Term
| maternal indications for APFT (10) |
|
Definition
| DM, HTN, heart diseases, renal diseases, sickle cell, SLE, CT disorders, RPL, substance abuse, 41wk |
|
|
Term
| general definition for indications for APFT |
|
Definition
| risk of stillbirth >8:1000 |
|
|
Term
| fetal indications for APFT (6) |
|
Definition
| oligo/poly, IUGR, isolated elevated AFP, alloimmunization, IHCP, multiples |
|
|
Term
| when do kick counts start |
|
Definition
|
|
Term
| evidence for kick counts (S/S) |
|
Definition
|
|
Term
| rate of correlation of bad NST with CP and encephalopathy |
|
Definition
| CP 0.1%, encephalopathy 4% |
|
|
Term
| negative perdictive value for stillbirth for good NST |
|
Definition
|
|
Term
| definition of variable deceleration |
|
Definition
| <30s from onset to peak, decrease >15 bpm, >15s long, <2m long |
|
|
Term
| physiological correlation for depth and duration of variable decels |
|
Definition
depth and duration = hypoxia
prolonged = acidosis
persistent = mild acidosis / CO2 retention |
|
|
Term
| definition of sinusoidal decel |
|
Definition
| 3-5 oscillations a minute, >20m |
|
|
Term
| definition of cartegory 3 |
|
Definition
| IN LABOR only for categories, no variability and decels or sinusoidal |
|
|
Term
|
Definition
| >/= 3 contractions in 10m lasting total 40-60s |
|
|
Term
| contraindications to CST (3) |
|
Definition
| ROM, multiples, any contraindication to vaginal delivery |
|
|
Term
| positive vs negative CST perinatal mortality prediction rate |
|
Definition
negative - 0.1% association with pernatal mortality
positive (>50% lates) - 10% assoc with perinatal mortality |
|
|
Term
| what do you do if a CST is equivocal (<50% lates) but not negative (no lates) |
|
Definition
|
|
Term
| doppler testing sensitivity for M/M |
|
Definition
| 66% in IUGR, 28% in normal sized fetuses |
|
|
Term
|
Definition
2pt - >/= 3 gross movements
2pt - >/= 1 flex/ext of extrem, digit, spine
2pt - breathing >30s
2pt - AFI >5 or MVP >2
2pt - reactive NST |
|
|
Term
| management and mortality rates for BPP 8-10 |
|
Definition
8-10 normal fluid - no change
8 with oligo - delivery at 36-67wk - 89:1000 death rate within 1wk |
|
|
Term
|
Definition
delivery at 36-37wk
<36wk repeat in 24h |
|
|
Term
| management and M/M rates for BPP 0-4/10 |
|
Definition
4 - delivery at 32wk, <32wk monitor
2- delivery now
M/M 600:1000 death of fetus in 1wk |
|
|
Term
| causes of fetal tachycardia - 5 maternal, 1 fetal |
|
Definition
maternal: fever, thyrotoxicosis, acidosis, ketosis, hypoxia
fetal: cardiac anomaly |
|
|
Term
| causes of sinusoidal tracing - 4 |
|
Definition
| isoimmunization, anemia (parvo, hemorrhage), medications (narcotics) |
|
|
Term
| physiology of early decelerations |
|
Definition
| increased parasympathetic output from fetal brain to fetal SA node |
|
|
Term
| dating requirements for elective 39wk induction |
|
Definition
| US <20wk, doptones for 30wk, >/= 36wk since +hCG |
|
|
Term
| outcomes from ARRIVE trial - CD, pre-e, GHTN, need for neonatal resp support, bishop correlation, M/M |
|
Definition
decreased - CD, pre-e, GHTN, resp support
no change - M/M
bishop no correlation |
|
|
Term
| define late pre term to post term |
|
Definition
late pre 34-36
early term 37-38
term 39-41
late term 41-42
post term 42 |
|
|
Term
| still birth rates term, late term, post term |
|
Definition
term 1:1000
late term 1.2:1000
42wk 2x
43wk 3x |
|
|
Term
| amniotomy effect on - labor time, CD, chorio, NRFHT, HIV transmission |
|
Definition
no change - labor time, CD, chorio, NRFHT
