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Maternity revision

antenatal & postnatal

QuestionAnswer
what does syntocinon do contains oxytocin. stimulates rhythmic contraction of the womb during & after delivery
What is konakionn for vit.K to prevent or treat blood clotting problems can be given in multiple tablet doses or 1 I/M
What is ergometerine for treatment of postpartum or postabortion haemorrhage. stimulates contraction of uterine
what is the safety formula for baby sleeping. aids in protection from SUDI Face up. Face clear. Smokefree
what's the average weight of neonate 2700-4000 grams (6-9 pounds)
how much weight do baby's loose in the first 3-4 days and why? 10% of their body weight. Output of meconium & urine exceeds input
what is the average length of a newborn 46-56cm
what is the average chest & head circumference of a baby chest: 30.5-33cm Head:32-36cm (should be 2-3cm larger than chest)
what is the normal vital signs of a new born resp: 30-60 H/R: 120-160 Temp: 36.3-37.5
what is the length of the umbilical cord about the length of the baby (50cm)
what is the purpose of hip checks to check for congenital dislocation of the hip
why is BGL screening important transient physiological drop may occur in 1st 2 hours of life. screening is directed at infants at risk for pathological hypoglycaemia
what is a serum bilirubin test a blood test to measure levels of bile pigment in blood serum to evaluate their liver function
what does an elevated bilirubin test suggest accelerated RBC destruction or may indicate bilirubin is not being excreted properly
what is TORCH/S screen for a blood test that checks for toxoplasmosis, rubella, cytomagalovirus, herpes simplex, HIV & syphilis
what is a guthrie test for A blood test obtained from the heel tests for PKU a genetic disorder caused by the faulty metabolism of phenylaline. Recommended to be obtained 48-72 hours after birth
what are the reflexes of position & movement Moro reflex: birth-1/3mth Tonic neck: birth-5/7mth Palmar grasp: birth-4mth Babinski: birth-2yr
what are the reflexes to sound blinking response & turning response
What are the reflexes of vision blinking to threat: 6-7mth horizontal following: 4-6wk vertical following: 2-3mth Postrotational nystagmus: birth
what are the food reflexes rooting response: birth- 3/8mth suckling response
what is the reflex not categorized headlag
what causes Rh or ABO incompatibility if mother is Rh- and foetus is Rh+ antibodies are made by mother for foetus's antigens ABO when mother is O & baby is A or B
what is 'isoimmunizaton' if foetal Rh+ blood leaks into Rh- mothers circulation her body may make antibodies to destroy the Rh+ erythrocytes
what is the treatment for Rh incompatibility prevent manufacture of anti-Rh-antibodies by giving Rh(D) immune globulin to the Rh- woman 28wk gestation & 72hours after birth of Rh+ baby
what is meconium The first stools. is made of amniotic fluid, mucus bile, and cells that have been shed from the skin and the intestinal tract
how many stools do infants pass a day Breastfed: 3-6/day Bottlefed: 1-4 then reduce to 1-2/day
what is physiological jaundice normal jaundice due to immature liver & slow processing of bilirubin. Appears 2-4days & disappears 1-2 weeks
what is pathological jaundice evident in first 24hour. liver cannot handle hemolysis & bilirubin levels rise. O2 capacity of RBC diminishes
what is kenicterus Accumulation of bilirubin in the brain tissue. a result from bilirubin toxicity.
what are the aims of ante-partum care maintenance of wellness for mother & child early detection & treatment of problems pregnancy to term followed by healthy birth preparation for breastfeeding preparation for parenting assist other family members to adapt to change
what are the blood tests for in ante-partum care blood group & antibodies Full blood count Hep B, Rubella & Syphilis ?HIV if needed
why is folic acid needed 1 month prior to pregnancy & first 3 months in pregnancy reduces the risk of neural tube defects
why is iodine needed in pregnancy As iodine is essential for normal brain development, it's important that the foetus have adequate intake. needed for thyroid hormones
what are the presumptive signs of pregnancy amenorrhoea, breast changes, nausea/vomiting, quickening, deepening pigmentation, urinary frequency
what are the probable signs of pregnancy Braxon-Hicks contractions, abdominal enlargement, ballottement, vaginal examination (Goodwells, Chadwick, Hegar & macdonald signs) Striae graviderum & + pregnancy test
what are the positive signs of pregnancy fetal heart, movement & fetal parts able to be palpated. Visualization on ultrasound
what is engorgement when vessels enlarge around breasts. Breasts become hard & painful & baby cannot fix on
what is chloasma increased pigmentation of face. A presumptive sign of pregnancy
what is linea nigra a line extending in the midline of abdomen from just above the umbilicus to the symphysis pubis
what is quickening fetal movement felt by mother. first perceived at 16-20weeks as a faint fluttering in lower abdo.
