OBGYN Shelf stuff 5 2015

ruhland1's version from 2015-07-23 12:21

Section 1

Question Answer
Labor phases4 of them
quiesence1st labor phase
activation2nd labor phase
stimulation3rd labor phase
involution4th labor phase
phase of paturitionbetween phase 2 and 3 (stimulation -> paturition -> involution)
inhibitory hormones causing quiesenceprogest, prostacylin, relaxin, NO
estrogen increases prostaglandin/oxytocin rec expression in myometactivation
stimulates regular contractionsoxytocin prostaglandin
mediates involutionoxytocin
3 _________'s of laborpower (contractions) Passenger Passage
assesses powerexternal tocadynamometry and intrautering pressure cath
"adequate contractions" in active phase200-250 MVU

Section 2

Question Answer
Lielongitudinal axis of fetus relative to longitudinal axis of uterus (longitudinal, transverse, oblqiue)
Presentation main typescephalic,breech,brow
frank breechfeet near head
complete breechlegs are crossed
incomplete breechone or both feet extended
attitudeposition of head with regard to fetal spine
attitude typesvertex, sinciput, brow, face
sinciputfront skull attitude
LOA=left occiput anterior
positionrelationship of fetal presenting part to maternal pelvis
malpositionanything not OA, LOA, ROA
asynclitismsaggital suture is not directly central, relative to maternal pelvis
location of "0" stationfetal vertex at level of ischial spines
engagementwidens diameter of fetal presenting part has passed through pelvic inlet
biparietal diam must pass throughpelvic inlet
measure of pelvic inletsacral promontory and pubis sympjhisis
diagonal conjugatesacral promontory to inferior pubic symphysis
true conjugate=obstetic conjugate
true conjugate measuresacral prom to suprior pubic sympph

Section 3

Question Answer
cardinal movements of laborare 7 (engage->descend->flex>int rot->ext->ext rot-> expulsion)
3flexion (bow)
4int rot
6ext rot

Section 4

Question Answer
1/50/-3 meansdilation effacement station
latent phase laborfrom labor onset until "active" (1st stage)
active phase laborwhen slopr of cervical dilation accelerates *at ~ 4 cm and 80% efface (1st stage)
1st stage laborfrom labor onset to complete cervical dil
2nd stage laborfull dilation to delivery of baby
3rd stage laborafter delivery of baby to delivery of placenta
active phase1.5cm/hr multiparous, 1.0cm/hr nulliparrior
crede manuversustained traction at uterine fundus and umbilical cord is fixed w/ opposite hand
brandt-andrews manuverabdominal hand secures uterine fundus while downward traction placed on umbilical cord
1st degree perineal injury confined to epithelial
2nd degree perineal injuryextends to perineal body
3rd degree perineal injuryinvolves ext anal sphincter
4th degree perineal injuryextends through rectal mucosa (cloacal defect)

Section 5

Question Answer
active phase and descent d/o'sboth protracted and arrested
labor dystocia"difficult labor or childbirth"
protracted latent phaseexceeds 20 hours in nulliparous/ 14 hours multiparous
protracted latent phase txrest morphine
inefficient uterine activityhypotonic(braxton hicks), hypertonic(out of sync), eutonic(normal but no cervical dil)
protraction active phase d/oless than 1.0cm/hr nulli or 1.5cm/hr multiparous
no dilation for >2hoursarrest of dil !!!!!
no descent >1 hourarrest of descent!!!!
amniotomy tximprove dysf labor, elimnate dysf early, progress protracted labor
requires IUPC monitoringgiving oxytocin in induction
adequate labor4contract/10min/200MVU

Section 6

Question Answer
CPD (cephalopelvic disporportion)causes dystocia at level of pelvic inlet/midpelvis
reasons why placenta does not detachjust unusually long period of detachment, placenta accreta, lower uterine seg contracted (stuck)
1st priority to correct/tx abnormal patternensure fetal and maternal wellbeing
protracted desent<1cm/hr nulli <2cm/hr multi
arrest descentcessation for >1hour
cephalopelvic disproportion (CPD)most important measure in 2nd stage labor!!!!
tx second stage d/oAUGMENTATION or forceps/vacuum/c-sec
when is head SYNCLITIC?when BPD is same as pevlic plane and sagital suture is midway b/t ant and posterior planes
dystocia=!!!difficult labor/childbirth
transverse liehead and butt at lateral ends of uterus
posterior presentationbabies face in same direction as mom's
c-sec macrosomiaif non-diabetic >5000g or diabetic >4500g