decrease - 1st stage of labor abnormalities (if used with pit)
HIV no increase unless >1000C |
|
|
Term
| outcomes if amniotomy alone is used for IOL |
|
Definition
| longer or unexpected time to delivery |
|
|
Term
| pit - concentration, low and high dose regimens |
|
Definition
concentration - 10 mU/mL
low - 0.1-2 mU/min, increase 1-2 mU q15-40m
high - 6 mU/min, increase 6 mU q15-40m |
|
|
Term
| benefits of high dose pitocin - 2 |
|
Definition
| decreased time in labor, decreased rate of CD |
|
|
Term
| risk of high dose pitocin - 1 |
|
Definition
| tachysystole with FHR changes |
|
|
Term
| pit t1/2 and steady state |
|
Definition
5min half life
40 min to steady state |
|
|
Term
| when does pit start working on the uterus |
|
Definition
|
|
Term
|
Definition
| water intoxication, hypotension (with rapid injection) |
|
|
Term
|
Definition
| 12-24h on pit ruptured without change |
|
|
Term
| definition arrest of dilation |
|
Definition
| 6+cm ruptured, 4h without change MVU>200, 6h without change MVU <200 |
|
|
Term
| mentum presentation - delivery method, cause |
|
Definition
associated with pelvic inlet contraction
Ma can Pa cant, cant deliver mentum posterior vaginally |
|
|
Term
| transverse lie delivery method |
|
Definition
back up regular CD
back down classical CD |
|
|
Term
| signs of placenta delivery - 4 |
|
Definition
globular firm uterus
gush of blood
uterus rises in abdomen
cord elongation |
|
|
Term
| effect of foley on - CD, pitocin use, labor length |
|
Definition
| decreases length of pit use, decreases CD rate, increases SVD within 24h |
|
|
Term
| contraindications to foley balloon |
|
Definition
| low lying placenta, consider if unstable lie |
|
|
Term
| hormone changes with membrane stripping |
|
Definition
| increased phospholipase A2 and prostaglandin F2A |
|
|
Term
| membrane stripping effect |
|
Definition
|
|
Term
| highest possible bishop score |
|
Definition
|
|
Term
|
Definition
0 pt - closed/posterior/0-30%/-3/firm
1 pt - 1-2cm/mid/40-50%/-2/med
2 pt - 3-4cm/ant/60-70%/-1,0/soft
3pt - 5+cm/--/80%+/+1/-- |
|
|
Term
| bishop score prediction of CD |
|
Definition
<6 2x risk CD in nullip
>8 no increased risk of CD compared to spontaneous labor |
|
|
Term
| effect of prostaglandins on - SVD rate, CD rate, FHR |
|
Definition
increased rate of SVD in 24h
no change in CD rate
increased tachy with FHR change (esp with 50mcg cytotec) |
|
|
Term
| dinoprostol 2 formulations and dosing, wait time to pit |
|
Definition
prepidil - gel q6h - 6h to pit
cervadil - 1x 12h dose - 6h to pit |
|
|
Term
| contraindications for prostaglandins - 4 |
|
Definition
| asthma, glaucoma, liver/renal issues |
|
|
Term
|
Definition
| tachysystole with FHR changes 1-5%, N/V/D, fever, uterine rupture |
|
|
Term
| dosing of misoprostol - SVD, IUFD, time to pit |
|
Definition
20-50 mcg q4-6h wait 4h for pit
IUFD 200-400 mcg q4-12h |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| delivery timing history classical |
|
Definition
|
|
Term
| delivery timing history myomectomy |
|
Definition
|
|
Term
| delivery timing IUGR singleton |
|
Definition
uncomplicated 38-39w
abn dopplers 34-37w
reverse flow now |
|
|
Term
| delivery timing IUGR di di twins |
|
Definition
uncomplicated36-38w
abn dopplers 32-34w
revers flow now |
|
|
Term
| delivery timing IUGR mo di twins |
|
Definition
|
|
Term
| delivery timing mo di twins |
|
Definition
|
|
Term
| delivery timing mo mo twins |
|
Definition
|
|
Term
| delivery timing twins with fetal death 3 |
|
Definition
|
|
Term
|
