Obstetrics And Care Of The Newborn Study Guide PDF

1. Anatomy a. Ovaries i. Female gonads, or sex glands ii. Secrete hormones estrogen and progesterone iii. Release egg needed for reproduction b. Fallopian tubes iv. Extend from ovaries to uterus c. Uterus v. Pear shaped organ that hol...

1. Anatomy a. Ovaries i. Female gonads, or sex glands ii. Secrete hormones estrogen and progesterone iii. Release egg needed for reproduction b. Fallopian tubes iv. Extend from ovaries to uterus c. Uterus v. Pear shaped organ that holds the fetus 1. Top portion -- Fundus 2. Middle portion -- body 3. Bottom portion -- cervix d. Placenta vi. Organ of pregnancy vii. Provides oxygen and nutrients to fetus e. Umbilical cord viii. Infants lifeline ix. One vein -- carries oxygenated blood to the fetus x. Two arteries -- carries waste back to the placenta f. Amniotic sac xi. Bag of waters xii. Contains amniotic fluid xiii. Insulates and protects the pregnancy g. Vagina xiv. The birth canal 2. Predelivery emergencies h. Spontaneous abortion xv. Miscarriage xvi. Passage of tissue before the 20^th^ week of gestation xvii. USUALLY in the first trimester, between 8-12 weeks gestation i. Ectopic pregnancy xviii. First trimester xix. Fertilized egg implants anywhere but the uterus xx. Usually the fallopian tubes xxi. Egg starts to grow and develop, rupturing the fallopian tubes xxii. Leads to intense lower quadrant abd pain, can lead to internal bleeding and shock j. Placenta previa xxiii. 3^rd^ trimester emergency xxiv. Placenta implants itself over the cervix xxv. [Noted by lots of vaginal bleeding with no pain] k. Abruptio placenta xxvi. 3^rd^ trimester emergency xxvii. Many causes, from hypertension to trauma xxviii. Placenta prematurely tears away from the uterine wall xxix. High mortality to both mom and baby xxx. [Noted by lots of pain, and little to no external bleeding] xxxi. No bleeding due to infants head covering cervix l. Ruptured Uterus xxxii. 3^rd^ trimester xxxiii. Spontaneous or traumatic rupture of uterine wall xxxiv. Releases fetus into abd cavity m. Preeclampsia / Eclampsia xxxv. 3^rd^ trimester xxxvi. Characterized by hypertension and swelling of the extremities xxxvii. Preeclampsia turns into eclampsia when the mother has seizures xxxviii. Pregnancy related seizures have a high mortality rate for both mom and baby n. Supine Hypertensive Syndrome xxxix. 2^nd^ and 3^rd^ trimester xl. The uterus and growing fetus compress the inferior vena cava when the mom lays flat on her back xli. Leads to hypotension when mom lays supine xlii. Always prop a pillow or similar under the patient's right side to ensure the fetus does not compress the inferior vena cava 3. Assessment of predelivery patient o. Gravida xliii. How many pregnancies p. Para xliv. How many deliveries past 20 weeks gestation 4. Stages of labor q. Stage one xlv. Dilation phase xlvi. From beginning of true labor until full dilation of the cervix xlvii. Braxton hicks contractions -- false labor r. Stage two xlviii. Expulsion phase xlix. From full dilation of the cervix until baby is born l. Look for [nuchal cord -- cord wrapped around baby's neck] s. Stage three li. Placental phase lii. From delivery of the baby until delivery of the placenta 5. Abnormal deliveries t. Prolapsed cord liii. Umbilical cord presents before the head liv. True emergency to the baby! lv. Can insert a gloved hand into the birth canal to lift presenting part of baby off of the cord u. Breech birth lvi. Legs or butt presenting first lvii. Allow delivery to happen lviii. If the head gets stuck, after 2 minutes, may insert gloved hand into birth canal to make an airway for the baby v. Limb presentation lix. Single arm or leg is the presenting part lx. True emergency, cannot deliver in the field lxi. Patient will need a c-section w. Multiple births lxii. Proceed as normal lxiii. Suspect twins or more if: 4. Belly is still large after the baby is born 5. Size of baby does not correlate to the size of the abdomen 6. Intense contracts start after delivery of the first baby x. Meconium lxiv. Baby had a bowel movement in the amniotic sac lxv. When water breaks, fluid is greenish or brown lxvi. Tells you that the baby was in distress at one time 6. Post partum hemorrhage y. Any bleeding over 500cc after baby is born z. Place mom on high flow O2 a. Massage fundus b. Baby to breast 7. Caring for the newborn c. APGAR score -- score out of 10 lxvii. Done at 1 and 5 minutes after baby is delivered lxviii. Appearance 7. Blue body -- 0 8. Pink body, blue extremities -- 1 9. Pink all over -- 2 lxix. Pulse 10. No pulse -- 0 11. Pulse \100 -- 2 lxx. Grimace 13. No reflex activity -- 0 14. Some grimacing -- 1 15. Crying, sneezing, etc -- 2 lxxi. Activity 16. Limp -- 0 17. Some activity, lethargic -- 1 18. Actively moving -- 2 lxxii. Respirations 19. No respiratory effort -- 0 20. Weak cry -- 1 21. Strone cry -- 2 lxxiii. Scoring 22. 7-10 a. Only routine care needed 23. 4-6 b. Stimulate baby c. Oxygen 24. 0-3 d. BVM e. CPR as needed