what are braxton hicks contractions are irregular painless, uterine contractions that begin in the 2nd trimester & become progressively noticeable as term approaches
what are the dates for the trimesters 1st trimester is to 12-14 weeks gestation, the 2nd trimester up to 28 weeks gestation, and the 3rd trimester is till term. 3 months each
what is ballottement a maneuver by which the fetal part is displaced by a light tap of a finger on the cervix and then rebounds quickly
what are the readings for gestational hypertension 130/90 two readings over a period of 6hours. 30 above systolic baseline & 15 above diastolic
what are the signs of pre-eclampsia oedema, increased BP & protein urea
what are the main signs of worsening pre-eclampsia complain of frontal headache oedema around retina egigastric pain
what is eclampsia cerebral oedema causes convulsions. affects circulation O2 (hypoxia of mother & baby). Placental abruption. Death. Convulsions can continue 48-72 hours after birth
what is the treatment for eclampsia I/V magnesium sulfate postpartum (for convulsions) I/V hydralasine (for BP)
what is HELLP syndrome Heamolysis of RBC ELevated liver enzymes Low Platelets
how much folic acid is needed to reduce effects of neural tube defects 0.4mg 0.5-0.6mg for pregnant or breastfeeding 0.8mg if hx of neural tube defect
how much blood loss is considered post partum heamorrhage >500ml
what can you do to help a woman with a post partum heamorrhage stimulate fudus. becomes tight & stops bleeding. Bladder must be empty so it can contract down
what is DIC ( disseminated intravascular coagulation) the proteins that control blood clotting become abnormally active. Won't return to normal until placenta is removed
gestational diabetes and baby weight >4kg baby tend to become diabetic 20% more than normal expected weight gain (normal 9-11kg)
what are the signs of impending labour braxton hicks contractions Increased vaginal discharge Bloody show Rupture of membranes Energy spurt weight loss
what are the mechanisms of labour descent, engagement, flexion, internal rotation, extensions, external roataions & expulsion
what are the 3 types of lochia rubra, serosa, alba
define lochia rubra red because composed mostly of blood. Lasts for 3 days
Define lochia serosa pinkish because of blood & mucus content. lasts 3-10days
define lochia alba is mostly mucus & is clear or colourless. Lasts 10-21 days
what are the 4 P's of the birth process Power Passage passenger Psyche
What does APGAR test for Activity Pulse Grimace Appearance Respiration
when should APGAR be done one & 5 min after birth May be repeated at 10min
what score of APGAR indicates intervention points out of 10. Below 7 indicates intervention
what does a score of 1 for activity in APGAR show arms & legs extended
What does a score of 1 for pulse in APGAR mean pulse above 100
What does a score of 1 indicate in APGAR for appearance pink body, blue extremeties
what is pelvic inflammatory disease a spectrum of inflammatory disorders of the upper female genital tract. endometriosis, salpigitis, tubo-ovarian abcess, pelvic peritonitis
what is acute P.I.D sudden violent attack. often with high fever, abcess may occur
what is recurrent P.I.D if untreated or not cleared. May be related to inappropraite use of antibiotics or reinfection by partner
What causes chronic P.I.D when untreated or inadequate treatment causes ongoing pain.
