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Doctor High Yield Ob-Gyn Already Graded A+

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Doctor High Yield Ob-Gyn Already Graded A+ define post partum hemorrhage 500mL by vaginal 1L if by CS most common cause of post partum hemorrhage uterine atony= spiral a. can't contract fast enough because of flaccid, weak uterus key finding in uterine atony boggy uterus above umbilic...

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  • September 27, 2024
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  • 2024/2025
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Doctor High Yield Ob-Gyn Already Graded A+
define post partum hemorrhage

500mL by vaginal
1L if by CS

most common cause of post partum hemorrhage

uterine atony= spiral a. can't contract fast enough because of flaccid, weak uterus



key finding in uterine atony

boggy uterus above umbilicus

first line tx for uterine atony

#1: uterine massage

#2: oxytocin

key US finding and tx in retained placenta

uneven endometrial lining

tx: D&C

risk for laceration causing postpartum hemorrhage

forceps delivery

when is latent phase of labor

0-6cm of cervical dilation

when is active phase of labor

6-10cm of cervical dilation

define arrest of active phase of labor

1- no cervical change over 4h w/ adequate contractions

2- 6h w/o adequate contractions

define adequate contractions

every 2-3 min w/ contractions

or

,>200 Montevideo units in 10 minutes

define arrest of descent

10cm max cervical dilation
delivery takes longer than 3h

#1 cause of arrest of descent

Cephalopelvic Disproportion

pathognomonic for uterine rupture

intense pain
baby's head was at 0 station and now at -3 station
difficult to palpate where fetus is in uterus

what is prolapsed cord and tx?

umbilical cord prolapsed through cervix and is in way of path of descent so need to go to C-section

causes of fetal tachycardia

160+

maternal fever

define tachysystole and what can it cause to fetus? tx?

5+ contractions every 10 minutes

fetal bradycardia

tx: terbutaline= B2 agonist

#1 adverse effect of tocolytic

pulmonary edema

marker to distinguish B thalassemia from other microcytic anemias

elevated HBA2

normal maternal changes in pregnancy

increased cardiac output
elevated GFR= glucosuria
respiratory alkalosis
increased tidal volume= PCO2 lower than average
increased plasma volume dilutes RBC= physiologic anemia of pregnancy

shoulder dystocia definition

, anterior should gets stuck behind mom's pubic bone

first step tx for shoulder dystocia

mcrobert's maneuver= hyperflex the hip

prenatal risk factors for shoulder dystocia

prior hx for mom
macrosomia due to GDM

GDM v pre-GDM-- which is more dangerous?

pre-GDM is diabetes before week 20!!

- more dangerous because of cardiac defects

fetal bradycardia can be caused by

maternal hypotension because of reflex vasoconstriction of spiral aa. in attempt to increase TPR

what causes vasoconstriction of spiral aa? (2)

uterine atony
cord compression

fetal heart rate accelerations
what is adequate?

used in fetal non-stress test= measure HR in 20 min

adequate= 15 in 15, 2 in 20
increase in HR by 15 in 15 seconds and see 2 of these in 20 min

when do we do a fetal non-stress test?

less mvmts felt by mom

what to do if fetal non-stress test is equivocal or not conclusive?

did not see 15 in 15, 2 in 20

go to biophysical profile

biophysical profile components and interpretation

BATMN

breathing
amniotic fluid= need a 2cm pocket
tone
movements of baby
non-stress test

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