Definition
|
|
Term
| delivery timing di di twins |
|
Definition
|
|
Term
|
Definition
no meds 38-39w
meds 37-39w
uncontrolled 36-37w |
|
|
Term
| delivery timing GHTN / pre-e |
|
Definition
GHTN 37wk
pre-e wo SF 37w
pre-e w SF 34w |
|
|
Term
| delivery timing pre-gestational DM |
|
Definition
well controlled 41
vascular complications 34-39w
unontrolled 34-39w |
|
|
Term
|
Definition
A1GDM 41w
A2GDM 39wk
poor control 34-39wk |
|
|
Term
| delivery timing prior stillbirth |
|
Definition
|
|
Term
|
Definition
|
|
Term
| requirements for operative delivery - 11 |
|
Definition
| consent, experience, 10cm, ROM, head engaged, vertex, known position, no CPD, bladder emptied, >/= 2cm, <45 deg rotation |
|
|
Term
|
Definition
| toe, shank, blade, heel, lock, handle |
|
|
Term
| indications for operative delivery - 4 |
|
Definition
| prolonged second stage, NRFHT, maternal fatigue, no accels for 30min in 2nd stage |
|
|
Term
| definition outlet forceps |
|
Definition
| scalp visible without separating labia |
|
|
Term
| definition low and mid forceps |
|
Definition
|
|
Term
| sutures of the fetal head |
|
Definition
metopic/frontal
coronal - by anterior fontanelle
saggital
lamboidal - by posterior fontanelle |
|
|
Term
| mmHg used in vaccuum delivery |
|
Definition
| 600 when pulling, 100 between pulls |
|
|
Term
| placement for vaccuum delivery |
|
Definition
| 3cm anterior to posterior fontanelle |
|
|
Term
| contraindications for vaccumm delivery |
|
Definition
|
|
Term
| failure rate of operative delivery |
|
Definition
|
|
Term
| forceps for - breech, molding, no molding |
|
Definition
pipers breech
simpson molding (lukart w/o fenestration)
tucker-mcclane no molding |
|
|
Term
|
Definition
saggital suture perpendicular to shanks
posterior fontanelle 1 finger breath to shanks |
|
|
Term
| pelvic inlet contracture - definition, complications |
|
Definition
lower pubic symphysis to sacral prominentory <11.5cm
face/shoulder presentation
cord prolapse 4-6x |
|
|
Term
| intraspinous contracture definition |
|
Definition
| distance between ischial spines <10cm |
|
|
Term
| interischial tuberous contracture definition |
|
Definition
| distance between ischial tuberosity <8cm |
|
|
Term
| pubic arch contracture - definition, complications |
|
Definition
| <90 deg, increased perineal lacerations |
|
|
Term
| how often should FHR tracinig be reviewed for complicated and uncomplicated patient |
|
Definition
uncomplicated - q30min in 1st and q15min in 2nd stage
complicated - q15m in 1st and q5min in 2nd stage |
|
|
Term
| PTD accounts for ___% of births and __% of fetal deaths. ___% of PTD is false labor. ___% is pre-viable (which accounts for __% of the deaths) |
|
Definition
| PTD accounts for 12% of births and 70% of fetal deaths. 80% of PTL is false labor not PTD. <1% is pre-viable (which accounts for 40% of the deaths) |
|
|
Term
|
Definition
history of PTD 1.5-2x
CL <2.5cm at 24-28wk
smoking
BMI <19.8
pregnancy <18-24mo apart
multiples
poly
HTN
DM
contractions
vaginal bleeding
extremes of age
low SES |
|
|
Term
| what is the training you should have before doing cervical lengths |
|
Definition
|
|
Term
| cervical length shapes and what they mean |
|
Definition
T - normal
Y - some funneling but good functional length
V - poor functional length
U - likely dilated |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| contraindications to tocolytics |
|
Definition
| hemodynamic instability, NEFHT, pre-e, fetal demise, lethal fetal anomalies, abruption, chorio, <34wk |
|
|
Term
|
Definition
