Obstetrics & Gynecology Lecture Notes PDF

o “Lightening” ▪ shape of abd changes, sensation that baby is lighter ▪ Fetal head descends into pelvis- breathing may improve, need to urinate more o Ruptured Membranes (ROM) ▪ Sudden gish of liquid or constant leakage of fluid (Water broke) o Bloody...

o “Lightening” ▪ shape of abd changes, sensation that baby is lighter ▪ Fetal head descends into pelvis- breathing may improve, need to urinate more o Ruptured Membranes (ROM) ▪ Sudden gish of liquid or constant leakage of fluid (Water broke) o Bloody show ▪ Passage of blood-tinged mucus, cervix begins to thin (effacement), mucus plug is expelled along w/ bleeding from small blood vessels ▪ Cervical effacement common before true labor- internal os is drawn into lower uterine segment, thinning o True Labor ▪ Regular, painful uterine contractions, causing cervical dilation and birth Braxton Hicks VS True Labor o Labor o Most pt undergo spontaneous labor between 37-42 wks o Go to hospital: contractions every 5 mins X 1 hour, water break, significant bleeding, significant decrease fetal movement o Initial evaluation ▪ Leopold maneuvers- series of 4 palpations of the uterus & fetus through abd wall Aids in determining: o fetal lie: relation of long axis of fetus to maternal long axis, longitudinal MC o presentation: portion of fetus lowest in birth canal (breech or cephalic) o position: relation of fetal presenting part to right or left side of maternal pelvis ▪ Fetal heart tones Reassuring patterns: absence of late or variable decelerations, moderate FHR variability (6- 25 BPM), age-appropriate FHR accelerations Non-Reassuring: absent/minimal variability w/ decelerations or bradycardia, recurrent late or variable decelerations, bradycardia: FHR