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6-30-10 OB Sess 3

6-30-10 OB Sess 3 Mid term Barry Class 2012

QuestionAnswer
Why is the term C section proven not to be linked to Julius Caesar Because a Cesarean section would have been fatal to his mother at such a primative time and there if evidence she was alive after his birth (plus cesarean means to cut - so cesarean section is repetative...should be cesarean delivery)
Name 3 Horizonal skin incisions for c section (starting at lowest) Rfannenstiel, then Maylard, then Supraumbilical (the vertical incision is called Midline)
T/F: Has the incidence of c sections increased to date Yes
What are the indications for having a c-section over a vaginal delivery Problems or just preference
Which ligament may cause a complication of c section hematoma Broad ligament
Premedications for C-section (3 classes) Benzodiazepines (which are considered a "D" by the FDA), Opioids, and Aspiration prophylaxis
What are 5 possible materal complications of Anesthesia for parturients Aspiration (r/t delayed gastric emptying and decreased esophagus sphincter tone), Hypotension (r/t decreased SVR and placenta hypotensive arena), Difficult intubation (swelling r/t progesterone), high spinal (r/t venous engourgement), Local CNS toxicity
Benefits of spinal over epidural (8 things) Spinal has quicker onset, reaches Sacrum better, denser block, cheaper, easier to perform, less painful, lower dose needed, and rare Shivering
Negatives of Colloid prehydration for spinal/Epidural Anaphylaxis, alter coagulation, and expensive
Bupivicaine dose for 5'9" 172 lb pt for Spinal 11.25 mg (1.5 dextrose)
A high spinal causes severe hypotension because of decreased CO2 secondary to decreased preload
If Moms systolic BP stays below (?) for 4-5 minutes it will cause irreversable fetal damage < 80 mm Hg
Brain stem hypoxia may trigger vomiting center
Shivering more common in Epidural or Spinal Epidural
What is better, treating hypotension or preventing it Prevention (although studies state prehydration doesn't prevent)
What is epinephrine role with epidural (4 things) Prolonged duration, reduced peak plasma concentration of local, increased density of block, and marker for intravascular injection
Where should the heart be to decrease the incidence of Venous air embolism Above the uterous
A hormone that stimulates gastric emptying Motilin (it is inhibited by progesterone)
What is the starting dose of Pitocin 20-40 units per liter (slide 69) - have methergine, hemabate, and misoprostol availible as back up for uterine atony
Uterine to delivery should be less than (minutes) 3 minutes
S/S of Classical scar ruture (6 of them) Sudden severe pain, Contractions, Palpable fetus, no heart tones, sudden colapse, and diffuse tenderness
VBAC stand for Vaginal birth after cesarian section
TOLAC stand for Trial of labor after c section
Created by: smorrissey1 on 2010-06-30



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