| 0.25mg q20min to q3h for 48-72h max |
|
|
Term
| terbutaline contraindications - 2 |
|
Definition
| sensitivity to cardiac arrhythmia, poorly controlled diabetes |
|
|
Term
|
Definition
| arrhythmia, MI, PE, hypotension, tachycardia, hyperglycemia, hypokalemia, decreased UOP, nausea, vomiting, palpitations, tremor |
|
|
Term
|
Definition
| 50-100mg loading, 25-50mg q6h up to 48-72h max |
|
|
Term
| indomethicin contraindications - 6 |
|
Definition
| renal disease, liver disease, >32wk, bleeding, asthma reaction to ASA, stomach ulcers |
|
|
Term
|
Definition
| closure of ductus, fetal pulmonary HTN, oligo, NEC, IVH |
|
|
Term
| dosing of CCB for tocolysis |
|
Definition
| 30mg loading, 10-20mg q4-6h |
|
|
Term
| contraindications CCB for tocolysis |
|
Definition
| BP <90/50, aortic insufficiency, increased LFT, renal disease, Mg |
|
|
Term
|
Definition
| flushing, dizziness, hypotension, headache |
|
|
Term
| when is Mg indicated for neuroprotection |
|
Definition
|
|
Term
| benefit of Mg for neuroprotection |
|
Definition
|
|
Term
|
Definition
| 4-6g bolus (20min), 2-3g/h |
|
|
Term
| dosing Mg for neuroprotection |
|
Definition
4g bolus, 1g/h
4g bolus
6g bolus, 2g/h |
|
|
Term
|
Definition
|
|
Term
|
Definition
| neuromuscular blockade, hypotension, decreased SBP |
|
|
Term
|
Definition
| flushing, lethargy, hypotonia, diplopia, dry mouth, pulmonary edema, nausea, vomiting, low Ca |
|
|
Term
| SE Mg prolonged use - fetal |
|
Definition
| fetal bone demineralization |
|
|
Term
| timing of steroids for lung maturity - initial |
|
Definition
| 23-36wk suspected delivery within 7d |
|
|
Term
| timing of steroids for lung maturity - rescue |
|
Definition
| 23-34wk, >7-14d from last dose |
|
|
Term
| dosing of steroids for lung maturity |
|
Definition
BMTZ 12mg IM q24h x2
DMTZ 6mg IM q12h x4 |
|
|
Term
| contraindications to steroids for lung maturity |
|
Definition
| if 34wk+ with ... DM, multiples, corio, delivery anticipated in <12h, prior steroids, major fetal anomalies |
|
|
Term
| benefits and risks of bedrest |
|
Definition
benefits - decreases contractions
risks - clots, DM
no change - PTD |
|
|
Term
|
Definition
IV 48h - ampicillin 2g q6h + erythromycin 250mg q6h
PO 5d - amoxicillin 250mg q8h + erythromycin 333mg q8h (can replace erythro with single dose azithro 1g) |
|
|
Term
| indications for immediate delivery if PPROM |
|
Definition
| 34wk, infection (WBC >50, glucose <15, + gram stain, IL6 >11.3), 32wk with proven lung maturity, NRFHT |
|
|
Term
| poor prognostic factors for PPROM |
|
Definition
|
|
Term
| good prognostic factors for PPROM |
|
Definition
| >24wk, normal karyotype on amnio, AFI >2 |
|
|
Term
| chance of survival in PPROM 18-23wk |
|
Definition
18-19wk 0%
20-21wk 6%
22-23wk 27% |
|
|
Term
| prevention of PTD - no history of PTD incidental cervix shortening |
|
Definition
>24wk - no further action
CX >2cm - no further action
CX <2cm - vaginal progesterone 90-100mg/d or 200mg micronized PV gel cap/d |
|
|
Term
| vaginal progesterone decreases PTD by __% |
|
Definition
|
|
Term
| prevention of PTD - history of 1-2 PTD, not clearly cervical insufficiency |
|
Definition
IM progesterone 250mg 16-36wk weekly
CL q2wk 16-24wk if 3cm+
CL q1wk 16-24wk if 2.5-2.9cm
cerclage if <2.5cm CL |
|
|
Term
| prevention of PTD - history of 3+ PTD or history of clear cervical insufficiency |
|
Definition
option A -
IM progesterone 250mg 16-36wk weekly
CL q2wk 16-24wk if 3cm+
CL q1wk 16-24wk if 2.5-2.9cm
cerclage if <2.5cm CL
option B - cerclage at 13-16wk |
|
|
