Term
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Definition
Ultrasound
Chorionic villus sampling
Amniocentesis and cordocentesis
Antepartum testing
Cervical cerclage
Abortion completion |
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Term
| 1st trimester ultrasound and last menstrualk period: best predictors of due date |
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Definition
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Term
Transvaginal ultrasound
1st trimester uterus is pelvic organ
Dating (CRL), location, number
Nuchal translucency (11-14 weeks)
Cervical length (esp. with ffn)
Placental location |
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Definition
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Term
CVS
10th-12th weeks
Placental mosaicism may limit
PUBS/Cordocentesis
Anemia (replaced by MCA velocimetry)
Intrauterine transfusion |
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Definition
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Term
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Definition
Cervical incompetence- painless dilation
McDonald- purse string
14 weeks, removed at 37 to 38 weeks
80-90% effective
Shirodkar
Abdominal |
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Term
| bleeding, cramping, with live fetus, closed os: |
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Definition
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Term
| Inevitable abortion has __ __. |
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Definition
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Term
| closed os, no cardiac activity: |
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Definition
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Term
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Definition
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Term
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Definition
Surgical
D&C
D&E- 14+ wks
MVA
Medical
Prostaglandins
Hypertonic solutions
Progesterone antagonists- RU486 |
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Term
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Definition
Shoulder dystocia reduction
Selective Episiotomy
Operative vaginal delivery
Perineal repairs
Cesarean delivery
VBAC |
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Term
| If mom has had a shoulder dystocia, high risk of another. Most can be releieve with McRoberts position |
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Definition
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Term
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Definition
Cesarean
Head flexion
Druschen’s incisions
Piper forceps
Same at cesarean delivery |
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Term
| Shoulder dystocia management: |
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Definition
Help
McRoberts
Suprapubic pressure (at angle)
Episiotomy
Anterior shoulder
Posterior shoulder
Zavanelli? |
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Term
Cord prolapse
To the OR (elevate head with hand) |
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Definition
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Term
| Selective episiotomy is done when you cut __ of the __ length. |
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Definition
half of the perianal length
good for assisted delivery |
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Term
| Pros to the median cut episiotomy include __ __ __, __ __ when healing. Cons include possible __ into or through the sphincter and ___. |
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Definition
Pros: less blood loss, more comfortable when healing
Cons: extension into sphincter, fistula |
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Term
| The Mediolateral Episiotomy is cut at a __ degree angle to the __ __. Pros to this include __ __ and __ __ of __ __. Cons include that is __ _ __, __ __ __, and __ __ while healing. |
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Definition
- 45 degree angle to the hymen ring
- more room and less risk of sphincter tear
- harder to repair, more blood loss, more discomfort while healing |
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Term
1st degree
2nd degree
3rd degree: through the sphincter
4th degree: through the sphincter and rectum |
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Definition
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Term
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Definition
Numb is good
Vaginal mucosa bleeds- use running locked stitches
3rd degree- repair sphincter first, either overlapping or end to end
4th degree- repair anorectal mucosa first, then sphincter |
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Term
Electronic fetal monitoring has increased rate of C sections.
VAGINAL BREECH IS CONTRAINDICATED. |
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Definition
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Term
| Incidence of C sections is increasing, why? |
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Definition
- decreased morbidity and mortality
- electronic fetal monitoring
- Delaying childbirth> increased nullips at older age > age related pregnancy complications> cesarean delivery
Increased dx of dystocia & fewer forceps deliveries
Vaginal breech now contraindicated
Increased multiple gestations
Increased repeat c/s |
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Term
| In preterm fetuses weighing greater than __ grams, C section decreases morbidity and mortality. |
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Definition
greater than 750 grams
Otherwise, no decrease seen. Why?
LBW and congenital anomalies continue to be leading causes of perinatal m&m |
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Term
| Cesarean Delivery is indicated when benefits to mother, fetus, or both outweigh the risk to the mother. These include: |
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Definition
Contraindications to labor
Placenta previa
Vasa previa
Previous classical c/s
Previous uterine reconstruction
Malpresentation
Active genital herpes
Declines TOL
Dystocia and failed induction
CPD, arrest of descent, arrest of dilation, failure to descend (failure to progress)
Failed operative vaginal delivery
Certain fetal malformations (hydrocephaly, tumors, etc. )
Emergent conditions
Abruption
Cord prolapse
NRNST
Fetal acidemia (category 3 FHR pattern)
Uterine rupture
Impending maternal death |
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Term
If have already tried forceps and vacuum> they didn’t work> have to do C section: these instances have higher rates of adverse outcomes
If mom is being resuscitated, put her on left side and have to decide in 4 min if give C section |
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Definition
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Term
| Types of Ceserean Delivery: |
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Definition
Abdominal incisions
Pfannenstiel (smile)
Vertical midline
Uterine incisions
Low transverse (Kerr)- minimizes subsequent rupture, low blood loss
Low vertical (Kronig)
Classical (Sanger)- must have repeat, simplest and quickest to perform, blood loss greatest
If vertical incision> increased risk of rupture
Low vertical: higher rates of hernia |
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Term
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Definition
Prep- hydration, h/h, empty bladder, antibiotics, antacids, consent
Anesthesia- spinal, epidural or general
Surgical technique
Abdominal incision
Fascial incision
Peritoneum (parietal)
Uterovescical peritoneum (visceral)
Hysterotomy
Infant delivery
Placental delivery |
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Term
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Definition
- Endomyometritis- 34-40% on avg w/o abx, less than 5% with cephalosporins
- UTI- catheter
- Wound infection- 2-16%, risk factors
- Thromboembolic issues- 3-5x higher after c/s than vaginal delivery
- Cesarean hysterectomy- low rate, usually major issues leading to indications |
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Term
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Definition
Rupture <1% after LTCS
10% after classical
VBAC success- previous vaginal delivery, spontaneous labor, nonrecurring indication for c/s |
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Term
| Assisted vaginal delivery with forceps or a vacuum indications: |
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Definition
- nonreassuring fetal status
- prolonged second stage
- maternal illnesses
- poor expulsive efforts |
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Term
| Complications of forceps and vacuum: |
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Definition
- scalp abrasions
- soft tissue injury
- Cephalohematoma: does not cross midline
- Subgaleal hemorrhage: can cross midline
- Intracranial hemorrhage |
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Term
Operative deliveries not really done on preterm babies.
The longer you use a vacuum/forceps, the higher the risk. |
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Definition
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