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23 Cards in this Set
- Front
- Back
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1. Preterm labour?
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a. <37 weeks.
b. Many pts present w/preterm contractions, but only those who have changes in the cervix are diagnosed as having preterm labour. |
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2. How does PTL differ from cervical insufficiency?
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a. Cervical insufficiency is silent, painless dilation of the cervix.
b. Both can result in preterm delivery, which is the leading cause of fetal morbidity and mortality in the US. |
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3. Low birth weight is under?
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a. <2,500 g.
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4. Infants who have not grown appropriately for their gestational age have?
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a. IUGR (Intrauterine growth restriction) or are small for gestational age (SGA).
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5. Tocolysis?
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a. An attempt to prevent contractions and the progression of labour.
b. The goal of tocolytics is to decrease or halt the cervical change resulting in contractions. |
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6. What is the only FDA approved tocolytic?
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a. Ritodrine- a beta-mimetic agent. Given as continuous IV therapy.
b. Terbutaline is also used. Both are β-agonists. |
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7. Drug shown to reduce risk of Respiratory distress syndrome RDS?
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a. Betamethasone.
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8. Why can hydration decrease the number and strength of contractions?
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a. Bc a dehydrated pt has increased levels of vasopressin or ADH, the octapeptide synthesized in the hypothalamus along w/oxytocin.
b. As it differs from oxy by only 1 AA, ADH may bind w/oxytocin receptors and lead to contractions. |
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9. MOA of Magnesium sulfate as a tocolytic?
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a. Magnesium sulfate decreases uterine tone and contractions by acting as a calcium antagonist and a membrane stabilizer.
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10. Best way to r/o magnesium toxicity?
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a. With serial reflex checks rather than serum levels bc DTRs are depressed and then lost at <10 mg/dl.
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11. How is mag sulfate given?
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a. 6g bolus over 15-40 minutes
b. Then maintained w/a 2-3 g/hr continuous infusion. c. Cleared by kidneys so slower infusion in renal insufficiency. |
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12. Ca channel blockers as tocolytics- which one and MOA?
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a. Nifedipine
b. Decrease influx of ca into smooth muscle thereby diminishing uterine contractions. |
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13. SE of Ca channel blockers-nifedipine?
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a. HA
b. Flushing c. Dizziness. |
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14. Dose of nifedipine?
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a. Oral- 10 mg dose Q15 min for first hour or until contractions have ceased.
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15. MOA of Prostaglandins?
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a. Prostaglandins ↑ the intracellular levels of Ca, thereby increasing myometrial contractions.
b. Have also been shown to enhance myometrial gap junction formation and are commonly used to induce labour and to heighten contraction. |
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16. Main prostaglandin inhibitor used?
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a. Indomethacin- an NSAID that blocks cox and ↓’s the level of prostaglandins- It is used as a tocolytic.
b. Inhibitor contractions and possibly halt labour. |
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17. Fetal SE of Indomethacin?
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a. Premature constriction of ductus arteriosus
b. Pulmonary HTN c. Oligohydramnios secondary to fetal renal failure. d. Possibly necrotizing enterocolitis and intraventricular haemorrhage if very premature and used w/in 48 hrs of delivery. |
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18. When does preterm rupture of membranes occur?
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a. <37 wks.
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19. Premature rupture of membranes (PROM)?
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a. Rupture before onset of labour.
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20. Obstetric conjugate?
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a. Distance between the sacral promontory and the midpoint of the symphysis pubis.
b. It is the shortest AP diameter of the pelvic inlet. |
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21. Cephalopelvic disproportion (CPD)?
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a. One of the most common indications for C-section is failure to progress (FTP), most often caused by cephalopelvic disproportion (CPD).
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22. 3 P’s?
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a. Pelvis, passenger, and power.
b. The 3 P’s are primarily responsible for vaginal delivery. |
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23. Complications of a vaginal breech delivery?
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a. Prolapsed cord
b. Entrapment of the head. |
