Universal Precautions correct answersUse barrier protection. Use gloves: blood/culture collection,
delivery, handling newborn, soiled items. Wash hands and contact Dr if contaminated. Use sharps
container. Never recap sharps.
Polyhydramnios correct answersExcess amniotic fluid. Large fundal height at 28wks increasing through
preg.
Associated with: multiple gestation, Rh incompatible, diabetes. Fetal anomalies - atresia of the
esophagus, hydrocephaly, anencephaly or spina bifida.
CPD (cephalopelvic disproportion) is the greatest risk in a breech birth because ... correct answersafter
the body is born, the head might not fit through the pelvis.
Breech risks correct answersCPD - leads to fetal hypoxia - leads to mortality. Cord prolapse.
To deliver breech safely at home correct answersFrank or Complete. Anterior or Transverse position.
Well-flexed head. Gynecoid pelvis. Average sized baby.
Newborn with HBV+ mom correct answersNeeds a Hep B vaccines - HBV and HBIG - within 12 hrs of
birth.
Can an HIV+ mom breastfeed? correct answersNo - infection can be transmitted through breastmilk
GBS profylaxis during labor correct answersPenicillin, ampicillin or cefazolin q 4hrs through the hours of
labor before birth.
Observe newborn 48hrs for s/s GBS
Most fetuses are in vertex position by correct answers35-36 wks gestation. Only 10% of breech will
spontaneously turn to vertex after 36 wks.
Predisposing factors for breech presentation correct answersPrevious breech. Prematurity. Multiple
gestation. Multiparty with lax uterine tone, poly, oligo, placenta previa.
Bicornate uterus. Large fibroids low in uterus.
Hydrocephaly. Anencephaly.
Infant born before 37 wks is correct answersPreterm.
Born between 34 and 36.6 is born in late preterm period.
,Infant born before 34 wks is correct answersPreterm.
Greatest risk of neonatal mortality correct answersPreterm birth.
Risk factors for preterm labor correct answersRisk assessment of preterm labor has low specificity and
sensitivity.
Mom was born premature. Cervix/uterine anomalies - short cervix. Poor nutrition, hydration, BMI,
weight gain. Substance use. Multiples. Polyhydramnios. Placenta previa/abruption. PROM.
Chorioamnionitis from vaginal or UTI infection. Recurrent UTI. Chlamydia. BV. GBS. Periodontal
infections.
Treat infections - UTI and chlamydia - to decrease risk of preterm birth.
Short cervix correct answersCervical length less than 25mm at 18-24wks gestation.
d.x.: transvaginal ultrasound (TVUS) measurement.
PROM correct answersRupture of membranes before 37 wks. Also refers to rupture of membranes
before onset of labor.
Newborn weight to diagnose prematurity correct answers5# 8oz before 37wks.
Newborn/fetal lungs are almost always mature by correct answers34 wks
Signs of RDS in newborn correct answersCyanosis. Tachypnea. Grunting. Retractions. Nasal Flaring.
Immature newborn lungs lack surfactant correct answersto lubricate and inflate the lung alveoli.
Lead to RDS.
Less than 34 wks.
Care for a woman predisposed to preterm labor correct answersHydration, fish oil, excellent diet.
Decrease stress. Monthly BV tests. Increase prenatal exams to every 2wks at 24 wks gestation. Gentle
, cervix check for change - if change no more sex. If regular ctx or cervical change contact Dr. Screen at
first sign of vaginal infection.
Medications for active pre term labor correct answersTocolytics (uterine relaxant): Mag Sulf. Ritodrine.
Terbutaline.
Suppress labor for 24-48 hrs up to 3-7 days.
I.U.G.R/ F.G.R (fetal growth restriction) correct answersAre used interchangeably. Fetal weight below
10th percentile for G.A. Send for ultrasound.
Can be a result of/result in S.G.A.
Fundal height normal until about 24 wks then steady decrease.
Asymmetrical I.U.G.R correct answersweight under 10th percentile, head over. Result of fetal
compromise after 30 wks. Any condition reducing placenta blood flow and O2: hypertension. diabetes.
renal disease. heart disease.
Symmetrical I.U.G.R correct answersHead and body under 10th percentile. Consistent from early
pregnancy: severe malnutrition. exposure to drugs/teratogens. Infection. Multiples. Chromosomal
anomalies.
S.G.A (small gestational age) correct answersmiscalculated dates. transverse or low-lying fetus.
hereditary disposition. I.U.G.R. Send for ultrasound
Management of decreased fetal movement correct answersFetal movement/kick counts. If no risk of for
uteroplacental insufficiency: eat something. Rest in semi recumbent position. count FM. 10 in 1hr is
good. Less than 10, repeat then office visit for NST to r/o I.U.G.R and stillbirth.
Decreased fetal movement is associated with correct answersStillbirth. I.U.G.R. Send for ultrasound.
Biophysical Profile correct answersUltrasound and NST: combo has fewer false pos/neg results. Looking
for s/s of fetal acidemia.
Used from 41wks twice a week. Any time concerned for fetal well being.
Score of less than 7 (scored like Apgar with 0-2 per 5 categories) induction.
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