| Card # |
English |
English |
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| 1 |
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| 2 |
12.5 |
flexed op head is 9.5cm and a deflex op head is |
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| 3 |
1st degree - skin subcutaneous tissue, vaginal mucosa - superficial. 2nd degree tear - superficial perineal muscles, perineal body, deep perineal muscle. 3rd degree - superficial and deep muscles and anal sphincter. 4thdegree same as 3rd but includes disruption of the extenal anal sphincter and or internal anal sphincter and anorectal epithelium. indications are to get baby out - fetal distress and if the peri is the only thing keeping baby in (if head is right there). risks are it may extend. infection and bleeding. |
episiotomies - definitions, degrees, reasons and risks |
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| 4 |
A condition in which blood vessels within the placenta or the umbilical cord are trapped between the fetus and the opening to the birth canal, a situation that carries a high risk the fetus may die from hemorrhage due to a blood vessel tearing at the time the fetal membranes rupture or during labor and delivery. Another danger is lack of oxygen to the fetus. |
Vasa Praevia |
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| 5 |
Bleeding due to the separation of a normally situation placenta after the 22nd week of pregnancy |
Abruptio Placentae (Placental Abruption) |
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| 6 |
Carbohydrate intolerance resulting in hyperglycaemia of varying severity with onset or first recognition during pregnancy. Risks: >30yrs, obsesity, family history, past GDM, glycosuria, multiple pregnancy, PH adverse pregnancy outcome. Indigenous Aust, Polynesian Indian (increased risk). Middle eastern and other asian (some risk). |
GDM and risks |
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| 7 |
Common disorder in the general population. Abdominal pain and altered bowel function. IBS has no impact on pregnancy. If symptoms increase, dietary modification and antispasmodic medication may be required. |
Irritable Bowel Syndrome |
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| 8 |
Disseminated Intravascular Coagulation. complex syndrome occuring as a secondary event to haemorrhage, shock, infection, HELLP. the clotting casde goes awry as a result of overproduction of fibran and a huge increase in plasmin which digests clots resulting in cathastrophic bleeding from anywhere (iv/nose/eyes/gums/vagina/surgic al site), Petechiae (brusing under skin red and speckled), swollen extremities, signs of shock, failureto clot. to treat: plasma and platelet replacement, monitoring of coagulotherpy, ICU, check of organ damage, treat underlying disorders |
DIC |
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| 9 |
FBE, U&E, platelets, coagulopathy, fibrinogen. |
What blood tests for any women you suspect of PE? |
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| 10 |
GCT (screening) at 26-28weeks 1hr >7.8mmol with 50gt. >8.0 at 75gm. DIanosis with GTT 75g fasting 5.5mmol then after 2 hrs 8mmol. |
Diagnosis of GDM |
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| 11 |
Gtt 6 weeks then every 2 years. education of lifestyle and diet. increased risk of getting type 2. baby increae 2.sed risk of obesity and typ |
Follow up post birth for a woman with GDM |
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| 12 |
Help - call for extra help. Evaluate for episiotomy. Legs - mcroberts manoeuvre. Pressure at the suprapubic area. Enter the vagina and atempt woods (rotate posterio shoulder) and rubin manoeuvres (shoulds in oblique). Remove the posterior arm. Roll if not already in all 4s. Documation. |
HELPERR |
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| 13 |
Hypertension > 140/90 and proteinuria >300mg in 24hrs. >30mg/dL MSU or 1+ on dipstick |
Preeclampsia |
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| 14 |
IUGR fetal hypoxia, prematurity, fetal compromise/death. maternal: HELLP syndrome, disseminated intravascular coagulation, stroke or cerebral oedema, pulmonary oedema, exlampsia/fittinre, hepatic failure, ^ chance placent abruption, GDM more likelyg, renal failu |
PE complications |
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| 15 |
Increases the risk of spontaneous miscarriage and pre-term labour. Classic clinical signs may be absent - progressive displacement. Delay in diagnosis can be serious - peritonitis. |
Appendicitis |
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| 16 |
Inflammatory response to exposure to gluten. Various symptoms which can be precipated by stress, lower levels of iron, vit b12, and folic acid absorbed, more likely to be anaemic. |
Coellac disease |
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| 17 |
Labour that begins before 37 completed weeks of (36 and 6 days is preterm) |
Define Preterm Labour |
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| 18 |
