OB

70-110 mg/dL

Normal blood glucose for adult

70-140 mg/dL

Normal blood glucose for pregnant

24-28 weeks

When does screening of GDM starts?

Indomethacin

Drug to reduce amniotic fluid

Dystocia

• Prolonged Difficult labor and problem because of problems with 5 P’s

• Faults of the passenger

occiput posterior

a presistent position of the passenger that is abnormal

200

How many mg/day of carbohydrates

35

How many calories/kg daily

15g of complex carbohydrates

Hypoglycemia management if the patient is concious

0.25mg glucagon

Hypoglycemia management if the patient is unconcious

10

how many fetal kick counts in 2 hours?

Reactive

for a nromal finding; non stress test

Negative

for a nromal finding; Contraction sress test

Non stress test

Observation of FHT related to fetal movement to test for fetal well being

Supine and side lying

Position for Non stress test

Reactive NST

Two or more FHR accelerations of 15 beats/minute lasting 15 seconds or more within 20 minutes; related to fetal movement

Nonreacive NST

No FHR acceleration with fetal movement.

Contraction Stress Test

• AKA oxytocin challenge test

• to observe response of the fetus to induced uterine contractions.

• Test of feto-placental well-being

Stat CS

Indication for a positive contraction stress test

strong suspicion of chronic asphyxia

Biophysical profile score: 0-4

Suspected chronic asphyxia

Biophysical profile score: 5-7

Normal Biophysical score

Biophysical profile score: 8-10

Apex heartbeat

4th intercostal space lateral to mid clavicular line

5 weeks

When does cardiac output during pregnancy arises?

28 - 32 weeks

Peak CO during pregnancy

Semi-fowlers, left side

labor and delivery postion for mothers with cardiac problems

Open-glottis

Instinctual pushing

Muscle relaxants; terbutaline & lidocaine

what drugs to avoid in a mother with cardica issues.

7

minimum g/dL for blood transfusion

Chlamydia

Increased risk of newborn eye infection and pneumonia

Syphilis

Neonatal blindness and increased risk of mother and baby death.

Zidovudine

Drug of choice for HIV that should be given to baby within 6 months

Western Blot

Confirmatory test for HIV

To see number and size

Acute Intoxication phase

Euphoria, anxiety, dry mouth, tachycardia

Withdrawal phase

Depression, decreased appetite, restlessness and irritability

Smoking Alcohol and drugs

vasoconstrictor, it narrows vessels, reduce placental circulation that leads to IUGR, preterm, abortion, and fetal addiction

300mg

Limited intake of caffeine and cocoa per day

Placenta Previa

• Implantation of placenta in the lower uterine segment

• Contributing factors

  • Multiparity (twins)

  • Scarring

  • Tumor in upper uterine segment

Placenta Accreta

Placenta is abnormally adherent to the myometrium

Increta

The placenta penetrates to the myometrium

Perceta

Invasion of the myometrium to the peritoneal covering

Abruptio Placenta

Separation of a normally located placenta after the 20th week of gestation that leads to hemorrhage.

Ectopic Pregnancy

Implantation of the fertilized ovum outside the uterus

Pelvic inflammatory disease

Common to have ectopic pregnencies

Kehr’s sign

Shoulder pain due to ruptured fallopian tube due to Ectopic pregnancy

Cullen’s sign

Violet discoloration of belly button, seen in ruptured ectopic pregnancy patients.

Phrenic nerve

Reason why ruptured ectopic pregnancy patients feel shoulder pain.

Methotrexate

Tubal abortion; inhibits embryo growth

Salpingostomy

Incision made to remove EP in the site

Salpinectomy

Removal of fallopian tubes

Gestational Trophoblastic Disease

Hydatidiform mole (H MOLE) is a form of gestational trophoblastic disease that occurs when the trophoblast attach the fertilized ovum to the uterine wall, develops abnormally

Abortion

A pregnancy that ends before 20 weeks’ gestation spontaneously or electively.

Spontaneous

Pregnancy ends because of natural causes

Induced

Therapeutic or elective reasons exist for terminating pregnancy

Threatened Abortion

Spotting and cramping without cervical change

Inevitable Abortion

Spotting and cramping occur and the cervix begins to dilate and efface.

