OB/Peds exam 1

What is the Inability to conceive?

infertility

Infertility:

___ months = < 35 years old

__ months = > 35 years old

12

6

T/f: most causes of infertility are unknown

F (85% known)

1/___ women recieve fertility services

1/8

ovulatory disorders, tubal factors, male factors, uterine or cervical

abnormalies, hormonal imbalances, or unexplained causes are all linked to what?

Infertility

What are the 4 best things people struggling with infertility should incorporate in their diet?

Omega- 3s

Protein

Vit d

Folic acid

What should people struggling with infertility avoid in their diet?

Trans fatty acids

Maintain a healthy body, abstain or quit smoking, prenatal vitamins, ovulation tracking, getting adjusted are the best things to optimize what?

Fertility

TQ: what are examples of medical interventions to help with conception?

Intrauterine insemination (IUI) and In vitro fertilization (IVF)

TQ: Patients with a history of ________ may have an increased risk for scarring and potential for fertility issues.

Chlamydia (STI)

What is a way for parents to communicate wishes to the midwives and doctors who care for them during pregnancy?

Birth plan

What part of the birth plan deals with Hospital, birthing center, or home?

Location

What part of the birth plan deals with Vaginal, Cesarean, VBAC?

Delivery type

What part of the birth plan deals with Partner, doula, family members?

Support people

What part of the birth plan deals with natural methods, epidural, or IV medication?

Pain management

What part of the birth plan deals with Monitoring, forceps/vacuum, episiotomy?

Intervention preference

What part of the care plan deals with immediate skin-to-skin, delayed cord clamping, breastfeeding plans?

Newborn care

Who is a An M.D or D.O who specializes in assisting labor and delivery?

OB/GYN

Who is best at managing high risk pregnancies?

OB/GYN

Who is a Specialist in care of healthy women anticipating a normal pregnancy and birth?

Midwife (focuses on wellness)

What does doula stand for?

"a woman who serves"

Who provides emotional support, and advice for mom and family and suggestions of easing discomfort?

Doula

What are the 3 main types of delivery?

1. Vaginal

2. Cesarean section

3. VBAC

Placenta previa, fetal distress, breech presentation are all good indications for what delivery type?

C-section

infection, blood clots, future pregnancy complications are all risk for what delivery type?

C-section

What is the recovery for a c-section

3-4 days in hospital; limited lifting/activity for several weeks

What delivery type is depending on uterine incisions type, overall health, and provider approval?

VBAC

TQ: What incisions are typically involved in a C-Section?

incisions in the abdomen and uterus (@pubic hair line)

What are the 3 types of stage 1 of labor?

early labor, active labor, transition

Stage 1 of labor: EARLY LABOR

What is the dilation of early labor?

What is the duration?

What is the contraction type?

0-6 cm

Hours-days

Mild-moderate irregular

What part of stage 1 labor has Lower back pain,

cramping, blood show (mucus plug release) as symptoms?

Early labor

Stage 1 of labor: ACTIVE LABOR

What is the dilation of active labor?

What is the duration?

What is the contraction type?

6-8 cm

4-8 hrs

Stronger, more regular, 3-5 minutes apart

Stage 1 of labor:

What is the dilation of transition?

What is the duration?

What is the contraction type?

8-10 cm

30 mins- 2hrs

Very strong, 2-3 min apart, lasting 60-90 secs

What part of stage 1 labor has intense contractions, nausea, water breaking as symptoms?

Active labor

What part of stage 1 labor has intense pressure, shaking, irritability as symptoms?

Transition

What is stage 2 of labor?

What is the dilation?

Delivery of the baby

10 cm

What is stage 3 of labor?

How long after baby is born?

delivery of the placenta

5-30mins

What is stage 4 of labor?

Immediate postpartum recovery (first few hours)

TQ: Cervical Dilation occurs during what stage of labor?

Stage 1

TQ: Early labor during stage 1 ends when the cervix is dilated to what diameter?

6 cm

TQ: the most ideal birth position is what?

Vertex Occiput Anterior

What are the typical (vertex/cephalic/head down)

positions for the baby?

Occiput posterior

Transverse lie

What typical positon is known as sunny side up?

Occiput posterior

What typical position is baby lying sideways across abdomen?

Transverse lie

What is buttocks or feet first; increased risks (cord prolapse, birth injuries)?

Breech

What breech position is when the baby's butt point downward, and both its hips and knees are flexed (the fetus is sitting on its folded legs)?

Complete

What breech position is when the baby's butt aim towards the vagina, and its legs are sticking straight up in front of its body (its feet are near its face)?

Frank

What breech positions in when The baby's butt points downward, and one leg extends towards the birth canal, and one foot below the butt?

Incomplete

What is a procedure to try to turn baby from breech to vertex?

External cephalic version (EVC)

previous scar on the uterus, placenta previa, unexplained

APH, Pre-eclampsia, multiple pregnancy are all contraindications for what?