Maternal: polyuhydramnios, PE, PPH, operative delivery, perinatal death. Fetal: macrosomia, birth trauma, RDS, hyperbilirubinaemia, polycythemia. |
Maternal and fetal complications of untreated GDM |
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| 19 |
The placenta is wholly or partly implacent in the lower uterine segment. may occur if the villi in the lower pole do not degenerate.or may be a result of poor vasculature in the upper uterus leaving the blastocyst to descend to lower healthier endometrium lining. |
Placenta Praevia |
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| 20 |
Tone - atonic uterus tone. Tissue - incomplete placental seperation. Trauma - lacerations to the birthing tract. Thrombin - Blood coagulation disorder. |
What are the four Ts that cause primary pph |
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| 21 |
Ulcerative colitis/Chrohn's disease. Pregnancy does not seem to impact on exacerbation of the disease. Multidisciplinary |
Inflammatory bowel disease |
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| 22 |
a major complication of pe. Haemolysis (destruction to the integrity of RBC), Elevated Liver Enzymes, and Low Platelets (v platelet lifespan). |
HELLP |
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| 23 |
after 20 weeks an elevated BP (no other signs) that resolves within 3 months post birth. treatment may be rest, oral antihypertensives and monitoring includes urinalysis, bloods, etc |
Pregnancy Induced Hypertension (PIH) |
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| 24 |
assessment of amniotic fluid volume using USS. calculated as the summation of the vertical diameters of the largest pools in each quandrant - normally 5-24cms |
amniotic fluid index (afi) |
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| 25 |
atemps by the accoucer to assist the babys birth before the natural rotation of the shulders before the next contraction. maternal - obesity, pelvic shape, diabetes, birthg weight, preivous shoulder dystocia. infatn - diabetic mother (therefore bigbaby), fetal size |
Risks for shoulder dystocia |
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| 26 |
blood coagulation disorder |
an empty contracted intact uterus will not bleed in the absense of a ....? |
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| 27 |
can be a reliable indicator of preterm birth (within the next 14 days if negative its fairly reasurring, if positive it might be a false positive. dont perform if VE or intercourse recently. |
Fetal fibronectin test |
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| 28 |
determining whether or not twins are identical |
zygosity |
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| 29 |
drug of choice to halt threatened or established preterm labour - smooth muscle reslaxant |
Nifedipine |
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| 30 |
explanation to parents. assist into lithotomy position. empty bladder. documention the time suction on and off as well as no. of times cup pops off and reapplications. after birth reassure parents mark on babies head is superficial. |
midwifes role in ventouse |
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| 31 |
external cephalic version. |
ECV |
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| 32 |
fetal anomaly detection, confirms dating, biparietal diameter, femoral length and head circumference, placental position, liquor volume |
ultrasound at 20 weeks |
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| 33 |
fetus liewith the buttocks presenting in the lower pole of the uteruss longitudinally |
breech birth definition |
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| 34 |
gestation >37 weeks, unstable hypertension despite treatment, increasing proteinuria, decreasing platelets, neurological symptoms/eclampsia, abruption, abnormal fetal wellbeing. |
Reasons for delivery for a woman with PE |
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| 35 |
if the mentum is anterior. if it is posterior the chin may be wedged at the sacrum |
when is it okay for a face presentation to birth normally |
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| 36 |
immediately massafe the fundus, call for assitance and reassure the partner. with assistance check vital signs, measure blood loss, oxytoic drugs, iv access and replace fluids, check placenta, IDC. ?bimanual uterine compression or exploration in theatre. |
midwifery care for a pph |
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| 37 |
malpresentation, non-engagement, loud maternal pulse below the umbi, difficult to palpate limbs, bright and painless bleeding beginning 24-28weeks. |
Signs and Symptoms of placenta praevia |
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| 38 |
management as for severe PE. severe fall in platelets and alters clotting mechanisms and haemolysis damages the internal strata of the blood vessels. multi system organ failure. may cause placental abruption. delivery of the baby asap is essential irrespective of gestation. |
