Flashcards in Outcome 5 Late Pregnancy and Delivery Deck (93):
Premature detachment of a normally positioned placenta during pregnancy
Placenta covering the opening of the cervix
What are 2 types of placenta previa?
2. complete or central
Type of placenta previa where majority of the placenta is away from the opening
Type of placenta previa where the more central portion of the placenta covers the opening
complete or central previa
Low implantation of the ____ in the uterine cavity causes placenta previa
Is vaginal delivery allowed when there is placenta previa present?
T or F. Immediate C-section is warranted when there is a massive hemorrhage in placenta previa
Contractions leading to cervical change before 37 weeks of pregnancy
What IM injections are given to mother in premature labor to reduce complications?
What IM injections reduce incidence of premature birth by 30%?
Spontaneous break in the amniotic sac before onset of regular uterine contractions
premature rupture of membranes (PROM)
When the infant is full term, the period between membrane rupture and the onset of labor is ____
When infant is pre-term, the period between membrane rupture and onset of labor is ____, which increases risk of fetal death
A cause for PROM is increased intrauterine tension due to ____ or ____
hydramnios or multiple pregnancies
PROM in pre-term pregnancy (28 to 34 weeks) is treated with hospitalization and ____ if there is evidence of infection
induction of labor
PROM in term pregnancy when vaginal delivery isn't achieved within 24 hours following prom, induction of labor with ____ is usually done
Pregnancy that persists for 41 weeks or more
prolonged post-term pregnancy
T or F. Prolonged pregnancies are not induced because dates may be wrong, inducing comes at a higher risk, hard on mom and baby
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)
Which stage of labor is the longest?
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
Stage two ends with the ____
birth of the baby
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
The third stage is managed by administering ____ and ____ which when given at time of birth, can reduce severe bleeding
oxytocin and ergonovine
position of baby in relation to mom
Lie: fetus is lying lengthwise (vertically) in the uterus
longitudinal fetal lie
Lie: fetus is lying crosswise or horizontally in the uterus
transverse fetal lie
T or F. Caesarean is always performed when fetus is at a transverse lie
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
direction of baby in relation to mom's pelvis
part of baby that passes through the pelvis first
Presentation: back part of skull (occiput) is the point of direction
Presentation: chin is the point of direction
Presentation: brow is the point of direction
Presentation: sacrum is the point of direction and the feet are crossed and the thighs are flexed on the abdomen
complete breech presentation
__% of breech babies are delivered by cesarean section
Presentation: thighs flexed on the abdomen, legs upon the thighs and one or both feet may be lowermost
incomplete (footling) breech presentation
Presentation: thighs flexed; legs extended over the anterior surfaces of the body
frank breech presentation
Presentation: prolapsed limb is alongside the presenting part
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
How is shoulder dystocia treated?
1. McRoberts maneuver
2. Wood screw maneuver
Extremely rapid labor and delivery, which may occur without professional assistance (labor of less than three hours)
Term used when fetus is believed to be in jeopardy, most often due to decrease oxygen flow.
Condition of a very large fetus; serious dystocia may arise when large head attempts to pass through a normal pelvis.
Excessive accumulation of cerebrospinal fluid in ventricles of the brain with consequent enlargement of the cranium.
Normal circumference: 32-38cm. Hydrocephalic babies: ___ cm
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
"Siamese twins" May be diagnosed antenatally, but not always identified until difficulty at delivery
Umbilical cord can wrap around baby’s neck during pregnancy and cut off fetal blood supply; knot is deadly
umbilical cord entanglement
Umbilical cord slipping through the cervix and into the vaginal canal before arrival of the fetus
prolapsed umbilical cord
Prolapsed umbilical cord is due to _____ before the descent.
amniotic membrane rupture
Condition in which a newborn does not breathe spontaneously.
asphyxia neonatorum or perinatal asphyxia
Dark green material in intestine of a full-term infant, often called the first stool of the newborn
Newborn inhales (aspirates) a mixture of meconium and amniotic fluid, which can partially or completely block the baby’s airways.
Excess of amniotic fluid. Associated with maternal disorders such as eclampsia and DM.
Placenta that has not been expelled within 30 mins after delivery of baby
Spontaneous traumatic rupture of the uterus. If fetus is alive at time of rupture, only chance of survival is immediate delivery.
Inverted uterus occurs during the delivery of placenta due to _____ on umbilical cord when placenta is firmly attached to uterine wall
Perineal lacerations are classified as:
1st, 2nd, 3rd, or 4th degree
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.
Loss of more than 500ml in vaginal delivery, or more than 1000ml in cesarean
Postpartum hemorrhage defined as
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
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
Forceps application is classified according to the position of the fetal head when forceps are applied
Performed in stage 2 of labor in order to substitute a straight surgical incision in place of a possible laceration of the perineum.
Removal of baby from the uterus through an incision in the abdominal wall and uterus.
What are the 3 types of c-section?
1. low segment
3. intraperitoneal or extraperitoneal cesarean
Type of cesarean: transverse incision in lower segment of uterus
Type of cesarean: Vertical incision into the wall of the body of the uterus
Type of cesarean: Tissue around urinary bladder dissected providing access to lower uterine segment without entering peritoneal cavity
intraperitoneal or extraperitoneal
Procedure involving the removal of uterus immediately following cesarean
Another name for cesarean hysterectomy
Usual forms: support persons (birth coaches, doulas), behavioral modifications and breathing, hypnotherapy, massages and showers to manage pain
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
Preferred method of analgesia because it is extremely effective
Allow pain relief without ability of patients to push during second stage of labor
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.
Death after 20 weeks gestational age and/or a fetus weighing >500g
intrauterine death or stillbirth
___ weeks is the difference between a spontaneous abortion and intrauterine death.
Intrauterine death is linked to what?
2. preexisting type 1/2 DM
3. APLA syndrome
Half of intrauterine deaths are unknown. T or F
Body does not produce adequate amounts of insulin to deal with increased demand during pregnancy.
Serious disease of pregnancy characterized by HTN and proteinuria
pre-eclampsia or toxemia
Pre-eclampsia is most common in the ___ trimester but can occur anytime after __ weeks
When a seizure occurs in a pt with preeclampsia Not all pt with preeclampsia will have this
What is given to reduce the possibility of a seizure?
Inflammation of birth canal during the puerperium. Common cause of childbirth related deaths.
What is the cause for pregnancy ifnections?
1. normal vaginal flora that become overgrown
When are infections diagnosed?
Fever for 48 hours after delivery with elevation of WBC count and erythrocyte sedimentation rate
All breast-feeding mothers experience some degree of this (more severe in primiparas) a few days after giving birth
Sudden drop of estrogen and progesterone after childbirth triggering deep, ongoing depression that begins in postpartum period.