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Stack #196722
AC OB MODULE 1
| Question | Answer |
|---|---|
| Birthrate | Number of live births per 1000 population |
| Fertility Rate | Number of births per 1000 women between 15-44, calculated on a yearly basis |
| Infant Mortality Rate | Number of deaths of infants under 1 yr of age per 1000 live births |
| Maternal Mortality Rate | Number of maternal deaths from births and complications of pregnancy, childbirth, and puerperium per 100,000 live births |
| Neonatal Mortality Rate | Number of infant deaths under the age of 28 days per 1000 live births |
| Perinatal Mortality Rate | Number of stillbirths and the number of neonatal deaths per 1000 live births |
| Stillbirth | An infant that demonstrates no signs of life at birth |
| Puerperium | The first 42 days after the termination of the pregnancy |
| Where does fertilization usually occur? | Ampulla of the uterine tube (outer 1/3) |
| Mitosis | Replication of body cells by division which produce exact copies of original cells. Facilitates growth and developement or cell replacement |
| Meiosis | Division of germ cells that decreases their chromosomal number by half |
| Ovum | Female reproductive cell, viable for 24 hours after release from ovarian follicle |
| Sperm | Male reproductive cell viable for 2-3 days within female reproductive tract |
| Sperm transit time to ovum? | 4-6 hours average, some 5 minutes |
| Zygote | Fertilized ovum, has 46 chromosomes |
| Morula | Day 3 embryo, consists of 16-50 blastomeres |
| Blastomeres | Cells of a morula that are successively smaller, keeping the morula from increasing in size |
| Trophoblasts | Blastomere cells that give rise to the placenta |
| Embryoblasts | Blastomere cells that give rise to the embryo |
| Blastocyst | The whole structure of an embryo which has a defined blastocyst cavity |
| Implantation | Occurs between 6-10 days post conception, trophoblastic enzymes breakdown the endometrium for blastocyst implantation |
| Chorionic Villi | Develope from trophoblasts and extend into blood filled spaces of the endometrium. Secrete hCG, provide nutrients for embryo,l dispose of waste from embryo |
| Decidua | Term for endometrium after implantation |
| Decidua Basalis | Decidua directly under blastocyst with Chorionic Villi |
| Decidua Capsularis | Decidua covering blastocyst |
| Decidua Vera | Decidua lining the uterus |
| Ovum / Preembryonic Stage | From conception to day 14 |
| Embryo Stage | From day 15 to 8 weeks |
| Fetus Stage | From week 9 to delivery |
| Corpus Luteum | Developes from a follicle after ovulation, secretes estrogen and progesterone |
| Primary germ layers | Differentiation of embryonic disk in 3rd week after conception into 3 layers |
| Ectoderm | Upper layer of embryonic disk. Forms glands,nails, hair, CNS, PNS, eye lens, tooth enamel |
| Mesoderm | Middle layer of embryonic disk. Forms bones, teeth, muscle, dermis, connective tissue, CV system, spleen, urogenital system |
| Endoderm | Lower level of embryonic disk. Forms epithelial lining of respiratory and digestive tracts, glandular cells, liver, pancreas, urethra, bladder, vagina, roof of yolk sac |
| Source of amniotic fluid | Maternal serum, fetal urine |
| How much amniotic fluid is swallowed by a fetus by month 5? | 600ml daily |
| How much amniotic fluid at term? | 800-1200ml |
| Oligohydramnios | Less than 300ml of amniotic fluid.Related to fetal renal abnormalitites |
| Polyhydramnios | More than 2l of amniotic fluid.Associated with gastrointestinal and other abnormalities. |
| Function of amniotic fluid | for fetus to drink, stabilized temp., washed vagina at birth, cushions against injury, enhanced fetal movement, prevents pressure on cord, fetal lung developement |
| Placenta originates from... | chorinic villi and decidua basalis |
| Palcenta is formed and functioning by what month? | Third |
| Placenta weighs.. | 400-600 grams |
| The hormone detected in pregnancy tests? | Human chorionic gonadotropin (hCG) |
| How soon after conception can hCG be detected? | 8-10 days |
| hCG functions to preserve the... | corpus luteum, which produces estrogen and progesterone to maintain the pregnancy early on. |
