Obstetrics and Neonatal Care Lecture Review

Flashcards covering comprehensive obstetrics and neonatal topics including prenatal care, labor stages, complications (PPH, PreE), newborn assessments, and high-risk neonatal conditions.

Mifepristone (Mifeprex)

An oral medication used for medical abortion within the first $70$ days of pregnancy that blocks progesterone, making the endometrium unstable; administered as a $200\,mg$ dose.

Misoprostol (Cytotec)

A medication taken $24$ to $48$ hours after Mifeprex that softens the cervix and stimulates uterine contractions to expel products of conception; administered as $800\,mcg$ buccally.

Infertility

The failure to achieve a successful pregnancy after $12$ months of unprotected intercourse.

Spinbarkeit

The characteristic of cervical mucus being stretchable, which occurs at the time of ovulation.

Clomid

A first-line oral medication that induces ovulation by stimulating large amounts of $FSH$ and $LH$.

Ovarian Hyperstimulation Syndrome

A potential side effect of Gonadotropin Drugs administered $IM$ characterized by cyst formation or rupture.

Fetal Demise

The death of a fetus after $20$ weeks of gestation, requiring evacuation of the uterus to avoid sepsis, shock, or maternal death.

Postpartum

The period from the birth of the baby until the mother's body returns to a near pre-pregnant state, typically lasting $6$ weeks.

Naegele's Rule (Due Date Calculation)

A method to calculate the due date by taking the first day of the last menstrual cycle, subtracting $3$ months, and adding $7$ days.

Gravida

A term referring to any pregnancy, regardless of duration, including the present one.

Para

A woman who has given birth after $20$ weeks of gestation, regardless of whether the baby is born alive or dead.

Effacement

The process of the thinning of the cervix that must occur before dilation can progress significantly.

Molding

The overlapping of cranial bones in the fetal head to facilitate movement through the birth canal, which typically resolves within $24$ hours.

Station

The relationship of the presenting fetal part to the maternal ischial spines; measured in centimeters where above the spine is negative ($-$), at the spine is $0$, and below is positive ($+$).

Lightening

A sign of impending labor where the fetus settles down into the maternal pelvis.

TACO

An acronym used to assess ruptured membranes: $T = ext{Time}$, $A = ext{Amount}$, $C = ext{Color}$ (meconium stained), and $O = ext{Odor}$ (earthy).

First Stage of Labor

The stage of labor consisting of three phases: Early/Latent ($0$-$3\,cm$), Active ($4$-$7\,cm$), and Transition ($8$-$10\,cm$).

Crowning

The point during the second stage of labor when the widest part of the fetal head is visible at the vaginal opening, often described as the ring of fire.

Schultz Presentation

A type of placental delivery where the fetal side of the placenta is expelled first, appearing shiny.

Chadwick’s Sign

A probable sign of pregnancy characterized by a bluish-purple coloration of the vaginal mucosa and cervix.

McDonald Method

A technique to measure fundal height in centimeters, which should approximately match the number of weeks of gestation (e.g., $26$ weeks should be $26\,cm$).

Hegar’s Sign

The softening of the lower uterine segment found during early pregnancy.

Colostrum

The initial thick, yellowish milk produced by the breasts starting around $12$ weeks of pregnancy, high in protein and fat.

Pseudo-anemia of Pregnancy

A hematological change where plasma volume increases more than the red blood cell count, leading to diluted hemoglobin levels.

Chloasma

Irregular pigmentation on the cheeks and face, often called the mask of pregnancy.

Nuchal Translucency (NT)

An ultrasound screening performed at $11$-$13$ weeks to measure the fluid-filled space at the back of the fetal neck; a fold greater than $3\,mm$ is considered abnormal.

Alpha-fetoprotein (AFP)

A serum protein measured in the Quad Screen; increased levels may indicate neural tube defects or multiples, while decreased levels may indicate Down syndrome.

Chronic Villus Sampling (CVS)

A first-trimester diagnostic test ($10$-$12$ weeks) used to detect DNA and genetic abnormalities but cannot detect neural tube defects.

Postpartum Hemorrhage (PPH)

Blood loss greater than or equal to $1,000\,mL$ following delivery.

Fetal Heart Rate (FHR) Variability

Beat-to-beat fluctuations in the baseline FHR that indicate reliable neurological and cardiac function; includes absent, minimal, moderate ($6$-$25\,bpm$), and marked (>25\,bpm).

Accelerations

A reassuring increase in FHR of at least $15\,bpm$ lasting for at least $15$ seconds.

Late Decelerations

A gradual decrease in FHR caused by inadequate blood flow through the placenta (uteroplacental insufficiency).

Lochia Rubra

The initial postpartum vaginal discharge consisting of bright red blood and clots, occurring on days $1$ through $4$.

Apgar Score

A rapid assessment of newborn transition performed at $1$ and $5$ minutes after birth, evaluating respiration, heart rate, muscle tone, reflex irritability, and color.

Cephalohematoma

A collection of blood under the scalp of a newborn that does not cross suture lines and typically disappears in $2$-$3$ weeks.

Brown Adipose Tissue

A specialized fat found over the shoulders and back of a newborn used for heat production through non-shivering thermogenesis.

Neonatal Abstinence Syndrome (NAS)

A cluster of withdrawal symptoms in an infant exposed to drugs (especially opioids) in utero, characterized by jitters, excessive sneezing, and poor feeding.

Hyperbilirubinemia

The hemolysis of red blood cells leading to increased bilirubin levels greater than $0.2\,mg/dL$; treated with phototherapy (bili lights).

Bishop Score

A scoring system used to predict the success of labor induction based on cervical readiness; a score of <7 suggests the need for ripening.

Magnesium Sulfate

An infusion used for neuroprotection in preterm labor and to prevent seizures in preeclampsia; therapeutic serum levels are $5.5\,mEq/L$ to $7.5\,mEq/L$ (tocolysis) or up to $9.0\,mEq/L$ (PreE).

Calcium Gluconate

The emergency antidote for magnesium toxicity, administered $IV$ if the patient shows signs like loss of deep tendon reflexes or respiratory depression.

Shoulder Dystocia

An obstetric emergency where the fetal head delivers but the shoulders become wedged behind the mother's pubis bone; managed with the McRoberts maneuver.

Abruptio Placentae

The premature separation of the placenta from the uterine wall, causing a rigid, board-like abdomen and vaginal bleeding.

Placenta Previa

A condition where the placenta covers the cervical opening, characterized by painless, bright red vaginal bleeding and a soft abdomen.

HELLP Syndrome

A severe complication of preeclampsia involving Hemolysis ($H$), Elevated Liver enzymes ($EL$), and Low Platelets ($LP$) less than $100,000/mm^3$.

Hyperemesis Gravidarum

Excessive, uncontrollable vomiting during pregnancy leading to a weight loss of at least $5\%$, dehydration, and ketonuria.

Ectopic Pregnancy

A pregnancy where the fertilized egg implants somewhere other than the uterus, often in the fallopian tube, presenting with low intense one-sided pain around $6$-$8$ weeks.

Gestational Trophoblastic Disease (Molar Pregnancy)

The rapid growth of abnormal cells (vesicles) characterized by thick, brown prune-juice vaginal bleeding and higher than expected hCG levels.