Incomplete Abortion

Loss of some products of conception, with parts of product retained (most often the placenta retained)

Complete Abortion

Products of conception are retained in utero after fetal death.

Criminal

Unlawful expulsion of the fetus by artificial means

Article 256

intentional Abortion

Article 257

Unintentional Abortion

Article 258

Abortion practiced by the woman herself or by her parents.

Article 259

Abortion practiced by a physician or midwife and dispensing of abortives

Act No. 3815

Revised penal code of the Philippines (abortion laws)

Habitual Abortion

Frequently termed recurrent pregnancy loss (RPL), is defined as the consecutive loss of two or more, often three or more, pregnancies before 20 weeks gestation.

Mcdonald Cerclage

Temporary intervention for habitual abortion

Shirodkar-Barter & Abdomen cerclage Cerclage

Permanent intervention for habitual abortion

Gestational hypertension

characterized by hypertension without proteinuria after 20 weeks of gestation and a return of the blood pressure to normal postpartum.

Magnesium Sulfate

• Prophylaxis to seizures

• Muscle relaxant

Calcium Gluconate

Antidote for magnesium sulfate used to treat magnesium toxicity

Diazepam

Given during a seizure

Labetalol and Nifedipine

Anti-hypertensives drugs

Deep tendon reflexes

Brisk reflexes - hyperreflexia - irritable cortex indicates central nervous system involvement.

clonus

Rhythmic involuntary contractions, often in the foot or ankle.

Nicardipine

If magnesium sulfate does not work.

>500mL

expected blood loss for vaginal birth.

>1L

Expected blood loss for cesarean birth

Subinvolution

Uterus not going back to normal size

Involution

Uterus goes back to normal size

Uterine Tamponade

24F foley catheter with a 30 mL balloon is inserted into the uterus via vagina. The balloon s filled with 60-80 ml of saline causing pressure on the vessels at the placental site.

Hematoma

Occurs when blood collects within the connective tissues of the vagina or perineal areas related to a vessel that ruptures and continues to bleed.

Mastitis

Usually occurs in just one of the breasts and within the first 2 postpartum weeks after milk flow has been established.

Improper latching

Primary cause of mastitis

Incision and drainage

Surgical treatment for mastitis

Dicloxacillin or cephalosporin

pharmacological treatment for mastits.

7-12 days

when should you examine breast after mensturation

Cystitis

• Infection of bladder, common occurrence in postpartum period

• Escherichia coli is the common cause

Metritis

Infection of the endometrium, myometrium, and/or parametrial tissues that usually starts at the placental site and spreads to encompass the entire endometrium.

Taking in

Passive and dependent (asks for the nurse always)

Taking hold

The patient is active and independent in taking care of the baby.

Letting go

Acceptance of parenthood/motherhood

Baby Blues

• 50-90% experience sudden sadness postpartum

• Peaks at day 4, 5, and resolves at 10

• No formal treatment

Postpartum depression

• If baby blues is more than 6 weeks

• nable to safely care for herself and baby.

Postpartum Psychosis

• Early symptoms resemble depression but may escalate to delirium, hallucinations, anger towards herself and infant, bizarre behavior, manifestations of mania, and thoughts of hurting herself and infant.

Deep Vein Thrombosis

Occurs when a blood clot forms in a deep vein. Usually develop in the lower leg, thigh, or pelvis, but they can also occur in the arm.

Premenstrual Syndrome

Combination of emotional and physical symptoms that begin during the luteal phase and diminish after menstruation begins.

Menorrhagia

Menstrual bleeding that is excessive in the number of days and amount of blood.

Metorrhagia

Bleeding between periods after menopause

Dysmenorrhea

Painful menstruation. Cramping usually begins 12-14 hours before onset of flow and lasts 12-24 hours.

Polycystic Ovary Syndrome

• AKA Stein-Leventhal syndrome

• Ovulatory and menstrual dysfunctions

• Anovulation

• Amenorrhea or decreased frequency of menses

• Menorrhagia when menses occur

• Hyperandrogenemia