| Where is hCG produced? | Placenta |
| Where is hCS produced? | Placenta |
| hCS functions to... | transport glucose aross placenta, stimulate lactation, increase maternal resistance to insulin, stimulates maternal metabolism. |
| When does hCG reach its max? | 50-70 days |
| Estrogen functions to.. | stimulate uterine growth and uteroplacental blood flow, breast tissue proliferation, stimulates myometrial contractility |
| Placental estrogen | estriol |
| Ovarian estrogen | estradiol |
| Progesterone functions to... | maintain endometrium and then the desidua, decreases contractibility of uterus. |
| Relaxin functions to... | relax joint articulations, increase maternal metabolism, develope breast alveoli. |
| First system to function in fetus? | Cardiovascular |
| Ductus arteriosis | Fetal shunt that bypasses lungs |
| Ductus venosus | Fetal shunt that bypasses liver and dumps into inferior vena cava |
| Foramen ovale | Fetal shunt from right atrium to left atrium |
| Umbilical vein | Brings highly oxygenated arterial blood to the fetus from the placenta |
| Umbilical arteries | 2 arteries that bring co2 from fetus to placenta, poorly oxygentaed |
| Gravida | Number of Pregnancies |
| Term Births | Births between 38-42 weeks |
| Premature births | Births after 20 weeks but before 37 weeks |
| Abortion | Termination before 20 weeks |
| EDC, EDB, EDD | Expected date of confinement, birth, or delivery, Figured by Nagele's Rule |
| Nagele's rule | (First day of last menstrual period)-(3 months)+(7 days)= EDD |
| Amenorrhea | absence of menstruation |
| Quickening | First flutters of fetal movement |
| Goodell's sign | Softening of cervix |
| Chadwick's sign | Cervix becomes bluish in color |
| Hegar's sign | Softening of the lower uterin segment |
| Ballotment | rebound of baby inutero any digital examination |
| When can fetal heart tones be heard? | Stethescope 17-19 weeks, Doppler 8-17 weeks |
| Presumptive signs of pregnancy | Breast changes,amenorrhea, N/V, urinary frequency, fatique, quickening |
| Probable signs of pregnancy | Goodell's sign, Chadwick's sign, Hegqar's sign, positive pregnancy test, Braxton Hicks, quickening |
| Positive signs of pregnancy | Positive ultrasound, x-ray visualization,FHT, fetal movements that can be palpated or seen |
| When do Braxton Hicks contractions start to occur? | After the 4th month |
| Uterine souffle | Uterine arterial blood flow, synchronized with maternal pulse |
| Uteroplacental blood volume at term | 1/6 of maternal blood volume |
| Funic souffle | Umbilical vessel blood flow, synchronized with the fetal heart rate |
| Friabilty | Easily broken |
| Cervical changes during pregnancy | Increased vascularity, increased fraibilty, mucous plug fills endocervix |
| Vaginal changes during pregnancy | Leukorrhea, pH increase from 3.5-6 (alkaline to neutral),more prone to yeast infections, increased vascularity may lead to increased sexual arousal |
| General body changes during pregnancy | Slight cardiac enlargement, apical pulse increases 10-15bpm @14-20 weeks, BP decreased in 2nd trimester |
| Supine hypotensive syndrome | Caused from compression of the vena cava by the uterus when lying falt on back.Decrease of systolic pressure of 30mm hg, reflex bradycardia, reduced cardiac output and faintness. |
| Striae graviderum | Stretchmarks |
| Chloasma | Mask of pregnancy |
| Linea Nigra | Darkened line form belly button to symphysis pubis |
| Pica | Craving and ingestion of non-nutritive substances or food substances |
| Rapid Plasma Reagent (RPR) | Syphillis test |
| Blood tests during pregnancy | RPR, CBC, RH blood typing, Heatitis B, H&H, WBC |
| Urine Test during pregnancy | Glucose, albumin, nitrates, leukocytes |
| Vaginal tests during pregnancy | GC, chlamydia, pap smear |
| McDoanld Method of measuring fetal development | Top of symphysis pubis to top of fundus, in centimeters, height corresponds to week of gestation |
| Alpha fetoprotein Test | Elevated levels indicate open neuro tube defects, decreased levels may indicate downs syndrome, done at 16-18 weeks gestation |
| Group Beta Strep | Swab done at 35-37 weeks, lives in vagina and rectum, deadly to newborns |
