Stages and Phases
Time defined by complete dilation and effacement of the cervix to delivery of baby
What is 2nd stage of labor?
Turtle sign, McRoberts, suprapubic pressure, call for help,
Actions/characterisics associated with Shoulder Dystocia
greater than 1+ proteinuria, BP +30 sys/+15 dia from baseline, gestational age 20 weeks or greater
mild preeclampsia
most difficult gyn cancer to catch in early stages
What is ovarian cancer?
baseline for vital sign comparison during pregnancy, record of OB history, Blood Type and Rh, cumulative weight gain, information used to determine due date
What is found in a prenatal record?
The longest phase, mom usually excited and does not want to rest
Latent /early phase, stage 1
Everyone at risk, actions based on QBL, highly preventable
What is PPH?
S/S include right epigastric pain, spots in vision, headache not resolved by Tylenol, more severe the earlier it begins in pregnancy
Preeclampsia
5 yr survival rate 50%, "orange peel skin" is hallmark of this condition
inflammatory carcinoma
Begins at 4 cm, becomes more inward and serious
What is active labor in Stage 1?
No option for vaginal delivery, dx made by ultrasound, spontaneous bleed may be first sign
What is placenta previa?
insulin resistence due to hormones of pregnancy, risk for LGA baby and increased risk of delivery by C/S if BS uncontrolled
Gestational Diabetes
diagnosis aided by PAP and HPV screens
Cervical cancer
Offered/encouraged testing during the first prenatal visit and again in 3rd trimester or when admitted for labor to have opportunity to reduce transmission to baby with meds
HIV screen
Urge to bear down in this stage is premature but not uncommon- pushing can cause swelling of the cervix. begins at 7 cm
What is transition? 1st stage
severity changes with seizure
Preeclampsia to Eclampsia
CMV, Parvo virus, Chicken pox
Examples of perinatal infections that can be transmitted across the placenta and effect the fetus
recently associated with use of talcum powder on perineum and BRAC gene
ovarian cancer
Non-invasive screen that takes minimum of 20 minutes but no more than 40 aimed at looking at perfusion of O2 to baby and neuro function
NST
lightening occurs, putting increased pressure on bladder, more room for lungs makes easier to breath
period around 2 weeks before delivery "premonitory"
Hemolysis of blood cells, elevated liver enzymes, low platelet
HELLP Syndrome
Concern is lack of oxygenated blood to baby; event usually associated with "severe pain" and rigid abdomen however, caregiver may not see blood immediately
What is a placental abruption?
most common kind of invasive carcinoma, invades surrounding breast tissue
invasive carcinoma
normal baseline (between 110-150) at least 2 Accels that are 15 beats above bl and last for 15 sec, no decels, mod variabiliy
What makes a reactive NST?