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A comprehensive overview of abnormalities of the puerperium, covering key concepts, clinical scenarios, and potential complications. It includes detailed explanations of cardinal movements of labor, analgesics and anesthetics used during childbirth, management of delivery, postpartum complications, and puerperal complications. Particularly useful for medical students studying obstetrics and gynecology, as it presents a series of questions and answers that test understanding of the subject matter.
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#Cardinal Movements of Labor - How a fetus in a vertex presentation passes through birth canal a) Engagement b) Flexion c) Descent and Internal Rotation d) Extension of Fetal Head e) External Rotation f) Expulsion b) Flexion - Allows smaller diameters of fetal head to present as fetus moves through birth canal c) Descent and Internal Rotation - Usually from an occiput transverse position to an occiput anterior or occiput posterior position d) Extension of Fetal Head - Occurs as it reaches the introitus and exits the birth canal e) External Rotation - After delivery of the head the fetus rotates face forward relative to shoulders f) Expulsion - ... ANALGESICS + ANESTHETICS - IV Narcotics: avoid near delivery bc of possible neonatal depression
General: Emergent c-sections Pudendal block: for pain relief at delivery Local block: for repair of episiotomy or tear Which type of anesthetic puts someone at risk for aspiration? - GENERAL T/F: If pt is in active phase of arrest, and does not dilate in 2-4 hours, she needs to have a C-section. - TRUE T/F: Molding of the fetal head and caput succedaneum are normal. - TRUE The upper limit is ___ hours in nulliparas and ___ hour in multiparas. - 3 hours in nulliparas 1 hour in multiparas Abnormalities in second stage (failure to descend) may be treated with ____ if there is no CPD and contractions are inadequate and fetus status is reassuring. - PITOCIN T/F: Operative vaginal delivery (vacuum or forceps) is usually only attempted if head is LOW in pelvis (below +3 AND cervix is completely dilated) - TRUE T/F: If the head does not descend with adequate contractions and operative vaginal delivery is not possible, deliver by cesarean - TRUE MANAGEMENT OF DELIVERY - - Control delivery of head + prevent maternal lacerations
The ___ stage of labor has high risk for hemorrhage - FOURTH How to Classify OB lacerations? - First degree: vaginal mucosa or perineal skin Second degree: involves subcutaneous tissue Third degree: involves rectal sphincter Fourth degree: involves rectal mucosa POST PARTUM COMPLICATIONS - a) Post- Partum Hemorrhage b) Coagulopathy c) Amniotic Fluid Embolus a) Post-Partum Hemorrhage: causes - - Uterine atony,
T/F: Endometritis postpartum is polymicrobial. - TRUE