External cephalic versions (EVC)

umbilical cord entanglement, abrupton of placenta, preterm labor, premature rupture of the membrane, severe maternal

discomfort are all complications of what procedure?

External cephalic versions (EVC)

TQ: What is the position in which the baby's butt or feet present first?

Breech

TQ: Pre-Labor, irregular contractions are known as what?

Braxton-Hicks

What type of contractions are regular, progressively get stronger, and slowly get closer together?

True labor

What type of contractions are irregular, do not change in intensity, and may stop with posture changes?

Braxton hicks

TQ what 3 test are done at EVERY routine visit during pregnancy?

Fetal Heartbeat

Material weight

Material BP

too tired, labor stops progressing, fetal distress are all good times to do what?

Use delivery interventions

What are the three main delivery interventions?

Episiotomy

Vacuum

Forceps

What is a surgical cut to the perineum

causes external damage (prevents internal tissue damage)?

Episiotomy

What Uses suction on the baby's head assisted delivery that can cause an Episotomy, urination issues, and vaginal tears?

Vacuum

Head swelling, shoulder dystocia, bleeding is skull, skull fracture

Are all baby side effects of what procedure?

Vacuum

What is a Tong-like instrument for assisted delivery that can cause tears, hemorrhage, pelvic floor dysfunction?

Forceps

Bruising, shoulder dystocia, trauma from forceps are all baby side effects of what?

Forceps

What is Done about 1 minute post-partum and AGAIN at 5 minute after birth?

APGAR SCORE

What does APGAR stand for?

Appearance (skin color), Pulse (heart rate), Grimace (reflex

irritability), Activity (muscle tone), Respiration (breathing effort)

What does the score range from on a APGAR?

What is the normal range?

0-10

7-10

100% TQ be able to give a APGAR score

110 pulse

Grimace on stim

Flexed extrem

Weak breathing

What is the score?

7

TQ: What reflex checks how the baby responds to stimuli?

Grimace reflex

What is the duration of early cord clamping?

10-15 secs after birth

What is the duration of delayed cord clamping?

> 30 seconds after birth

TQ: research shows that the cord should be clamped after how long?

30-60 secs

TQ: Blood loss greater or equal to 500 mL (vaginal) or greater or equal to 1000 mL (c-section) is called what?

Postpartum hemorrhage (May lead to shock; requires prompt treatment.)

Endometrits, mastitis, incision infections, or UTIs are all examples of what?

Postpartum infections

TQ: Fever is a clinical red flag that needs urgent evaluation in a postpartum patient what should you do?

patient should go to emergency room or call obstetrician immediately.

TQ: What is the recommended dosing for Iron during pregnancy?

27mg

What us a Mild mood swings, anxiety, & irritability that can last a

few days postpartum to 2 weeks?

Baby blues (80%)

What is a More severe; feelings of hopelessness, possible inability to function. May require therapy, medication, and additional support?

Postpartum depression (10-15%)

What is the time frame of postpartum depression?

Within the first year anytime (last much longer the baby blues)

Chewing ice shows a def in what?

Iron (Need 27 mg)

TQ: What is a natural remedy for morning sickness?

Ginger and B6

How much iodine is required for a preg mother?

How about Vit D?

150 ug

>600 IU

What B Vit are most important for a preg mother?

B6, B9, B12

How much DHA is recommended for a preg mother?

200-300

Conception to age ___ is the most critical time for proper nutrition leading to growth and development

2

reduced risk of breast/ovarian cancer, quicker postpartum recovery are benefits of what for the mother?

Breast feeding

Ideal nutrition, immune protection, reduced infections are all benefit of what for the baby?

Breastfeeding

express milk frequently, hydration, sleep, skin to skin, calories, oats are all good tips for what?

Tips to grow breastmilk supply

Breasfeeding is recommended to continue for how long?

6 mo (EXCLUSIVELY)

__mo to __mo breastfeeding should still be primary nutrient

6-18 mo

At what age should you start incorporating food?

6 months

TQ: Breastmilk with the highest levels of lactose is known as what?

Mature milk

What is breast milk called right after birth?

Colostrum

healthy bowl flora, high levels of protein, mother's antibodies describes what?

Colostrum

What milk is between 7-14 days and has an increases levels of lactose?

Transitional

What milk is highest level of lactose and is after day 14?

Mature milk

What stimulates tissue growth and milk production?

What can inhibit this hormone?

Prolactin

Stress

What is released when infant starts sucking and stmulates "let down"?

Oxytocin

TQ: Normal HcG hormone progression should be?

double every 72 hours for about 10 weeks (not normal can indicate preg vs miscarriage)

HcG made by what cells?

placental cells

What is a fertilized egg implant outside of the uterine cavity?

What is the Mc location?

Ectopic preg

Fallopian tubes