Term
|
Definition
|
|
Term
| benefits/outcomes of cerclage |
|
Definition
| 30% reduction in PTD, 36% reduction in M/M |
|
|
Term
| cc of blood in lap sponge |
|
Definition
100cc soaked
75cc saturated
50% 25cc |
|
|
Term
|
Definition
|
|
Term
| cc of blood in a peri pad |
|
Definition
|
|
Term
|
Definition
| <25h, >1000cc or signs of hypovolemia |
|
|
Term
| causes of uterine atony - 8 |
|
Definition
| poly, multiples, multiparous, rapid labor, long labor, chorio, fibroids, relaxants |
|
|
Term
| methods of uterine tamponade - 6 |
|
Definition
| sterile may cover, laps tied together, 4in gauze soaked in 5000U thrombin in 5mL saline, 300-500cc bakri, stengsakon-blackimore balloon, 60-80cc foleys |
|
|
Term
| success rate of uterine tamponate |
|
Definition
|
|
Term
|
Definition
|
|
Term
| complications b-lynch - 3 |
|
Definition
| uterine necrosis, pyometria, suture erosion |
|
|
Term
|
Definition
| vesicouterine peritoneal level of uterine artery |
|
|
Term
|
Definition
|
|
Term
| spot of a UAE for hemorrhage |
|
Definition
| anterior division of the internal iliac |
|
|
Term
|
Definition
|
|
Term
| complicatications of UAE - 6 |
|
Definition
| infertility, pain, uterine necrosis, gluteal ischeia, vascular perforation |
|
|
Term
|
Definition
|
|
Term
| methergine PPH - dose, interval, comp, contraindications |
|
Definition
0.2mg q2-4h, N/V
contraindicated HTN |
|
|
Term
| hemabate PPH - dose, interval, complications, contraindications |
|
Definition
0.25mg q15-90m
conntraindication asthma
se- n/v, fever |
|
|
Term
| misoprostol pph - dose, interval, SE, contraindications |
|
Definition
800-1000mcg q30m
se - n/v/d, fever
cont- asthma, glaucoma, hepatic/renal dysfunction |
|
|
Term
| TXA PPH - dose, interval, SE |
|
Definition
1g q30m
n/v, dizziness, photophobia |
|
|
Term
| dinoprostol PPH - dose, interval, SE, contrainidications |
|
Definition
20mg PR q2h
n/v/d, fever
contraindications - asthma, glaucoma, hepatic/renal dysfunction |
|
|
Term
| causes of uterine rupture and % - 3 |
|
Definition
history of CD 1%
history of classical 4-9%
no ovbious history 0.05% |
|
|
Term
| causes/risks of uterine rupture - 10 |
|
Definition
| prior CD, prior classical, forceps, ECV, myomectomy, multiples, multip, prolonged labor, close interval pregnancy, prostagladins |
|
|
Term
| long umbilical cord - define, complications, signs |
|
Definition
>70cm
comp - prolapse, knots, IUFD
placental lesions - hypoxia indocator |
|
|
Term
| rate of uterine inversion |
|
Definition
|
|
Term
| stages of uterine inversion |
|
Definition
1 - inside cervix
2 - outside cervix
3 - outside perineum
4 - complete |
|
|
Term
| types of uterine inversion |
|
Definition
acute <24h
subacute >24h
chronic >1mo |
|
|
Term
| management of uterine inversion - 4 |
|
Definition
johnson 80-90% sucess
med augmentation - terb, NTG, Mg, halothine
huntington
haultain |
|
|
Term
| #1 benign placental tumor and incidence |
|
Definition
|
|
Term
|
Definition
|
|
Term
| complications chorioangioma - 4 |
|
Definition
all worse if >0.5cm
hydrops, poly, PTD, IUGR |
|
|
Term
|
Definition
| delivery for fetal indications (hydrops) |
|
|
Term
| associations with vilamentous cord insertion - 4 |
|
Definition
| vasaprevia, succuncuate lobe, bilobed, marginal |
|
|
Term
| risk factors for villamentous cord insertion - 2 |
|
Definition
|
|
Term
| vasa previa associations - 4 |
|
Definition
50% villamentous
50% bilobed, succuncuate, or marginal |
|
|
Term
|
Definition
|
|
Term
| abruption is ___% of 3T bleeding and __% of pregnancies |