Complications and management of HELLP syndrome |
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| 39 |
maternal - abnormalities of the uterus. placenta praevia. pelvic shape. multiparity. fetal - prematurity. fetal abnormailyes. error in orientation. short cord. |
causes of breech presentation |
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| 40 |
maternal energy needs increase + placental hormones help baby grow blcok the action og insulin (insulin resistance) mean the woman needs more insulin therefore BSL can rise. Oestrogen (highest at the start of pregnancy) increases insulin production and decreases glucose output from liver. progesterone increases insulin production and insulin resistance. Human placental lactogen highest at end of pregnancy increases insulin resistance and decreases insulin production |
Pathophysiology of GDM in pregnancy |
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| 41 |
maternal: perineal and vaginal trauma. pph. rupture of preivously scarred uterus (forceps),. faecal anbd urinary incontincence. neonatal: forcep marks, bruising, lacerations, cephalhaematoma, facial nervce palsy, skull fractures, increased chance of sholder dystocia, increased jaundice.u |
complications of instrumental births |
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| 42 |
menstrual like cramps, backache, urinary frequency, pink vinal dischae, diarrhoea, pelvic pressure of increased discharge |
Warning signs of preterm labour |
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| 43 |
no ves (spec by experience professional maybe), management depends on gestation and fetal condition. if major PP woman is advised to stay in hospital for the rest of her pregnancy due to the risk of further and severe haemorrhage. conservativee treatmeent till 38 weeks to avoid complications. active treatment if bleeding is severe or continuous, fetal disress, labour commences or maternal condition deteriorates. be prepared for PPH as there are no oblique muscle fibres in the lower uterine segment |
management of placenta praevia |
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| 44 |
not fully dilated. unknown position,. station hgigher than plus one. inexperience accoucher. inadequate analgesia. |
contraindications to vacuum or forceps |
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| 45 |
nulliparity, maternal obesity, macrosomia, antepartum haemorrhage, previous pph, abruption placenta, multiple pregnancy, operative birth, prolonged labour, infections, fibroid uterus, uterine abnormaliities |
risk factors for primary pph |
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| 46 |
only benefit when there is a risk such as DM, suspected fetal anomaly, amniotic fluid volume, IUGR, etc |
24 weeks ultrasound |
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| 47 |
pathophysiology: exaggerated response to oestrogen, more common in multiple pregnancies, more common in winter, prescen of gall stones, viral hepatitis. SYmptoms severe generalised persistent pruritis with no rash. abnormal lfts. tired, malaise, mild jaundice. associated with adverse fetal outcomes - increased lvls of bile salts - preterm labour, fetal distress, still birth. monitoring issues. associated with increased risk ofpph and psychological toll (sleep deprivation and concerns regarding pregnancies). |
Cholelithiasis |
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| 48 |
poor uterine action (e.g. incoordinate). lack of descent of presenting part. OP position. malpresentation. macrosomia. failure to dilate. |
Causes of prolonged labour |
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| 49 |
preferred after the 14th week. provide information, explain procedure, acknowledge grief, share concerns, support the partners, ensure privacy, refer to services for support. FBE, clotting and roup and hold, IV access, medication is inserted into the posterior aginal fornix until labour is established and pain relief offered. women RIB 30min after insertion then frequent obs until labour starts - can take up to 24 hrs, nil orally during labour, place witches hat on tolet, no oxytocix for third stage normall - sometimes up to 60 minutes for the placenta. Take care when handling the baby, involve the couple if they want, ? dress baby, encourage parents to hold and spend time with their babyyi |
Caring for a women with a medical termination of pregnacny |
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| 50 |
present prior to pregnancy (often detected prior to 20weeks, remains unresolved after the birth, can progress to pregnancy related hypertension complications) |
Essential Hypertension |
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| 51 |
previous c/s, previous pp, previous uterine curretege, spontaneous abortion, endometriosis, multiparity, closely spaced pregnancies, age, anaemia, smoking, circulatory issues, congenital malforamtions, male fetus, placental abnormaility (biopartite placenta) |
Risk for placenta praevia |
