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32 Cards in this Set
- Front
- Back
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What fetal head diameter presents in full head flexion?
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Suboccipitobregmatic diameter - the shortest
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What fetal head diameter presents in full head extension?
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Occipitomental diameter - the longest
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What is asynclitism?
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Lateral flexion of the head - a major factor in forceps application
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What do extreme degrees of asynclitism lead to?
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Shoulder dystocia
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What causes "Back labor"?
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Occiput posterior presentation - the bab is backwards
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What is back labor?
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When there is more pain in the back during labor due to assmetric dilation
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How can you diagnose Occiput Posterior presentation?
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By ease of palpating the anterior fontanelle on the vaginal exam
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What is the problem with Occiput Posterior?
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LABOR IS PROLONGED
not necess increased mortality, but more lacerations |
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What are possible ways to deliver an OP baby?
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1. Manually rotate
2. Vacuum 3. Forceps 4. natural 5. C/s |
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How should you place the vacuum for extraction of an Occiput Posterior baby?
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More posteriorly..
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What is a Frank breech?
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Frank sucking both thumbs
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What is a Complete Breech?
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Sitting indian style
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What is a Footling?
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Breech with one leg hanging down
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What is Footling at risk for?
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Cord prolapse
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What is a major risk factor for Breech?
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Prematurity
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What is the incidence of breech at 21-24 weeks?
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33%
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What are 2 position exercises for prenatal attempts to turn a breech?
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1. Knee chest position (all 4s)
2. Deep Trendelenburg |
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When should you NOT attempt a vaginal breech delivery?
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-Unfavorable pelvis
-Macrosomia -Severely premature -IUGR, placental insufficiency -Footling breech -Fetal head hyperextended -Fetal anomalies -Nuchal arm -PROM or nonprogressive labor -Lack of skills |
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What should you probably always do before a breech delivery?
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Episiotomy
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What is an optional first step in breech delivery?
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Deliver the legs
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What should you wait to do in breech delivery, until wait?
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Do not put traction until delivery of the umbilicus
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What comes after the umbilicus delivers and you see the scapula?
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The anterior arm
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What is the last maneuver in a breech delivery?
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MSV maneuver with suprapubic pressure
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How do you do the MSV maneuver?
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One hand on the posterior head, other hand on the 2 maxilla of the face; flip the baby onto mom's belly
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What type of Mentum delivery is possible vs not possible to do vaginally?
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Mentum anterior is OK
Mentum posterior is impossible |
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What type of presentation has the highest incidence of cord prolapse?
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Footling breech
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What should you do if you do see a cord prolapse?
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-Do not replace cord
-Elevate presenting part -Fill the maternal bladder -Try position change |
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What are risk factors for cord prolapse?
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-Malpresentation
-High presentation |
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How should a mom ride to hospital if she has SROM at home and a risk factor for cord prolapse?
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Ride to the hospital with knees to chest!
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What is the deal with multiple gestations?
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2-5X HIGHER PERINATAL MORTALITY!!
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What are complications of multiple gestations?
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-Premature
-Congenital anomalies -Preg-induced HTN -Placenta previa -Fetal death -Cord prolapse -Pre-eclampsia |
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What is not successful in preventing preterm labor in multiple gestations?
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Bed rest and tocolytics
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