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26 Cards in this Set
- Front
- Back
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1. Signs that could confirm the rupture of membranes?
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a. Visualization of amniotic fluid from the cervix
b. Presence of pooling of amniotic fluid in the posterior vaginal fornix c. Demonstration of a pH > 6.5 in fluid collected from the vagina using Nitrazine paper. d. Visualization of “ferning” on a sample of fluid on air-dried microscope slide. |
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2. What is normal vaginal fluid pH?
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a. <5.5
b. So >6.5 is amniotic fluid in a pregnant woman. |
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3. What can cause elevated pH in vaginal secretions and a false-positive Nitrazine test?
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a. The presence of semen, blood, or bacterial vaginosis.
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4. Recommended ABX prophylaxis for GBS colonization during labor?
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a. Penicillin 5 million units IV loading dose
b. Followed by: i. 2.5 million units IV every 4 hours. 1. Alternatively: IV ampicillin |
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5. Alternative ABX prophylaxis for GBS in penicillin allergic patients?
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1. Cephalothin
2. Erythromycin 3. Clindamycin 4. Vancomycin |
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6. What is the risk with prolonged rupture of the membranes?
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a. May predispose to development of infection (especially after 24 hours or longer).
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7. Fetal lie?
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a. The relationship of the long axis of the fetus to the long axis of the mother
b. Either longitudinal or transverse |
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8. Fetal presentation?
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a. The part of the fetus that is either foremost in the birth canal or in closest proximity to the birth canal.
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9. Labor?
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a. Regular uterine contractions that leads to the effacement and dilation of the cervix
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10. Premature rupture of membranes?
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a. Rupture of fetal membranes prior to the onset of labor
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11. When is labor usually begin?
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a. Spontaneously and occurs normally within 2 weeks of the estimated data confinement (280 days after the 1st day of the last menstrual period)
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12. Preterm labor definition?
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a. The onset of labor more than 3 weeks before the estimated data confinement.
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13. Postremum labor?
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a. If labor has not started spontaneously by 2 weeks after the EDC, the pregnancy is considered the postterm.
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14. 1st stage of labor?
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a. From the onset of labor until the cervix is completely dilated
b. This can be further divided into the latent phase and active phase |
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15. Latent phase of first stage of labor?
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a. The contractions become stronger, longer lasting, and more coordinated
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16. Active phase of first stage of labor?
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a. Usually starts at 3 to 4 cm
b. It is when the rate of dilation is at its maximum. c. In active labor, in a woman without an epidural, the minimum expected rates of cervical dilation or 1.2 cm/h for nulliparous woman in 1.5 cm/h for parous woman |
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17. 2nd stage of labor?
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a. Is from complete cervical dilation (10 cm) through delivery of the fetus.
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18. Normal length of 2nd stage of labor?
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a. Last less than 2 hours in a nulliparous patients and less than 1 hour in a parous patient.
b. The presence of epidural anesthesia can prolong these times by up to one hour. |
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19. 3rd stage of labor?
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a. Begins after the delivery of the baby and ends with the delivery of the placenta and membrane.
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20. What is the progress of labor usually dependent on (hint: 3 Ps)?
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1. Power (strength of uterine contractions during the active phase of labor and of the maternal pushing efforts during the second stage
2. Passenger (fetus size] [lie, presentation, and position w/in the birth canal]) 3. Pelvis (shape and size) |
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21. Note: The diagnosis of active labour is an indication for admission to the birthing unit for labour management and monitoring.
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a. The presence of ruptured membranes is also an indication for admission.
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22. How is fetal well-being assessed once a patient is admitted to the labor and delivery unit?
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a. By either continuous or intermittent fetal heart rate monitoring
b. Continuous monitoring is the more commonly used procedure in the US c. A Doppler ultrasound device is used continuously trace the fetal heart rate. |
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23. 3 important considerations in interpreting fetal heart rate data?
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1. Baseline heart rate
2. Variability 3. Periodic heart rate changes |
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24. Baseline fetal heart rate?
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a. The approximate average heart rate during a 10 min tracing.
b. A baseline heart rate of 110-160 per minute is considered normal. |
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25. Fetal bradycardia value?
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a. < 110
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26. Fetal tachycardia value?
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a. >160.
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