Ob/gyn-Operative Delivery

Front 1

The national rate of C/S is climbing due to the increased ?

Back 1

increased #'s of repeat c/s

Front 2

T/F

maternal advances diminishing maternal risks such as antibiotics and blood banking

Back 2

true

Front 3

What are some L & D related causes to the increasing numbers of c/s performed?

Back 3

repeat c/s
continuous fetal monitoring
dystocia (dec. use of forceps)
epidurals
macrosomia
dec. use of forceps and vacuum

Front 4

A baby is considered macrosomic if the birth wt is >___

Back 4

4000 grams

Front 5

what are some maternal factors that have increased the c/s rate?

Back 5

older moms/delayed child birth
more nulliparous women with attendent risks
inc. maternal risks

Front 6

What are some fetal causes for incresed #'s of c/s?

Back 6

fetus tx'd as a patient
breech presentation
vlbw babies
active genital hsv
post term pregnancy
multiple gestation
failed induction

Front 7

What is the current rate of HSV in the US?

Back 7

1:5

Front 8

what are some physician causes of inc. #'s of c/s?

Back 8

fear of litigation
physician compensation
physician convenience

Front 9

What is higher risk, c/s or vaginal delevery?

Back 9

c/s is 7x's riskier

c/s deaths average 6.1-22/100,000 per year (33% r/t the c/s itself)

Front 10

__ is contraindicated or vaginal delivery is unlikely to be accomplished safely or in a time frame necessary to prevent fetal/maternal morbidity in excess of that expected following vaginal delivery.

Back 10

LABOR

Front 11

___is designed to minimize neonatal morbidity and possible long term consequences of intrapartum metabolic acidemia and/or trauma from birth.

Back 11

c/s indication for fetus

Front 12

T/F

A baby can be delivered safely if the the mother is HIV positive with a high viral load

Back 12

false, but tx of HIV decreases the viral load, decreases rate of transmission from 25% to <1%

Front 13

placenta previa, placenta abruptio, labor dystocia, mechanical vaginal obstruction, permanent cervical cerclage are ___ indications for a c/s.

Back 13

maternal

Front 14

-large fetus
-small pelvis
-inefficient contractions
-CPD

are all examples of __?

Back 14

dystocia

Front 15

suturing the cervix closed is AKA?

Back 15

cervical cerclage

Front 16

When is it appropriate to do a c/s with placenta previa?

Back 16

after amniocentesis at 36 weeks

Front 17

What is the most common surgical technique used for c/s?

Back 17

pfannenstiel

Front 18

when is it appropriate to use a vertical incision/classic insicion?

Back 18

obese pts
emergencies
anticipation of complications

Front 19

the layers of fascia around the fat layer include all of the following except?

-anterior rectus fascia
-scarpa's fascia
-camper's fascia

Back 19

anterior rectus fascia is anterior to the rectus abdominus muscle

Front 20

which layer of fascia would you encounter just prior to entering the peritoneum?

Back 20

posterior rectus fascia

Front 21

-upper uterus
-upper cervix
-lower uterus
-lower cervix

Back 21

upper cervix

Front 22

What is the greatest risk of doing a classical incision?

Back 22

risk of rupture in future pregnancy, these women would have to be delivered at 35-36 weeks after amniocentesis

Front 23

what benefit is there to either a classic or low vertical incision?

Back 23

east to extend if necessary

Front 24

when you rupture the amniotic sac,,,,what must you pay attention to?

Back 24

the color of the amniotic fluid

Front 25

you should make sure that the infants head is in what position if delivered in the breech position?

Back 25

the head should be in the flexed position

Front 26

if the baby is laying transverse what should you try to grab for to pull it out? What should you NOT grab for?

Back 26

fish around for the head or feet

do not grab an arm

Front 27

what is cord blood used for?

Back 27

abg's to determine pH

Front 28

the baby should do what 2 things in the first 30 seconds?

Back 28

breathe and cry

Front 29

what is done to the baby immediately after birth?

Back 29

dried and transferred to warmer

Front 30

the mom get's what iv meds during the c/s?

Back 30

iv antibiotics

Front 31

once the placenta is delivered what med is given and why?

Back 31

pitocin given to contract the uterus and to decrease bleeding, and the uterus is cleared of clots and debris (vernix, meconium, membrane)

Front 32

there is a __ layer closure of the uterus.

there is a __ layer closure of the uterus if vertical incision.

Back 32

2 layer if transverse

3 layer if verticle

Front 33

what anatomical structures should be visualized or palpated before closing after a c/s?

Back 33

ovaries/tubes

Front 34

what is the most common intraoperative complication of c/s?

Back 34

bleeding

Front 35

what are the top 4 reasons of intraoperative bleeding?

Back 35

-uterine vessel laceration
-placenta previa
-placenta abruptio
-uterine atony

Front 36

of the top 4 causes for intraoperative bleeding, what are the 2 most common?

Back 36

uterine vessel laceration
uterine atony