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OB/GYN > Prenatal Care and Normal Pregnancy > Flashcards

Prenatal Care and Normal Pregnancy Flashcards

1
Q

During pregnancy, this organ system has the earliest and most dramatic changes

A

Cardiovascular

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2
Q

Marked increase in cardiac output during pregnancy up to what percentage range?

A

30-50%

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3
Q

Increase in total body oxygen consumption during pregnancy by what percentage?

A

20% more than non-pregnancy state

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4
Q

What amount of a mother’s CO is going through the uterus at term which also makes the risk for post partum hemorrhage significant?

A

1/5 of CO goes through uterus at term

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5
Q

What is the primary fuel for the placenta and fetus?

A

Glucose

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6
Q

Pregnant patients are considered hypercoagulable because the mother’s blood volume increases by what percentage by term?

A

35%

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7
Q

The mother needs what extra amount of iron in a normal pregnancy?

A

1000mg iron

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8
Q

Pubic symphysis separates at about what week(s)?

A

28-30 weeks

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9
Q

Determined by the presenting fetal part in the birth canal in relation to the ischial spines halfway between the pelvic inlet and outlet

A

Fetal Station

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10
Q

What are the two most common causes of overestimation in the amount of descent of fetus?

A

Molding – fetal cranial bones alternate their relationship

Caput succedaneum – edema of the fetal scalp from pressure on fetal head by cervix (swelling)

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11
Q

What are the types of fetal lie?

A

Cephalic – 95% of cases
Occipitoposterior position
Compound positions
Mentum anterior face presentation
Breech
fundic

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12
Q

Fetus body in relation to mom is called what?

A

fetal lie

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13
Q

What is the most common type of fetal lie?

A

Cephalic

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14
Q

What type of fetal lie is described below?

95% of cases
Three subtypes

A

Cephalic

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15
Q

What type of fetal lie is described below?

Associated with longer labors

A

Occipitoposterior Position

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16
Q

What type of fetal lie is described below?

One or more limbs prolapse alongside presenting part

C-section needed

A

Compound Positions

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17
Q

What are the three subtypes of the cephalic fetal lie?

A

Vertex/Occiput (Most common - we WANT this!)
Brow
Face

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18
Q

Which subtype of the cephalic fetal lie is the most common and the presentation we want?

A

Vertex/Occiput

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19
Q

What type of fetal lie is described below?

Chin towards mom’s abdomen

Need C-section

A

Mentum Anterior Face Presenation

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20
Q

What type of fetal lie is described below?

Troublesome presentation with three types

A

Breech

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21
Q

What is the most common type of breech presentation?

A

Frank Breech

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22
Q

What are the three types of the cephalic fetal lie?

A

Frank Breech 65%
Complete Breech 10%
Incomplete Breech 25%

23
Q

Which type of multiple gestation is described below?

Division of fertilized ovum

A

Monozygotic

24
Q

Which type of multiple gestation is described below?

Two separate ova are fertilized

A

Dizygotic

25
Q

With each additional fetus, the length of gestation decreases by approximately how many weeks?

A

2-3 weeks

26
Q

Increased perinatal morbidity is how much greater in multiple gestations than a single birth?

A

3-4x greater than single

27
Q

What is the most significant cause of morbidity in multiple gestations?

A

preterm labor and delivery

28
Q

Spontaneous abortions and congenital abnormalities is how much greater in multiple gestations than a single birth?

A

2x as common

29
Q

List some risk factors for multiple gestations?

A

IUGR
Hydramnios
Preeclampsia
Post partum hemorrhage
Placental abruption
Congenital anomalies
Umbilical cord accidents
Fetal demise (Increased risk of losing one or more fetuses from delivery)

30
Q

Net flow from one twin to the other

AV anastomes

Donor and recipient twin

A

Twin-Twin Transfusion Syndrome

31
Q

50% of cases

Deliver of a single fetus because of the intrauterine demise and
resorption of one embryo/fetus

A

Vanishing Twin Syndrome

32
Q

In multiple gestations, need to get an ultrasound every how many weeks starting at 16-18 weeks?

A

3-4 weeks

33
Q

What laboratory test can aid in predicting preterm labor?

A

Fetal fibronectin

34
Q

What are some risks/complications of the mother of multiple gestations?

A

Prolapsed umbilical cord (Risk of multiple gestations)

Uterine atony - Overdistended uterus, Higher risk for postpartum
hemorrhage

35
Q

What stage of labor is described below?

Onset of labor to full dilation (10cm)

Latent: 6 hours
Active: 3-7 hours

A

First stage

36
Q

What stage of labor is described below?

complete dilation until fetal delivery

Greatest rate of descent

Pushing can begin

Two hours

A

Second stage

37
Q

What stage of labor is described below?

delivery of fetus to delivery of placenta

Uterus rises in abdomen, gush of blood, lengthening of umbilical cord
= placenta has separated from uterus

5-30 minutes

A

Third stage

38
Q

What stage of labor is described below?

delivery of placenta until 2 hours post partum

Time when patient undergoes significant physiological adjustment

Likelihood of serious complications is at it’s greatest

A

Fourth stage

39
Q

What type of contraction is described below?

Over the fundus/fundal location

About 1min lasting

Radiate to lower back and lower abdomen

Become increasingly intense and frequent – not relieved by anything

During contraction, uterus not easily indented

A

True Contractions

40
Q

What type of contraction is described below?

False labor

Irregular, short lasting

Not associated with dilation of the cervix

Discomfort characterized as over the lower abdomen and groin areas

May resolve with ambulation, hydration, or analgesia (true contractions won’t be relieved)

Can indent the uterus

A

Braxton Hicks

41
Q

When should a patient in labor go to the hospital?

A

Contractions 5 minutes apart for one hour

Broken bag of water

42
Q

Blood-tinged mucus as the cervix begins to efface

Cervix often significantly effaced before onset of labor especially in
nulliparous women

A

“Bloody show”

43
Q

Occurs in late pregnancy

Shape of abdomen changes and baby feels lighter because the
head has descended into the pelvis (lower abdomen is more
prominent)

Increased frequency of having to urinate due to baby head

A

“Lightening”

44
Q

These maneuvers helps determine fetal lie, presentation, and position

A

Leopold’s Manuevers

45
Q

Baby obstructs venous return 🡪 decreases cardiac output 🡪 leads to
hypotension

Preferred position – dorsal lithotomy position used instead

A

Supine Hypotensive Syndrome

46
Q

Most common major operation performed in US

A

C- Section

47
Q

What are some indications for a C-section?

A

Hemorrhage from placental previa

Abrupto placentae

Prolapse of the umbilical cord

Uterine rupture

48
Q

It is not recommended to perform a C-section before how many weeks?

A

39 weeks

49
Q

Having a C-section puts the patient at higher risk for what complication?

A

Higher risk for endometritis

50
Q

Assess newborn’s condition

Scores assigned at 1 minute and 5 minutes

Assess every 5 minutes until 20 minutes if scores are less than 7

Should not be used to define birth asphyxia

NOT used to predict neonatal outcomes (ex: neuro)

A

APGAR Scoring

51
Q

The APGAR scoring of 7-10 is indicative of what?

A

great, no active resuscitation

52
Q

The APGAR scoring of 4-6 is indicative of what?

A

mild to moderate depressed infant

53
Q

The APGAR scoring of less than 4 is indicative of what?

A

poor, severely depressed and requires immediate resuscitative efforts

OB/GYN (14 decks)

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