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30 Cards in this Set
- Front
- Back
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how to dx gestational dm
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at 24-28 wk, do 50g GTT, if >140 at 1 hr then confirm with 3 hr GTT:
at 1 hr >180 at 2 hr >155 at 3 hr >140 |
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why does gestational dm develop
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the placenta produces insulin antagonist hormones (hpl, cortisol)
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describe the first stage of labor
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divided into latent and active labor
in latent: to 3-4 cm dilation in active: to full dilation in a prime, latent labor can take 11 hrs and active labor should be 1.2 cm/hr in a multip, latent labor can take 8 hrs and active labor should be 1.5 cm/hr |
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when does prolonged latent occur
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excessive sedation or hypotonic uterine contractions
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when does prolonged active labor occur
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cephalopelvic disproportion
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what is the 2nd stage of labor
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full dilation till birth of newborn
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how long should the second stage of labor take
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up to 3 hrs in prime, 30 mins in multip
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what causes accelerations on fht
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fetal movements
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what causes early decels in fht
what do they look like |
head compression (this is normal)
hr changes mirror contrctions |
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what causes late decels in fht
what do tehy look like |
uteroplacental insufficiency and fetal hypoxemia
everything happens after ctx is over |
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what causes variable decels
what do they look like |
umbilical cord compression (usually from oligohydramnios)
drop in hr >15 sec but less than 2 mins |
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nml fetal hr
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110-160
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what is a non-stress test
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mom lays in lld position and fhr is monitored
"reactive" is 2 accelerations >15 bpm above baseline lasting 15 seconds, in a 20 minute period "non-reactive" is <2 accelerations over a 20 minute period, perform bpp or contraction stress test |
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what are potential causes for non-reactive stress test
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ga <32 wks, fetal cns anomalies, maternal sedative, narcotics, baby is sleeping
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what is a contraction stress test
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fhr is monitored during contractions
fhr is monitored |
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positive cst
negative cst equivocal cst |
positive: late decels following >50% of ctx, fetus not doing well. deliver immediately
negative: no late or significant variable decels, baby's ok equivocal: internittent late decels or significant variable decels |
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biophysical profile
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u/s is used to determine fetal well being
Test the Baby MAN tone breathing movement amniotic fluid volume non-stress test |
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what is the afi if there is oligohydramnios
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afi <5
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what role does sodium citrate play in c-sections
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it is given to reduce gastric acidity and prevent acid aspiration syndrome
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definition of gestational htn
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htn s proteinuria that develops >20 wks
25% can go on to develop pre-eclampsia |
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definition of chronic htn in pregnancy
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htn before conception or <20wks
can persist for >12 wks post-partum 1/3 --> pre-eclampsia |
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what anti-htn meds --> uterine ischemia
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ace inhibitors and diuretics
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definition of pre-eclampsia
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htn (>140/90) and proteinuria at greater than 20 wks
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definition of antepartum hemorrhage
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any bleeding after 20 wks
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definition of arrest of second stage of labor
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>2 hrs in nullip (+1 hr w anesthesia)
>2 hrs in multip (+1 hr w anesthesia) |
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definition of arrest of latent labor
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in nullip, if latent labor >20 hrs
in multip, if latent labor >14 hrs |
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tx of arrest of latent labor
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therapeutic rest with analgesia
amniotomy cervical ripening |
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tx of arrest of active labor
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amniotomy
oxytocin c/s if above are ineffective |
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tx of arrest of second stage of labor
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decrease epidural rate, keep giving otc
assisted vaginal delivery (forceps or vacuum) c/s |
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definition of premature rom
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rom >1 hr before onset of labor
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