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| 52 |
primary is over 500 within first 24 hours. secondary pph excessive bleeding after the first 24 hours until the 6th week postpartum |
definition of primary and secondary pph |
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| 53 |
quiet dark room, frequent obs, observe for any signs of bleeding (DIC), hourly urine measures including proteinuria, strict FBC, basic hygiene and comfort, CNS obs (reflexes, mental state, twitching), IV access - group and hold, bloods (PE screen), hypertension treatment, magnesium sulfate reduces risk of exlampsia, epidural, CTG, ?syntocinon raises blood pressure. |
Stabilisation and management of severe PE |
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| 54 |
rare disorder associated with high rates of maternal and fetal morbidity and mortality. Presents as unexplained liver failure usually occuring in T3. Nausea, vomiting abdo pain and general malaise early symptoms. later symptoms hypoglycaemia, hyperuricaemia, jaundice, renal failure, signs of PET/HELLP. Abnormal LFTs. Treatment correction of coagulopathy (FFP), immediate birth of baby, supportive care of mother and baby, consider transfer of care |
Acute Fatty Liver of Pregnancy (AFLP) |
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| 55 |
renal tubules become inflamed and affect the bodies ability to reguylate sodium, potassium and ammonia, urea, creatinine, and uric acid can lead to oedema and cardiorespirator compromise. women are usuall admitted with antibiotics, pain relief, rest, lying on unaffected side, MSUs |
Pyelonephritis |
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| 56 |
respiratory (big issue), poor temp control, poor feeding (suck reflex not developed), hypoglycaemia, jaundice, PDA, anaemia, vit k deficiency bleeding, necrotizing enterocolitis (bowel disorder), bonding issues, infection, pain |
Challenges for a premature baby |
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| 57 |
retained products or infection. signs of secondary pph are heavy lchoial loss. returns to a bright red loss and may be offensive. subinvolution of the uterus. tachycardia. express any clots and keep all pads to measure loss. ?oxytoxic agent. a/b. u/s. |
possible cause and management of secondary pph |
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| 58 |
revealed: site of detachmen is the placental margin - blood goes between the membranes and the uterus and out of the cervix. concealed means the site of detachment is close to ethe centre and blood cannot escape. partially conceal means some blood escapes and some reamins concealed. |
Revealed abruption, concealed and partially concealed: |
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| 59 |
steroid given for lung maturity if baby is born premature |
Bethamethason |
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| 60 |
suture of the cervic at the level of the internal os which is removed later in pregnacy or at start of labour |
Cervical cerclage |
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| 61 |
tests for fetal hypoxia that measures breathing, limbs, tone, amniotic fluid volume, fetal reactivity on a ctg |
Biophysical profile - BPP |
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| 62 |
to shorten 2nd stage due to maternal exhaustion, maternal medication condition (severe hypertesnion or cardiac condition), fetal distress, failure to progress, delay in 2nd stage. |
indications for assisted vaginal birth |
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| 63 |
umbilical arterial blood velocity is measured. not invalsive. normal - 2.3. increased is 7.0. may be indicated for IUGR, PE, hypertension, renal disease, diabeteies, etc |
Doppler umbilical arterial flow velocity waveform analysis |
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| 64 |
unknown, multiple pregnancy, infection, PROM, antepartyum death of fetal malformations, maternal pathology, elective preterm birth, age, uterine abnormailty, poor nutirtion, bleeding, retained IUD, rhesus disease, UTS |
Risk of preterm labour |
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| 65 |
ureters and pelvis of trhe kidney become dilated due to increased vascular volume, enlarging terus preseing on the ureters at the pelvic brimn and uirinary reflux. |
Why are pregnant women susceptible to UTIs? |
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| 66 |
uterus may be soft, firm or hard. tenderness may be present, pain may be present, fetal condition will range |
placental acreta abdominal findings |
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| 67 |
when suspected fetal compromise and corrective measures failure. poor variability, poor baseline,. prolonged decels, non reassuring ctg. ruptured membranes and cervix must be deliated. seterile procedure. avoid fontanelles. taken between decelerations to allow for recovery. normal is 7.25-7.35. lactates are a marker for metabolic acidosis |
fetal blood sampling |
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