what causes P.I.D ascending spread of micro-organisms from vagina & endocervix to upper GI tract. often occurs at end or after menses
Define exclusive breast feeding infant has never had any other liquid or solid foods only breast milk prescribed medicines have been given since birth
Define full breast feeding within past 48 hours the infant has had BM only, no other liquids/solids, except minimal water or prescribed meds
Define partial breast feeding infant taken some BM & some formula or other solids in past 48 hours
Define artificial feeding infant had no BM but has had alternative liquid such as formula, with/without solid food in past 48 hours
what is WHO hierarchy of infant feeding 1. Breast 2. Expressed BM given in another way 3. Milk from another human mum 4. Artificial milk
risks of formula for infant from WHO Decreased resistance against illnesses, Reduced cognitive development & visual acuity. Increase risk of 1 & 2 diabetes, child obesity & coeliac. Increased mortality in 1st year.long term negative impacts for heart health
What are the long term benefits for breast fed children (WHO) Lower BP. Lower total cholesterol. Less likely of being overweight. less likely to get type 2 diabetes. better school performance in late adolescent or young adulthood
What are the benefits for mothers that breast feed. (WHO) prevent post partum haemorrhage, breast & ovarian cancer & potentially prevent post manopausal hip fracture
name the benign breast diseases (6) fibroadenoma. Fibrocystic disease. Fat necrosis. Breast abscess. Ductal papiloma. Mammary duct ectasia
what is fibroadenoma smooth, hard movable lumps, not painful. common in mid 30s. AKA breast mice
what is fibrocystic disease round tumors, may be multiple. common 35-45. associated with menustruation, hormonal changes, tender, larger than normal breast
what is fat necrosis common in women over 50. can mimic cancer, is usually painless. Is responsive to tissue injury (MVA)
what is a breast abscess often seen in breast feeding women. Staph aureus reaching breast via cracked nipple from pharynx of infant. very hot, tender & women systemically unwell. Antibiotics needed & sometimes surgical draining
what is ductal papiloma benign tumor of ductal epithelium. Lump in areola region. may present as blood stained discharge, causes discomfort. Duct surgically removed [microdochectomy]
What is mammary duct ectasia common 40-50. abnormal involution of breast ducts, dilated ducts, leakage & inflammatory changes, pain & nipple discharge (not bloody) and lumpiness. Lumps treated with anti inflammatory
what is breast cancer a malignant area of the breast. most in milk ducts but other begin in lobules. may develop over years. Spreads to lymph nodes then commonly to lungs, bones & liver. may also spread in blood
what are the risk factors for breast cancer ageing. Previous breast biopsy identifying risk. family Hx genetic factors exposure to repeated radiation obesity, weight gain after 18. alcohol intake not having kids first kid after 35. HRT, oral contraception & depo provera ovarian cancer, t
what are the signs of breast cancer a new lump or thickening. Change in shape/size. Pain that is unusual. Puckering/dimpling of skin. Changes in nipple, inverted/discharge. Rash/ redness only on 1 breast
whats the best way to find breast cancer early educate women, breast models to enable detection. Fine needle biopsy, mammography & ultrasound
what is mammography women 45-69, every 2 years. can detect tissue changes in breast before being seen/felt. Can detect 75-90% of unsuspected cancer. Early detection does not prevent cancer.
what are the surgical options for breast cancer total mastectomy& axillary node dissection or local excision of breast tumor with axillary node dissection
what are the treatments options, other than surgery, for breast cancer radiotherapy to breast & axillary. Hormonal therapy & chemotherapy. counselling ect
breast screening in NZ Breastscreen Aoteroa is a free national screening for 45-69years. Uses mammography to detect early breast cancer-only proven method
What is used for Cervical screeing Gardisal 12-18 years vaccine. Screeing in 3 yearly intervals until age of 70 commencing at beginning of sexual activity. Colposcopy & biopsy to detect changes in cervix
Define the Cervical intraepithelial neoplasm 1 1. low grade, mild dysplasia, cells mildly abnormal, seen within 5-6mths of referral then one follow up appointment
Define the Cervical intraepithelial neoplasm 2 high grade changes or moderate dysplasia, cells moderately abnormal, seen withing 4wk of referal. 2 follow up after treatment
Define the Cervical intraepithelial neoplasm 3 high grade changes, sever dysplasia or carcinoma in situ seen within 4wk of referal. 2 follow up after treatment
breast screening in NZ Breastscreen Aoteroa is a free national screening for 45-69years. Uses mammography to detect early breast cancer-only proven method
what is the reason for a cone biopsy of the cervix Gardisal 12-18 years vaccine. Screeing in 3 yearly intervals until age of 70 commencing at beginning of sexual activity. Colposcopy & biopsy to detect changes in cervix
Define the Cervical intraepithelial neoplasm 1 cryotherapy- ice expands, cracks, scab breaks away away leaving healthy epithelium. Laser- local. destorys cells, strict aftercare to avoid infection. Diathermy-local. abnormal cells cut away from cervix
Define the Cervical intraepithelial neoplasm 2 high grade changes or moderate dysplasia, cells moderately abnormal, seen withing 4wk of referal. 2 follow up after treatment
Define the Cervical intraepithelial neoplasm 3 high grade changes, sever dysplasia or carcinoma in situ seen within 4wk of referal. 2 follow up after treatment
what is a cone biopsy minor surgical procedure under general A when a cone shaped segment moved from cervix.
