wall, and is delivered by expulsion by the birth canal

third stage of labor

25

The third stage is managed by administering ____ and ____ which when given at time of birth, can reduce severe bleeding

oxytocin and ergonovine

26

Lie

position of baby in relation to mom

27

Lie: fetus is lying lengthwise (vertically) in the uterus

longitudinal fetal lie

28

Lie: fetus is lying crosswise or horizontally in the uterus

transverse fetal lie

29

T or F. Caesarean is always performed when fetus is at a transverse lie

T

30

Lie: maternal axes cross at a 45 degree angle, forming an unstable lie that'll always become either longitudinal or transverse during the course of labor

oblique fetal lie

31

direction of baby in relation to mom's pelvis

position

32

part of baby that passes through the pelvis first

presentation

33

Presentation: back part of skull (occiput) is the point of direction

vertex presentation

34

Presentation: chin is the point of direction

face presentation

35

Presentation: brow is the point of direction

brow presentation

36

Presentation: sacrum is the point of direction and the feet are crossed and the thighs are flexed on the abdomen

complete breech presentation

37

__% of breech babies are delivered by cesarean section

85%

38

Presentation: thighs flexed on the abdomen, legs upon the thighs and one or both feet may be lowermost

incomplete (footling) breech presentation

39

Presentation: thighs flexed; legs extended over the anterior surfaces of the body

frank breech presentation

40

Presentation: prolapsed limb is alongside the presenting part

compound presentation

41

Where the fetal head is delivered but one of the shoulders gets stuck behind the pelvic bone, if not managed appropriately, could lead to the fetus suffering serious trauma from the delivery

shoulder dystocia

42

How is shoulder dystocia treated?

1. McRoberts maneuver
2. Wood screw maneuver

43

Extremely rapid labor and delivery, which may occur without professional assistance (labor of less than three hours)

precipitate labor

44

Term used when fetus is believed to be in jeopardy, most often due to decrease oxygen flow.

fetal distress

45

Condition of a very large fetus; serious dystocia may arise when large head attempts to pass through a normal pelvis.

fetal macrosomia

46

Excessive accumulation of cerebrospinal fluid in ventricles of the brain with consequent enlargement of the cranium.

fetal hydrocephalus

47

Normal circumference: 32-38cm. Hydrocephalic babies: ___ cm

50-80 cm

48

Result of greatly distended urinary bladder, ascites, or enlargement of kidney or liver; spontaneous delivery may be impossible due to large amount of fetal swelling.

large fetal abdomen

49

"Siamese twins" May be diagnosed antenatally, but not always identified until difficulty at delivery

conjoined twins

50

Umbilical cord can wrap around baby’s neck during pregnancy and cut off fetal blood supply; knot is deadly

umbilical cord entanglement

51

Umbilical cord slipping through the cervix and into the vaginal canal before arrival of the fetus

prolapsed umbilical cord

52

Prolapsed umbilical cord is due to _____ before the descent.

amniotic membrane rupture

53

Condition in which a newborn does not breathe spontaneously.

asphyxia neonatorum or perinatal asphyxia

54

Dark green material in intestine of a full-term infant, often called the first stool of the newborn

meconium

55

Newborn inhales (aspirates) a mixture of meconium and amniotic fluid, which can partially or completely block the baby’s airways.

meconium aspiration

56

Excess of amniotic fluid. Associated with maternal disorders such as eclampsia and DM.

polyhydramnios

57

Placenta that has not been expelled within 30 mins after delivery of baby

retained placenta

58

Spontaneous traumatic rupture of the uterus. If fetus is alive at time of rupture, only chance of survival is immediate delivery.

ruptured uterus

59

Inverted uterus occurs during the delivery of placenta due to _____ on umbilical cord when placenta is firmly attached to uterine wall

excessive traction

60

Perineal lacerations are classified as:

1st, 2nd, 3rd, or 4th degree

61

Major cause in the majority of maternal deaths: excessive bleeding from the placental implantation site and/or trauma to the genital tract and adjacent structures.

maternal hemorrhage

62

Loss of more than 500ml in vaginal delivery, or more than 1000ml in cesarean

Postpartum hemorrhage defined as

63

Amniotic fluid travelling into the bloodstream of the mother through the highly vascular uterine wall due to the pressure generated during labor and delivery; affects lungs and kidneys

amniotic fluid embolism

64

Delivered through a device similar to a suction cup, where vacuum is placed on head of fetus and traction is applied; lower risk and less postpartum pain for mother than forceps.

vacuum assisted delivery

65

Forceps application is classified according to the position of the fetal head when forceps are applied

forceps delivery

66

Performed in stage 2 of labor in order to substitute a straight surgical incision in place of a possible laceration of the perineum.

episiotomy

67

Removal of baby from the uterus through an incision in the abdominal wall and uterus.

Cesarean section

68

What are the 3 types of c-section?

1. low segment
2. classical
3. intraperitoneal or extraperitoneal cesarean

69

Type of cesarean: transverse incision in lower segment of uterus

low segment

70

Type of cesarean: Vertical incision into the wall of the body of the uterus

classical

71

Type of cesarean: Tissue around urinary bladder dissected providing access to lower uterine segment without entering peritoneal cavity

intraperitoneal or extraperitoneal

72

Procedure involving the removal of uterus immediately following cesarean

cesarean hysterectomy

73

Another name for cesarean hysterectomy

porro operation

74

Usual forms: support persons (birth coaches, doulas), behavioral modifications and breathing, hypnotherapy, massages and showers to manage pain

psychoprophylaxis

75

Often used if mother has very short time before the second stage as estimated by nature of contraction and dilation of cervix

inhaled agents and injections

76

Preferred method of analgesia because it is extremely effective

epidural infusion

77

Allow pain relief without ability of patients to push during second stage of labor

continuous options

78

Anesthesia used for c-section and non-emergency (planned) cases where pt does not have an epidural, and is the preferred method of anesthesia because of reduced mortality and morbidity.

spinal anesthesia

79

Death after 20 weeks gestational age and/or a fetus weighing >500g

intrauterine death or stillbirth

80

___ weeks is the difference between a spontaneous abortion and intrauterine death.

20 weeks

81

Intrauterine death is linked to what?

1. eclampsia
2. preexisting type 1/2 DM
3. APLA syndrome

82

Half of intrauterine deaths are unknown. T or F

T

83

Body does not produce adequate amounts of insulin to deal with increased demand during pregnancy.

gestational diabetes

84

Serious disease of pregnancy characterized by HTN and proteinuria

pre-eclampsia or toxemia

85

Pre-eclampsia is most common in the ___ trimester but can occur anytime after __ weeks

third, 20

86

When a seizure occurs in a pt with preeclampsia Not all pt with preeclampsia will have this

eclampsia

87

What is given to reduce the possibility of a seizure?

magnesium sulfate

88

Inflammation of birth canal during the puerperium. Common cause of childbirth related deaths.

infection

89

What is the cause for pregnancy ifnections?

1. normal vaginal flora that become overgrown

90

When are infections diagnosed?

Fever for 48 hours after delivery with elevation of WBC count and erythrocyte sedimentation rate

91

All breast-feeding mothers experience some degree of this (more severe in primiparas) a few days after giving birth

breast engorgement

92

Sudden drop of estrogen and progesterone after childbirth triggering deep, ongoing depression that begins in postpartum period.

postpartum depression

93

True postpartum depression persists up to ___ months or longer, and can become chronic depression.

six