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17 Cards in this Set
- Front
- Back
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What is fetal lie?
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- Longitudinal vs. transverse in the uterus
- Determine by Leopold maneuvers |
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What are Leopold maneuvers?
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Used to determine fetal lie.
1. palpate fundus 2. palpate both sides of uterus 3. palpate presenting part of fetus at pubic symphysis |
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What is fetal presentation?
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- Breech vs. vertex position of fetus
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What is PROM?
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- premature rupture of membranes
- rupture of membranes > 1 h before onset of labor - rupture of membranes > 18 h before onset of labor = bad for mom and fetus --> increased risk of infxn |
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What is PPROM?
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- pre-term, premature rupture of membranes
- rupture of membranes at < 37 weeks gestation |
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How do you diagnose PROM?
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- Suspected with history of gush or leaking of fluid from vagina
- May be difficult to tell from stress incontinence - Use lab tests to confirm dx: - Pool, nitrazine, and fern tests |
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What are the pool, nitrazine, and fern tests? When are they used?
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Pool test:
- With sterile speculum, examine vagina for pooling of fluid; ask pt to bear down or cough to try to elicit fluid from cervix Nitrazine test: - Vaginal secretions are acidic; Amniotic fluid is alkaline - Place fluid on nitrazine paper to assess pH; blue = alkaline (AF) Fern test: - Estrogens in AF cause crystals when they dry on slide which resemble blades of fern If still in doubt, use ultrasound to see amt of fluid around baby; compare to previous values |
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What is the Bishop score? What are the five components of the Bishop score?
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- The Bishop score is used assess whether the pt is in labor, the phase of labor, and how it is progressing
1. Cervical dilation 2. Cervical effacement 3. Station 4. Cervical consistency 5. Cervical position Bishop > 8 --> cervix favorable for spontaneous labor |
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The Bishop score: Cervical dilation
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- assess with fingers at internal os
0 = closed 1 = 1-2 cm 2 = 3-4 cm 3 < 5 cm |
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The Bishop score: Cervical effacement
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- Subjective assessment of how much length of cervix is left and how effaced (thinned out) it is
- Typical cervix = 3-5 cm in length; so assess as % of that 0 = 0-10% 1 = 40-50% 2 = 60-70% 3 < 80% |
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The Bishop score: Station
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Station = relation of fetal head to ischial spines
- (-) stations are vertex above the spine; (+) stations are vertex below spines 0 = Station -3 1 = Station -2 2 = Station -1, 0 3 = Station <+1 |
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The Bishop score: Cervical consistency
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Cervical consistency
0 = Firm 1 = Medium 2 = Soft |
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The Bishop score: Cervical position
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Cervical position relative to fetal head
0 = Posterior 1 = Mid 2 = Anterior |
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What is vertex position?
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Vertex = head down
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What is breech position?
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Breech = buttocks down
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What is transverse position?
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Transverse = neither breech nor vertex
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How is fetal position determined?
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Position of the fetal occiput relative to the maternal pelvis
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