| When and where can the fundus first be palpated? | 14 weeks at level of symphysis pubis |
| Uterine Souffle | Uterine arterial blood flow. Synchronized with maternal pulse |
| Uteroplacental blood volume | 1/6 of maternal blood volume contained in uterus at term |
| Funic souffle | Umbilical vesssel blood flow, Synchronized with fetal pulse |
| When do Braxton Hicks start? | 4th month |
| Presumptive signs of pregnancy | Breast changes, amenorrhea, N/V, Urinary frequency, fatigue, quickening |
| Probable signs of pregnancy | Goodell's sign, Chadwick's sign, Hegar's sign, Positive pregnancy test, Braxton Hicks, ballotment |
| Positive signs of pregnancy | Positive ultrasound, x-ray visualization, FHT, Fetal movements that can be palpated or seen |
| Intrauterine growth restriction | Featl undergrowth from any cause |
| SGA baby | Small for gestational age |
| Underweight BMI | <19.8 should gain 12.5-18kgs |
| Normal BMI | 19.8-26 should gain11.5-16kgs |
| Overweight BMI | 26-29 should gain 7-11.5kgs |
| Obese BMI | >29 should gain 7kgs |
| Glucose tolerance test GTT | done at 24-28 weeks, screen for gestational diabetes |
| Hemoglobin | >11 |
| Hematocrit | >33 |
| RBC's | 1500-1900 |
| Plasma Volume, per ml | 3700 |
| Mean Arterial Pressure MAP | (Systolic +2)(Diastolic)/3=Map |
| Weight gain in first and second trimester due to... | growth of maternal tissue |
| Weight gin in third trimester due to... | fetal growth |
| Physiologic Anemia | Decrease of hemoglobin relative to the increase of plasma |
| False labor | Irregular contractions, no increase in frequency duration or intensity, NO CERVICAL CHANGE |
| How to stop false labor | Comfort measures, walking, changing position |
| True labor | CERVICAL CHANGES, regular contractions increase with walking,increase in frequency |
| Essentials factors of labor | PassengerPassagewayPowersPosition of MotherPsyche |
| Fetal Presentation | Portion of the fetus overlying the pelvic inlet. Cephalic, breech, shoulder |
| Sutures of skull | Sagitall,lambdoidal.coronal,frontal |
| Fetal Lie | Relation of long axis (spine) of fetus to long axis of mother. Longitudinal and transverse |
| Fetal Attitude | Chin on chest, thighs to chest, knees bent (fetal position) |
| Fetal Position | Relationship of fetal presenting part to quadrants of maternal pelvis |
| Maternal Pelvic Quadrants | Anterior, posterior, transverse |
| 3 part abbreviation for POSITION | First letter-denotes location of presenting part related to side of maternal pelvis (R-L)Second Letter-Specific presenting part of fetus (Occiput, sacrum, mentum, scapula)Quadrant of maternal pelvis |
| Best place to hear fetal heart tones (FHT) | Over the shoulder |
| Leopold's Maneuver | 4 external maneuvers to determine fetal position in utero |
| Lightening | Moving of fetus into the pelvis 10-14 days before labor |
| Mechanisms of labor | Engagement, descent, flexion, internal rotation, extension, restitution and external rotation, expulsion |
| How many stges of labor? | 4 |
| First stage of labor | Onset of regular uterine contractions to full effacement and dilation of the cervix |
| Second stage of labor | Full dilation of cervix to birth of baby |
| Third stage of labor | Birth of the baby to the separation and expulsion of placenta |
| Fourth stage of labor | 1-2 hours after delivery |
| First stage latent phase | Phase in the first stage of labor when the cervix dilates form 1-3cm |
| First stage active phase | Phase in first stage of labor when the cervix dilates form 4-7cm |
| First stage transition phase | Phase in first stage of labor when the cervix dilates from 8-10cm |
| Passageway | Birth canal, consists of the pelvis, cervix, pelvic floor, vagina, introitus |
| Gynecoid Pelvis | 50% of women, round |
| Android Pelvis | 23% of women, heart shaped |
| Anthropoid Pelvis | 24% of women, oval shaped |
| Platypelloid Pelvis | 3% of women, flat shaped |
| Primary Powers | Involuntary contractions responsible for effacement,dilation and descent of fetus |
| Terms used to describe involuntary contractions | Frequency, duration, intensity |
| Effacement | Shortening and thinning of cervix |