what are the reasons for a cone biopsy lesions not adequately seen in coloscopy. abnormal cells in high neck of cervix unable to be reached. abnormal area developing below surface of cervix
treatment for abnormal cervix cells cryotherapy-ice expands, cracks, scabs break away leaving healthy cells laser- under local. destroys cells, after care to avoid infection, minimal bleeding Diathermy- under local. abnormal cells cut away in segments
what are the tubal causes for infertility (14%) inability to conceive after 12mths of unprotected intercourse aprox. affects 10-15% of couples
What is the difference between primary & secondary infertilty Primary- woman never been able to conceive. Secondary- conception has taken place regardless of outcome
what are the 4 main causes of infertility anovulation (no release of ovum) tubular factor/adhesions endometriosis male factors- semen abnormalities
what are male factors of infertility (24%) testicular disease, orchitis (inflam. of tetes) trauma, drugs. Obstruction of ductus deferens- surgical functional cystic fibrosis Sperm antibodies
tubular factor affecting infertility (14%) PID, endometriosis, surgical adhesions, bowel disease-ruptured appendix, chrons
what are miscellaneous factors affecting infertility endometriosis 6% sexual dysfunction 6% cervical mucus hostility 3% unexplained infertility 27%
ART ( assisted reproductive therapy) options for infertility - In vitro fertilisation indicated for tubal disease, unexplained infertility, endometriosis, male infertility, failed donor insemination or cervical hostility
ART ( assisted reproductive therapy) options for infertility- donor donor oocytes used with ovarian disorder e.g early menopause
ART ( assisted reproductive therapy) options for infertility - Gamete intrafallopian transfer suitable for all indications of IVF except where there may be a blockage or absent tubes. Not a common choice for ART
ART ( assisted reproductive therapy) options for infertility - intracytoplasmic sperm injection used for sperm dysfunction. sperm are harvested from epidydimis or testes & injected into ovum. embryo is transferred to uterus
Name the types of contraception combined pill, mini pill, depo provera, intra-uterine device, diaphragm & caps, condoms, emergency pill, fertility awareness, female sterilisation, vasectomy
what is endometriosis endometrial tissue in parts of the body other than in the uterine cavity
what is the average age for endometriosis 20-45 Highest in 40-44
what are the S&S of endometriosis worsening menstrual cramps. painful poo & diarrhoea painful sex abnormal bloating heavy bleeding stomach upset infertility
what are the management options for endometriosis suppression of oestrogen levels- reduction in endometrial growth Contraception for menstruation surgery if needed
what is a complete miscarriage the entire pregnancy is lost
what is an incomplete miscarriage part of the pregnancy is lost. parts of the placenta & blood remain in the uterus
what is an inevitable miscarriage the woman experiences bleeding, the cervix opens thus the products of contraception will be expelled
what is a missed abortion the pregnancy has stopped growing, often due to an abnormal ovum, the woman will expel the products of contraception
what is secondary health for addictions early detection & intervention: screening, advice, assistance programmes, media campaigns, community education programmes, stress management techniques
Created by: 888570690