|
Definition
| 30% 3T bleeding, 1% of pregnancies |
|
|
Term
|
Definition
| ruptured vessels in decidua basalis |
|
|
Term
|
Definition
| smoking, HTN, cocaine, parity, HTN, trauma, multiples, uterine anomalies, PPROM, history of abruption, thrombophilia, fibroids |
|
|
Term
| detection rate and method of abruption |
|
Definition
| 50% detection on US, poor NPV |
|
|
Term
| lab changes with abruption - 3 |
|
Definition
| fibrinogen <250, leukocytosis, DIC |
|
|
Term
|
Definition
couvelairs uteris / uterine placental apoplexy
pain
port wine bleeding
hypertonic uterus
decels |
|
|
Term
| prognosis of abruption - M/M, recurrence |
|
Definition
50% fetal death
10% recurrence (20% if needed transfusion or had fetal death) |
|
|
Term
| incidence of low lying placenta in 2T and 3T |
|
Definition
90% resolve by 30w
15% at 16-20wk
1:200 at 3T |
|
|
Term
| definition low lying pacenta |
|
Definition
|
|
Term
|
Definition
| loss of decidua basalis and nitabach layer |
|
|
Term
| risk percent of accreta with previa and CD |
|
Definition
no CD 5%
1CD 11%
2CD 40%
3+CD 60% |
|
|
Term
| risk factors for accreta - 6 |
|
Definition
| uterine sx, multip, D+C, >35yo, CD, previa |
|
|
Term
| signs of accreta on US - 4 |
|
Definition
placenta lakes/swiss cheese
turbulent lake flow
loss of retroplacental hypoechoic layer
thin mymetrium |
|
|
Term
|
Definition
| indicated if multiple prior CD, US at 36wk |
|
|
Term
|
Definition
| consider cell saver, no evidence for roboa or uterine stents, blood |
|
|
Term
| signs of uterine rupture - 6 |
|
Definition
| acute ripping sensation, loss of station, cessation of contractions, new onset vaginal bleeding, shock, fetal distress |
|
|
Term
| recurrence rate of uterine rupture |
|
Definition
low segment 6%
up segment 32% |
|
|
Term
| rate of elective primary cd |
|
Definition
|
|
Term
| how to educated for elective primary cd |
|
Definition
| SVD is safer, but we have no studies specifically comparing |
|
|
Term
| risks of multiple c-sections - 9 |
|
Definition
| accreta, previa, injury to organs, increased OR time, increased ICU admits, increased hospital stay, increased transfusion, hysterectomy |
|
|
Term
| dosing of lidocaine for CD under local |
|
Definition
w/ epi - 7mg/kg at 70kg = 500mg
w/o epi - 4mg.kg at 70kg = 250mg |
|
|
Term
| treatment of lidocaine toxicity |
|
Definition
| IV lipid sink 20%, 1.5 mg/kg bolus then 2.5mg/kg/h for 30-60m |
|
|
Term
| lidocaine toxicity signs at 4-8 mg/mL |
|
Definition
neurotoxic excitation: HA, dizziness, tinnitus, slurring, metalic taste, sense of doom, mouth numbness
cardiotoxic excitation: hypertension, tachycardia |
|
|
Term
| lidocaine toxicity signs at >8 mg/mL |
|
Definition
neurotoxic convulsion: fasiculations, seizure
neurotoxic depressive: LOC, apnea
cardiotoxic depression: hypotension, arrhythmia, arrest |
|
|
Term
|
Definition
| uterine rupture, infection, PPH, death, hysterectomy, injury to organs |
|
|
Term
| is it ok to TOLAC in twins |
|
Definition
|
|
Term
| is it ok to TOLAC in the 2T |
|
Definition
|
|
Term
| positive perdictive factors for TOLAC - 7 |
|
Definition
| CD for NRFHT/breech, 75-85% CD before 10cm, prior SVD 93%, low BMI, white, <20yo, labor 86% |
|
|
Term
| negative predictive factors for TOLAC - 10 |
|
Definition
| CD for labor dystocia, IOL/augmentation, high BMI, >40wk, macrosomia, close interval pregnancy, AA/hispanic/asian, >35yo, no prior SVD, pre-e |
|
|
Term
| overall TOLAC success is ___-___%, it is improved to ___% if prior SVD and to ___% if prior CD was for breech/NRFHT |
