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Details

OBGYN Labor Eval Pain Manage
KYCOM Block 13
23
Medical
Graduate
01/17/2014

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Cards

Term
what do you use to tx GBS, what if their allergic
Definition
pen G tx, if minor allergy get ceph
if major allergy send it to culture and see what it is susceptable to
Term
when should mom come to the hospital for labor
Definition
contractions <5 minutes apart
sudden gush of fluid
bleeding
decrease in fetal movement
Term
what are the first things you do when mom gets to the hospital to deliver
Definition
review chart and prenatal record (GBS!)
ascultation of fetal heart
evaluation of contractions (freq/intensity)
determine lie (leopold maneuver)
determine presentation
determine position
Term
define leopold maneuver
Definition
determine fetal like, presentation and position felt with hand
Term
what is lie
Definition
relation of long axis of fetus with maternal long axis
Term
what are the 3 types of lie, which is most common
Definition
99% longitudinal
transverse
oblique
Term
define presentation
Definition
portion of fetus lowest in birth canal
Term
what are the 2 types of presentation
Definition
breech
cephalic
Term
define position
Definition
relation of fetal presentation to right or left maternal pelvis
Term
what is left occiput posterior
Definition
baby is face up with occiput on left inominate
Term
what is left occiput transverse
Definition
baby is sideways with occiput in center of left inominate
Term
what is left occiput anterior
Definition
baby is face down with occiput on left pubic area of inominate
Term
what are the parts to the vaginal exam
Definition
membranes in tact
cervical effacement
cervical position (posterior, midpoint, anterionr)
cervical dilation
station
Term
what are the parts of labor management
Definition
lab info
NPO: popsicle/ice if no C section expected
IV line
external monitors or FRH Q15min
amniotomu
internal monitors
bladder emptying
maternal temps q4hr
BPs, pulses, urine output
Term
where can GBS colonize, statistics in mom and body
Definition
cervix, vagina, rectum
30% of mom positive
50% of exposed babies colonized
Term
diagnosis of GBS in mom
Definition
results only intermittently positive
Term
effects of GBS in baby
Definition
usually inconsequential
3/1000 will get infection

early: septicemia, septic shick, pneumonia, meningitis (probablly premature)

late: (up to 4wk post partum) meningitis most common, less common are bone and joint infections
Term
how is GBS colonization in mom managed
Definition
culture at 35-37wks for all women

GBS culture positive (or other indications)...
IV antimicrobials for >48h during tocolysis
intrapartumm antimicrobials at delivery
Term
when is intrapartum prophylaxis to GBS indicated
Definition
previous infant with invasive GBS disease
GBS bacteriuira during current pregnancy +GBS screening culture during current pregnancy

unknown GBS status if delivery <37 wks, membrane rupture >18h, intrapartum temp >100.4F
Term
when is intrapartum prophylaxis not indicated
Definition
previous pregnancy with positive GBS screening culture, without positive this pregnency

planned C section (before membrane rupture)

negative vaginal and rectal GBS screen
Term
pain management technuques in childbirth
Definition
prepared childbirth
breathing techniques
systemic analgesia
regional analgesia
epidural block
analgesia for labor
anesthesia for delivery
maintain sense of touch and allows movement
penedal nerve block
paracervical block
local block
spinal and general
Term
what is used for systemic analgesia in labor (3)
Definition
demerol
stadol
nubain
Term
what is used for regional analgesia in labor, how is it administred
Definition
pain sensation from uterus, cervix, upper vag T10-L1 1st stage

pain sensation from lower vagina and perineum S2-S4 (2nd stage)
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