Maternity

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Author:
woohoologist
ID:
244600
Filename:
Maternity
Updated:
2013-11-02 21:12:47
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Maternity
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Maternity
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  1. Day 1 of cycle
    • First day of menses (bleeding)
    • Ovulation on Day 14
    • 28 days total
    • Sperm 3-5 days, Eggs 24 hrs
    • Fertilization in Fallopian Tube
  2. Chadwick’s Sign
    Bluing of Vagina (early as 4 weeks)
  3. Hegar’s Sign
    Softening of isthmus of cervix (8 weeks)
  4. Goodell’s Sign
    Softening of Cervix (8 weeks)
  5. Pregnancy Total wt gain
    25-30 lbs (11-14 kg)
  6. Increase calorie intake by
    • 300 calories/day during PG
    • Increase protein 30 g/day
    • Increase iron, Ca++, Folic Acid, A & C
  7. Dangerous Infections with PG
    TORCH = Toxoplasmosis, other, Rubella, Cytomegalovirus, HPV
  8. Braxton Hicks
    common throughout PG
  9. Amniotic fluid
    • 800-1200mL
    • (< 300 mL = Oligohydramnios = fetal kidney problems)
  10. Polyhydramnios and Macrosomia
    (large fetus) with Diabetes
  11. Umbelical cord
    • 2 arteries, 1 vein
    • Vein carries oxygenated blood to fetus (opposite of normal)
  12. FHR
    120-160
  13. Folic Acid Deficiency
    Neural tube defects
  14. Pre-term
    20-37 weeks
  15. Term
    38-42 weeks
  16. Post-term
    42+ weeks
  17. TPAL
    Term births, Pre-term births, Abortions, Living children
  18. Gravida
    # of pregnancies regardless of outcome
  19. Para
    # of Deliveries (not kids) after 20 weeks gestation
  20. Nagale's rule
    add 7 days to first day of last period, subtract 3 months, add 12 months = EDC
  21. Hgb and Hct a bit lower during PG due to
    hyperhydration
  22. best position for uteroplacental perfusion
    Side-lying (either side tho left is traditional )
  23. 2:1 Lecithin:Sphingomyelin Ratio
    Fetal lungs mature
  24. AFP in amniotic fluid
    possible neural tube defect
  25. for Amniocentesis early in PG
    Need a full bladder (but not in later PG)
  26. Lightening
    Fetus drops into true pelvis
  27. Nesting instinct
    burst of energy just before labor
  28. true labor
    regular contractions that intensify with ambulation, LBP that radiates to abdomen, progressive dilation and effacement
  29. station
    negative above ischial spines, positive below
  30. leopold maneuver
    tries to reposition fetus for delivery
  31. laboring maternal VS
    • p <100 (usually a little higher than normal with PG; BP is unchanged in PG)
    • t <100.4
  32. non-stress test
    Reactive= Healthy (FHR goes up with movements)
  33. Contraction Stress Test (Ocytocin Challenge Test)
    • Unhealthy = Late decels noted (positive result) indicative of UPI
    • “Negative” result = No late decels noted (good result)
  34. watch for hyporeflexia with Mag Sulfate admin
    diaphragmatic inhibition

    keep calcium gluconate by the bed (antidote)
  35. early decels
    head compression = ok
  36. variable decels
    cord compression = not good
  37. late decels
    utero-placental insufficiency = BAD!!
  38. if variable or late decels
    • change maternal position
    • stop pitocin
    • administer 02
    • notify physician
  39. DIC
    • tx is with heparin (safe in pg)
    • fetal demise, abruptio placenta, infection
  40. fundus 12-14 weeks
    at level of symphysis
  41. fundus 20 weeks
    20 cm = level of umbilicus
  42. fundus rises
    ~1 cm per week
  43. labor stage 1
    beginning of regular contraction to full dilation and effacement
  44. labor stage 2
    10 cm dilation to delivery
  45. labor stage 3
    delivery of placenta
  46. labor stage 4
    1-4 hours following delivery
  47. placenta separation
    • Lengthening of cord outside vagina, gush of blood, full feeling in vagina
    • Give oxytocin after placenta is out, NOT BEFORE
  48. Postpartum VS Schedule
    Every 15 min X 1 hr

    Every 30 min X next 2 hours

    Every Hour X next 2-6 hours

    Then every 4 hours
  49. lochia
    • no more than 4-8 pads/day and no clots >1cm
    • fleshy smell is normal
    • foul smell = infection
  50. massage boggy uterus
    • to encourage involution
    • empty bladder ASAP - may need to cath
    • full bladder can lead to uterine atony and hemorrhage
  51. tears
    • 1st Degree = Dermis,
    • 2nd Degree = mm/fascia,
    • 3rd Degree = anal sphincter,
    • 4th Degree = rectum

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