Labor & Delivery
The "turtle sign" is
Retraction of the fetal head against the perineum, indicating shoulder dystocia
Top priority in a prolapsed cord situation?
Relieve pressure on the cord; elevate presenting part, prepare for emergency delivery.
Describe the APGAR assessment.
Appearance, Pulse, Grimace, Activity, Respirations – each scored 0-2.
S/S of DVT.
Unilateral leg pain/swelling, warmth, redness, positive Homan’s sign.
When do we administer Rhogam?
If mom is Rh-negative and baby is Rh-positive, typically within 72h PP.
Define a precipitous labor.
Labor lasting less than 3 hours from onset to delivery.
Common causes of subinvolution.
Retained placental fragments, infection, or uterine atony.
What is a cephalohematoma?
A collection of blood between the skull and periosteum, does not cross suture lines.
Causes of RDS in newborns.
Surfactant deficiency, immature lungs, prematurity.
Why should pregnant patients avoid cat litter?
Risk of toxoplasmosis from contaminated litter.
List interventions for shoulder dystocia.
McRoberts maneuver, suprapubic pressure, repositioning.
Purpose of betamethasone
To enhance fetal lung maturity in preterm labor.
Normal NB findings (HR, GLU, etc.)
Normal HR: 120-160, BG: >40 mg/dL, meconium in 1st 24-48h, molding and edema is normal along suture lines, murmurs
What is necrotizing enterocolitis?
Inflammation of intestinal tissue in premature infants, can cause perforation
Use Naegele’s Rule to estimate EDD.
First day of LMP + 1 year - 3 months + 7 days.
Why do we use prostaglandins in IOL?
To ripen the cervix and induce labor.
What are PPH medications?
Oxytocin, Methergine (CI: HTN), Hemabate (CI: asthma), Cytotec
What to expect during the Golden Hour?
NB is alert, bonding with parents, initiating breastfeeding, skin-to-skin contact.
Complications from oxygen tension?
Retinopathy of prematurity, bronchopulmonary dysplasia.
What hormones are in UPT?
Human chorionic gonadotropin (hCG).
What are signs and symptoms of chorioamnionitis?
Fever, uterine tenderness, foul-smelling amniotic fluid.
Signs of puerperal infection.
Fever, foul lochia, pelvic pain, tachycardia
When to notify pedi immediately?
Respiratory distress, abnormal tone, poor feeding, seizures.
Most common cause of late PPH?
Uterine atony (failure of uterus to contract)
First care step for substance-exposed NB?
Stabilize airway, assess and monitor for withdrawal signs