Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
38 Cards in this Set
- Front
- Back
Determined by the fetus's presenting part:
-Denotes the portion of the fetus felt through the cervix on vaginal exam -Denotes that portion of the fetus that overlies the pelvic inlet |
Presentation
3 types: -Cephalic, Breech, Shoulder |
|
Alignment of fetal spine to maternal spine
|
Lie
|
|
"Lie" can be subdivided into two categories: What are they
|
Longitudinal
Transverse |
|
Vertex or breech presentations have what kind of "Lie"
|
Longitudinal Lie
|
|
Shoulder presentations have what kind of "Lie"
|
Transverse Lie
|
|
Denotes the relationship of a specific fetal bony part to the mothers pelvis
|
Position
|
|
Vertex presentations will have what kind of position
|
Occiput
|
|
Face presentations will have what kind of "Position"
|
Mentum
|
|
Breech presentations will have what kind of "Position"
|
Sacrum
|
|
Shoulder Presentations will have what kind of "Position"
|
Acromion
|
|
What are the factors associated with the Breech position?
|
Uterine distention or relaxation
Uterine abnormalities Fetal abnormalities OB conditions |
|
List "Breech associated factors" that involve "uterine distention or relaxation"
|
-Multiparity
-Multiple Gestation -Hydramnios -Macrosomia |
|
List "Breech associated factors" that involve "Uterine abnormalities"
|
-Pelvic tumors
-Uterine anomalies -Pelvic contracture |
|
List "Breech associated factors" that involve "Fetal abnormalities"
|
Hydrocephalus and Anencephalus
|
|
List "Breech associated factors" that involve "OB conditions"
|
-previous breech
-preterm gestation -Oligohydramnios -Cornual-fundal placenta -Placenta previa |
|
Type of "Breech" position where the lower extremities are flexed at the hips, extended at the knees with the feet in the face
|
Frank Breech
|
|
What is the most common type of breech presentation
|
Frank Breech
|
|
Type of "Breech" presentation where flexed at both hips and the buttocks and feet sit on the cervix
|
Complete Breech
|
|
Type of "Breech" presentation where one or both hips are not flexed - and the feet sit below the the buttocks
|
Incomplete breech
|
|
This type of Breech presentation is common in 50% of Preterm infants
|
Incomplete breech
|
|
Cord prolapse is most common in which type of Breech presentation
|
incomplete breech
|
|
T or F
The occurrence of Cord prolapse is dependent on the infants gestational age |
False
it is dependent on type of Breech presentation |
|
The following definition describes what?
-Converts breech presentation to vertex |
External cephalic version
|
|
What factors increase the success of External cephalic version
|
-presenting part not in pelvis
-Normal amniotic fluid volume -Fetal back is not positioned posteriorly -Pt not obese -Pt is parous -Frank breech or transverse -Rarely successful if ruptured or dilated |
|
List 3 anesthetic emergencies for breech presentation
|
-Uterine hypertonus (tight)
-Fetal Head Entrapment (<32wks) -Need for cervical and uterine relaxation |
|
You have a pt presenting in the "Breech position" who needs emergent delivery. In order to provide cervical and uterine relaxation you would do?
|
-RSI with 2-3 MAC halogenated agent (relaxes in 2-3 mins, but may increase uterine bleeding)
-NTG 50-100 mcg |
|
What are the Hazards of "Breech vaginal delivery" that increase maternal morbidity?
|
-Cervical lacerations
-Perineal injuries -Hemorrhage -Retained placenta -infection |
|
What are the Hazards to the infant when a "Breech vaginal delivery" is done?
|
-Increased Infant trauma:
- asphyxia (cord compression) - Head trauma - Intracranial hemorrhage |
|
Describe the maternal physiology with multiple gestation?
Blood volume? C.O. ? Resp ? |
Blood volume increases by 500ml
C.O. is 20% greater Pre-eclampsia Edema and anemia faster weight gain Dyspnea |
|
List "fetal" problems associated with multiple gestations
|
-preterm delivery
-congenital anomalies -polyhydramnios -cord entanglement -cord prolapse -IUGR -Malpresentation (30-50% in vertex presentations) -Twin-to-twin transfusion -4-6 times greater mortality |
|
The following statement defines?
Monochorionic, monoamniotic placenta with vascular anastamosis |
Twin-to-twin transfusion
|
|
In twin-to-twin transfusion syndrome:
the "Recipient" has? the "Donor" has? |
Recipient: has polycythemia & cardiomegaly
Donor: has decreased blood volume - which causes IUGR |
|
What are the advantages of Epidural anesthesia in labor?
|
-provides effective pain relief
-Inhibits early pushing -Provides relaxed pelvic floor -Easily extended for emergency C/S |
|
How can you achieve Rapid uterine/cervical relaxation?
|
- NTG 50-100 mgs
-RSI-GETA (high concentrations volatile agents |
|
(KP)
A higher incidence of breech presentation occurs among pt's with? |
preterm labor
|
|
(KP)
What two things are associated with an increased incidence of perinatal morbidity and mortality, regardless of the method of delivery |
breech presentation and multiple gestation
|
|
(KP)
What effect does multiple gestation have on the "physiologic and anatomic changes of pregnancy" |
"exaggerates the effects"
|
|
(KP)
What is the analgesic technique of choice during labor in the pt with multiple gestation |
Epidural analgesia
|