OB final Kat Review

What are common physical changes in pregnancy?

Stuffy nose, puffy face, and darkening of the face.

How do you calculate the estimated due date using Naegele's Rule?

Add 7 days and add 9 months to the last menstrual period.

What are presumptive signs of pregnancy?

Subjective signs including amenorrhea, nausea and vomiting, increased urinary frequency, excessive fatigue, breast tenderness, and quickening at 18-20 weeks.

What are probable signs of pregnancy?

Objective signs including

Goodell's sign (soft cervix),

Chadwick's sign (bluish cervix),

Hegar's sign (soft lower uterine segment),

uterine enlargement,

Braxton Hicks contractions,

uterine souffle,

integumentary pigment changes,

ballottement at 16-20 weeks, and

positive pregnancy test.

What does GTPAL stand for?

Gravida (total pregnancies),

Term births (>37 weeks),

Preterm births (20-36 weeks),

Abortions/miscarriages (<20 weeks), SAB (spontaneous abortion), TAB (therapeutic abortion),

Living children.

What were insurance statistics in the U.S. in 2015?

49% employer-based, 20% Medicaid, 9% uninsured.

Where is the fundus located at 12 weeks?

At the symphysis pubis.

Where is the fundus located at 16 weeks?

Midway between the symphysis pubis and umbilicus, uterus begins to bend anteriorly.

Where is the fundus located at 20 weeks?

At the umbilicus.

Why are pregnancies after age 35 high risk?

Diminished egg quality, increased complications, and increased preexisting conditions.

Why are adolescent pregnancies under 20 high risk?

Largely due to socioeconomic conditions.

What are the three trimesters of pregnancy?

1st (0-12 weeks), 2nd (13-27 weeks), 3rd (28-40 weeks).

When should the first prenatal visit occur?

Within the first 12 weeks.

What is the prenatal visit schedule?

Monthly (16-28 weeks),

every 2 weeks (29-36 weeks),

weekly (36+ weeks).

What is the most common type of cerclage?

McDonald cerclage.

What does 4-1-1 mean for contractions?

Every 4 minutes, lasting 1 minute, for 1 hour.

How is contraction strength assessed?

Mild (nose), moderate (chin), strong (forehead).

What is oligohydramnios associated with?

Cord compression.

What is a hydatidiform mole?

Abnormal pregnancy with grape-like clusters, risk of cancer, requires avoiding pregnancy for 1 year and monitoring hCG.

How is GBS treated?

Antibiotics (penicillin, ampicillin, amoxicillin) given 4 hours before delivery; not needed for C-section.

What is gestational hypertension?

High blood pressure without proteinuria.

What is preeclampsia?

Hypertension with +1 protein, headaches, and swelling.

What is eclampsia?

Severe preeclampsia with seizures and +3 protein.

What is HELLP syndrome?

Hemolysis, elevated liver enzymes (ALT/AST), and low platelets.

What is DIC?

Disseminated intravascular coagulation causing petechiae and bleeding.

What are signs of magnesium toxicity?

Low respirations, diminished reflexes, impaired cognition.

What treats magnesium toxicity?

Calcium gluconate.

What are the steps of Leopold maneuvers?

1st fundus,

2nd sides for back,

3rd presenting part,

4th fetal head (feet, butt, back, head).

What is the most common fetal position?

Left occiput anterior.

What are internal fetal monitoring methods?

Fetal scalp electrode and intrauterine catheter.

What is external fetal monitoring?

Tocodynamometer (toco).

What is a reactive non-stress test?

Shows adequate blood and oxygen with 2 accelerations in 20 minutes.

What does a biophysical profile assess?

Breathing, amniotic fluid, tone, movement, and NST.

What BPP score is normal?

8-10.

What is the Bishop score?

A tool to determine cervical readiness for induction.

What Bishop score is favorable?

8 or higher.

What is oxytocin (Pitocin) used for?

Induction of labor and stopping bleeding.

What is a side effect of Pitocin?

Stronger, more painful contractions and hypertension.

What is placenta abruption?

Painful, bright red vaginal bleeding.

What are signs of amniotic fluid embolism?

Cyanosis, decreased respirations and heart rate, decreased fetal heart rate.

What are the 5 P's of labor?