| Ferguson reflex | Urge to push |
| Secondary Powers | Ferguson reflex |
| Second stage latent phase | Resting phase |
| Second stage descent phase | Active pushing |
| Second stage trasition phase | Presenting part on the perinium |
| Fetal Tachycardia | 160 BPM or more sustained for 10 minutes or more |
| Fetal Bradycardia | 110 BPM or less sustained for 10 minutes or more |
| FHR Baseline | Average rate during a 10 minute segment excluding episodic changes, marked variability, and segments of the baseline that differ more than 25 beats |
| Minimal Variability | <5 BPM from FHR baseline |
| Moderate Variability | 6-25 BPM from FHR baseline |
| Marked Variability | >25 BPM from FHR baseline |
| Absence of variability | A non-reassuring sign |
| Periodic Accelerations | Caused by dominance of sympathetic nervous response, usually breech babies |
| Accelerations during movement are... | a sign of fetal well being |
| Decelerations | Decrease of FHR, related to parasympathetic response |
| Early decelerations | Associated with head compression |
| Variables are caused by... | umbilical cord compression |
| Amnioinfusion | Increasing amount of amniotic fluid to reduce variable decelerations (floating the cord) |
| IUFD | Intrauterine fetal demise (stillborn) |
| Postmaturity | Overdue |
| Oxytocin | "Pit", used to induce or augment a slow labor |
| Piggy back pitocin into... | the closest site to patient |
| Pitocin "Recipe" | 20 units/1000 mlLR on a pump at 1-2 miliunits/minute |
| 2 miliunits equal | 6 mls |
| Increase pitocin... | Every 15-30 minutes until regular contraction pattern established. 1-2 miliunits intervals |
| Amniotomy | Artificial rupture of mambranes |
| Check maternal vitals with pitocin drip every... | 15 minutes |
| Amniocentesis indications for use | Genetic concerns, fetal maturity, fetal hemolytic disease |
| Possible maternal complications from amniocentesis | Hemorrhage, infection, labor, abruption, amniotic embolus, maternal RH isoimmunization, leakage |
| Possible fetal complications from amniocentesis | death, hemorrhage, infection, direct injury from needle, miscarriage, preterm labor |
| Amnioitis | Infection of amnion |
| Biophysical Profile (BPP) | Assessment of physical and physiological characteristics of the developing fetus, non-invasive |
| Normal BPP for fetal breathing movements | One or more episodes in 30 minutes, each lasting >= 30secs |
| Normal BPP for gross fetal body movements | 3 or more discrete body or limb movements on 30 min. |
| Abnormal BPP for fetal breathing movements | Episodes absent or no episodes in >= 30 sec in 30 minutes |
| ABnormal BPP for groos fetal body movements | Less than 3 episodes of the body or limb movements in 30 minutes |
| Normal fetal tone | 1 or more episodes of active extension and flexion of fetal limbs, trunk, hands |
| Slow fetal tone | Slow extension and flexion, movement of limb in full extension, or movement absent |
| Reactive fetal heart rate | 2 or more episodes of acceleration (>15 bpm) in 20 minutes, each lasting >=15 seconds and associated with fetal movement |
| Qualitative amniotic fluid volume | 1 or pockets of fluid measuring >=1cm in 2 perpendicular planes |
| Scoring for BPP | Normal 8-10Equivocal 6Abnormal <4 |
| Nonstress Test (NST) | Tests fetal well being, most commonly used |
| Accelerations of the FHT is associated with... | Gross fetal body movements |
| NST Procedure | Semi fowlers, slight lt tilt, |
| Non reactive NST | If after 1 hr the test does not meet criteria |
| NST testing recommendations | 2x weekly after 28 weeks for women with diabetes, or are at risk for fetal death |
| Oxytocin contraction test (OCT) | Contraction stress test |
| Purpose of an OCT test | Indentify a fetus that cannot tolerate labor |
| OCT procedure | Determine FHR baseline with external fetal monitor for 20 minutes, Induce contractions with oxytocin (1-2 mu/min of Pitosin) or nipple stimulation |
| OCT contraction | 3 contractions in 10 minutes lasting for 40 seconds |
| Neg OCT | No late decelerations |
| Pos OCT | 2 out of 3 contractions have decelerations |
Created by:
janelloyd
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