|
Definition
overall 60-80%
93% prior SVD
75-85% breech |
|
|
Term
| rate of shoulder dystocia |
|
Definition
|
|
Term
| rate of shoulder dystocia recurrence |
|
Definition
|
|
Term
| risks of shoulder dystocia - 7 |
|
Definition
DM, obesity, post dates, prior
LGA, labor dysfunction, operative delivery, history of dystocia |
|
|
Term
| degree used for traction in shoulder dystocia |
|
Definition
| 25-45 deg below horizontal plane |
|
|
Term
| success rate of mc roberts |
|
Definition
|
|
Term
|
Definition
| flattening of lumbar curve, cephalic rotation of pubic symphysis |
|
|
Term
| success rate of delivery of posterior arm |
|
Definition
|
|
Term
|
Definition
| anterior arm pushed anterior |
|
|
Term
|
Definition
| posterior arm pushed posterior |
|
|
Term
|
Definition
| flex head to anterior shoulder, deliver posterior shoulder via axillary sling |
|
|
Term
| how do you cut a symphasotomy |
|
Definition
|
|
Term
| when is CD recommended for suspected macrosomia |
|
Definition
| 4500g diabetes, 5000g regular |
|
|
Term
| rate of brachial plexus injury in shoulder dystorica |
|
Definition
|
|
Term
| outcomes of term breech trial |
|
Definition
decreased CD
increased fetal MM
same maternal MM |
|
|
Term
| ACOG stance on breech delivery |
|
Definition
if delivery is imminate deliver breech
always try to ECV first if not imminate
dont do it without experience |
|
|
Term
| requirements for breech delivery - 7 |
|
Definition
| CD able to be done STAT, frank breech, 2500-4000g, flexed head, effective labor, adequate pelvis, ideally multip |
|
|
Term
|
Definition
frank - both legs pike
footling/incomplete - one leg piked
complete - indian style |
|
|
Term
| how are arms delivered in breech delivery |
|
Definition
|
|
Term
| how are legs delivered in breech delivery |
|
Definition
|
|
Term
| how is head delivered in breech delivery |
|
Definition
| marseau smellivite or prague |
|
|
Term
| complications of breech delivery - 3 |
|
Definition
| cord prolapse, maternal/fetal trauma, head entrapment |
|
|
Term
| how do you fix fetal head entrapment |
|
Definition
| dehurssen (2, 6, 10 o clock) |
|
|
Term
| contraindications to ECV - 4 |
|
Definition
| frank breech and fixed in pelevis, oligohydraminos, previa, history of uterine sx (not CD) |
|
|
Term
| complications of ECV rate |
|
Definition
|
|
Term
|
Definition
| ROM, uterine rupture, reversion, NEFHT, fetal death, maternal fetal hemorrhage, cord accident, abruption, stat CD |
|
|
Term
|
Definition
|
|
Term
|
Definition
| 60-75% overall, 1-2% >38wk, increased with terb, unknown effect of epidural |
|
|
Term
|
Definition
|
|
Term
|
Definition
| anaphylactic reaction to normal amniotic particles in blood |
|
|
Term
|
Definition
|
|
Term
| diagnostic criteria for AFE - 5 |
|
Definition
O2< 90 with SOB
SBP <90 or arrest
hemorrhagc/DIC
in labor or 30m PP
no fever
*note particles in blood not part of it |
|
|
Term
|
Definition
|
|
Term
|
Definition
| 70% in labor, 10% in CD, 20% PP SVD |
|
|
Term
|
Definition
| DIC, shock, organ failure, fetal distress, death |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| estimated EFW at 20, 28, 34, 40wk |
|
Definition
|
|
Term
| what does the placenta transport via facillitated diffusion - 1 |
|
Definition
|
|
Term
| what does the placenta transport via active diffusion - 4 |
|
Definition
| amino acids, calcium, phosphate, iron |
|
|
Term
| what does the placenta transport via simple diffusion - 4 |
|
Definition
|
|
Term
| how does the placenta transport IgG |
|
Definition
|
|
