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OB 8 (L&D part 1)

Step-2

QuestionAnswer
Which abx should be avoided during pregnancy due to potential teratogenic effects? Fluoroquinolones, tetracyclines, aminoglycosides, sulfonamides
What laparoscopic findings can be seen in endometriosis? Chocolate cysts, powder-burn lesions in peritoneum or on ovaries.
Why is thiamine given in a glucose infusion to alcoholics with hypoglycemia? In the abscence of thiamine glucose can worsen Wernicke Encephalopathy.
Fetal tachycardia is when FHR is > than ____ for > 10minutees. 160
Fetal bradycardia is when FHR is < than ____ for > 10minutees. 110
A sinusoidal, oscillating amplitude of 5-15 bpm (baseline 120-160) often due to fetal ______. anemia
What causes loss of variability in FHR? poor short-term or long term variability due to fetal sleep, CNS depression, or fetal acidosis, normal variability ranges for 6-25bpm
What cause early decels in FHR tracing? due to pressure on fetal head
What causes variable decels in FHR tracing? often due to cord compression
What causes late decels? due to uteroplacental insufficiency/fetal hypoxia
What type of fetal surveillance strategy is typically for high risk pregnancies? weekly/biweekly biophysical profile or nonstress test
What is considered a normal, reactive non-stress test? In 20 min, 2 episodes of 15bpm for 15 sec
What are the first steps in the management of non-reassuring fetal heart tones during labor? place maternal O2 + turn off Pitocin + put mom on left side. Correct hyperstimulation if needed with terbutaline, correct any hypotension in mom, SVE and place FSE(check for cord prolapse), consider amnioinfusion or c-section
Match the following statement to the type of deceleration with which it belongs: a check mark-shaped fetal heart tracing late
Match the following statement to the type of deceleration with which it belongs: onset either before, during or after uterine contraction variable
Match the following statement to the type of deceleration with which it belongs: consistent dips in fetal heart tones when uterine contractions begin early
Match the following statement to the type of deceleration with which it belongs: occur after uterine contractions has begun late
Match the following statement to the type of deceleration with which it belongs: unpredictable changes in fetal heart tone tracing variable
What would be some contraindications to fetal scalp electrode placement? breech presentation, pregnancy <36 weeks, maternal viral infection such as HIV, HepC, active HSV outbreak
What defines prolonged latent phase (in both nulliparous and multiparous pts)? does not progress from latent to active phase for > 20 hours in nulliparous pt or >14 hours in a mutiparous pt.
What defines a prolonged active phase of labor dystocia (in both nulliparous and multiparous pts)? active phase >12 hours or in Nulliparous < 1.2 cm/hour dilation, Multiparous < 1.5 cm/hr dilation
What type of contraction pattern is typically necessary for cervial dilation to occur? contractions q 2-3 min
What are the 3 Ps that must be assessed in the event of labor dystocia? Power (contraction strength, duration, and frequency), Passenger (fetal weight, fetal lie, presentation, and position), Passage (adequacy of pelvis in shape and diameter)
What is the definition of arrest of descent? arrest of descent occurs when the cervix does not continue to dilate during the active phase: Multips: stage 2> 2 hours(epidural), Stage 2 > 1hour (no epidural. In Primips stage 2> 3 hours (epidural), stage 2> 2 hours(no epidural)
How is arrest of descent generally managed? reassess the 3 Ps, placement of IUPC to better assess "power", augmentation with oxytocin to augment "power", C/s if power, passenger and passage are unable to to be further augmented.
One hour into the active stage of labor, a fetus' heart tones become nonreassuring. What actions are taken immediately? maternal O2, remove uterine stimulating agents, left latera decubitus positon
What could you do to manage uterine hyperstimulation? add terbutaline to stop uterine contractions
What is the role of fetal pulse oximetry in L&D? no role
Created by: shelybel
 

 



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