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33 Cards in this Set
- Front
- Back
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maternal complication of shoulder dystocia
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hemorrhage
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fetal complication of shoulder dystocia
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erbs C5-C6 (injures flexers)
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prolonged 2nd stage of labor in multiparous
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2, 3 with epidural
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Mcroberts maneuver works by
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causing anterior rotation of the symph. pubis and flatening of the lumbar spine, reliveing anterior shoulder from impaction
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what is the rationale for suprapubic pressure in shoulder dystocia
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move the fetal shoulders from an AP to an Oblique plane allowing the shoulder to slip out under the symphisis pubis
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how does delivery of the posterior arm in shoulder dystocia work
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the shoulder girdle diameter is reduced from shoulder-to-shoulder to shoulder to-axilla
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weakness of what muscles is associated with Erbs
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deltoid and infraspinatus as well as some flexors with the arm hanging limply internally rotated
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tends to obliterate tissue planes making what more likely
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endometriosis tends to obliterate tissue planes making ureteral injury more likely after reparative surgeryu
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whats the cardinal ligament
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attachment of the uterine cervix to the pelvic side walls through which the uterine arteries traverse
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The majority of ureteral injuries occur in what type of gyn surgery
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hysterectomy
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Where is the the most common location for ureteral injury
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at the cardinal ligament
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Lacerations to what part of the bladder require stents and to what other part of the bladder do not
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trigone lacs...will require stents while injuries to the dome can be repaired intraoperatively
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endometrial thickness 5mm or more as seen on TV/US
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endometrial stripe
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what does surgical staging of endometrail Ca. entail
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TAH-BSO, Omentectomy, lymph node sampling and peritoneal washings
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most common female genital tract malignancy
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endometrial Ca.
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How to manage postmenopausal bleeding
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office Bx, proceed to hysteroscopy if negative (or observe) if positive cancer staging
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Long term management of placenta previa
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as long as bleeding is not copious can manage expectantly with a C-section at 36-37 weeks
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postcoital spotting earlier durin pregnancy
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a sx of previa
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the placenta abuts the internal os
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marginal previa
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the edge of the placenta is within 2-3cm of the internal cervical os
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low lying placenta
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does previa bleeding predispose to coagulopathy
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no not like an abruption may
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risk factors for placenta previa
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multiparity, prior csection, previa, curretage, multiple gestation
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Couvelaire uterus
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bleeding into the myometriumof the uterus giving a discolored appearance to its color
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bleeding into the myometriumof the uterus giving a discolored appearance to its color
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Couvelaire uterus
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type of fibroids that place one at risk for abruption
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submucosal, also a short cord is a risk factor, as well as pretermprematurerupture
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the coagulopathy of placental abruption is 2/2 this
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Hypofibrogenemia usually not encountered unless the level is below 150-100
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is US sensitive for abruption
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no
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in cases of abruption with fetal death and coagulopathy what is the preferred delivery method
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vaginal...
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for managing fluid status in abruption
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keep Hct above 25-30% and urine output over 30cc/hour
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most significant risk factor for a breech presentation is what
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cord prolapse
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what is the 5 part staging procedure for cervical cancer?
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exam under anesthesia
IVP CXR Barium Enema and proctoscopy cystoscopy |
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early cervical cancer (contained within the cervix) can be treated
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equally well with radical hysterectomy and hysterectomy however advanced cervical cancer is best treated with radiotherapy, consisting of brachytherapy (implants) with teletharapy (whole pelvis radiation) along with chemotherapy, usually platinum based to sensitize the tissue
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what is the most common cause of death due to cervical cancer
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it often spreads through the cardinal ligaments toward the pelvic sidewalls, obstructing the ureters causing hydronephrosis and subsequent uremia
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