Passenger, passageway, powers, position, psychological.

What is the ideal pelvic shape?

Gynecoid.

What is fetal station?

Measured at ischial spines, with 0 station at the spines.

What is augmentation of labor?

Enhancing ineffective contractions.

What is induction of labor?

Starting labor artificially.

What are types of breech presentation?

Complete, footling, frank.

What is occiput posterior position?

Baby positioned spine to spine.

How is rupture of membranes confirmed?

Ferning pattern and nitrazine test turning blue.

What are indications for forceps or vacuum?

Poor progression of labor.

What is McRoberts maneuver used for?

Shoulder dystocia.

What is the turtle sign?

Head retracts back, indicating shoulder dystocia.

What are the stages of labor?

1st (dilation), 2nd (pushing), 3rd (placenta), 4th (recovery).

What are phases of the first stage of labor?

Latent (0-3 cm), active (4-7 cm), transition (8-10 cm).

What medications are used for cervical ripening?

Misoprostol and dinoprostone.

What are indications for C-section?

Cord prolapse, malpresentation, placenta previa, vasa previa.

What are risks of epidural anesthesia?

Hypotension, fall risk, allergic reaction, hemorrhage.

What labs should be checked with bleeding disorders?

RBC and hematocrit.

What does methylergonovine do?

Increases blood pressure and causes uterine contractions.

What does misoprostol do?

Decreases blood pressure.

What does fetal heart rate >160 indicate?

Risk of infection.

Who benefits from cerclage?

Multiple gestation, preterm history, cervical insufficiency.

When is gestational diabetes screened?

24-28 weeks.

What is a complication of gestational diabetes?

Macrosomia.

What is the intervention for cord prolapse?

Insert hand and lift fetal head.

What is uterine atony?

Failure of uterus to contract.

What are risk factors for uterine atony?

History, prolonged labor, macrosomic baby.

What is subinvolution?

Uterus remains enlarged due to infection or retained placenta.

When is colostrum produced?

2-3 days after birth.

How often should breastfeeding occur?

Every 2-3 hours.

How do you relieve breast engorgement?

Ice packs and cold cabbage leaves.

What hormone is released during breastfeeding?

Oxytocin.

What does BUBBLEHEAV stand for?

Postpartum assessment tool.

How does the uterus change postpartum?

Descends one finger breadth per day.

What are signs of episiotomy infection?

Foul-smelling discharge.

What are the stages of lochia?

Rubra (1-3 days),

serosa (4-10 days),

alba (up to weeks).

What indicates postpartum hemorrhage?

Soaking a pad in 15 minutes.

What teaching is important postpartum?

No tampons and good hand hygiene.

What are signs of postpartum blues?

Mood swings, sadness, anxiety within 1-10 days.

What are signs of postpartum depression?

Prolonged sadness and inability to care for self/baby.

What are signs of postpartum psychosis?

Hallucinations and paranoia.

What is the priority for postpartum psychosis?

Safety and 1:1 supervision.

What vaccines are contraindicated in pregnancy?

Rubella within 4 weeks.

What vaccines should family receive?

Flu, pneumonia, and Tdap.

What is a normal APGAR score?

7-10.

What does APGAR stand for?

Appearance, pulse, grimace, activity, respirations.

What is caput succedaneum?

Localized swelling that resolves in 3-4 days.

What is cephalohematoma?

Does not cross suture lines and resolves in weeks.

What are car seat recommendations?

Rear-facing until 2 years old.

What must be given before circumcision?

Vitamin K.

What is a contraindication to circumcision?

Epispadias.

What should be monitored after circumcision?

Bleeding and voiding.

What are the 3 H's of cold stress?

Hypothermia, hypoxia, hypoglycemia.

What indicates adequate breastfeeding?

Weight gain, 6-8 wet diapers, content infant.

What are Epstein pearls?

White spots in mouth.

What does erythromycin prevent?

Eye infections from STIs.

What does a bulging fontanelle indicate?

Increased intracranial pressure or infection.

What does a sunken fontanelle indicate?

Dehydration.

What are types of heat loss?

Conduction, convection, evaporation, radiation.

What is hyperbilirubinemia?

Elevated bilirubin causing jaundice.

What are phototherapy interventions?

Eye protection, repositioning, monitor skin.