tx for Pruritus Gravidarum

Pruritus Gravidarum is associated with:

Common pregnancy-specific cause of pruritus, (aka) pruritic urticarial papules and plaques of pregnancy (PUPPP) typically starting in abdomen -> arms, thighs, back + buttocks; NOT associated with poor maternal or fetal outcomes

tx for mild Polymorphic Eruption of Pregnancy

tx for severe Polymorphic Eruption of Pregnancy

Usually disappears shortly after birth but can reoccur in ½ of subsequent pregnancies.

• Usually resolves before birth or within several weeks after birth; rarely persists or begins after birth; does not usually recur in subsequent pregnancies​

• common liver disease of pregnancy; Characterized by generalized pruritus that usually begins in the third trimester of pregnancy.

characteristics of Intrahepatic Cholestasis of Pregnancy (ICP)

Abnormal labs with ICP

tx for ICP

major fetal complications of ICP

if a NST and/or BPP is reassuring for a pt with ICP, when is it recommended to give birth?

T/F: maternal vitamin K deficiency can occur with ICP thus increasing the risk for

postpartum hemorrhage

• ICP can recur in ________ of subsequent pregnancies​

which pts would be eligible for a Vaginal Birth After Cesarean (VBAC)

who would NOT be allowed to have a VBAC?

How long is a reasonable trial of labor for VBAC patients?

fundal height steadily descends into the pelvis approximately ___ finger breath (cm) per day

1 stage of lochia: Dark red color, bloody consistency, fleshy odor; small clots, transient flow increases during breastfeeding and upon rising; Lasts 1 to 3 days after birth

2 stage of lochia: Pinkish brown color and serosanguineous consistency; small clots and leukocytes; Lasts from approximately day 4 to day 10 after birth

3 stage of lochia: Yellowish white creamy color, fleshy odor; mucus and leukocytes; Lasts from approximately day 10 up to 6 weeks postpartum

lochia saturation is <2.5 cm

lochia saturation is 2.5 cm to 10 cm

lochia saturation is one pad within 2 hrs

lochia saturation is one pad saturated in 15 min or less, or pooling of blood under buttocks​

lochia assessment: excessive spurting of bright red blood from the vagina

lochia assessment: numerous large clots and excessive blood loss

lochia assessment: Foul odor

lochia assessment: persistent heavy lochia rubra in the early postpartum period beyond day 3

lochia assessment: continued flow of lochia serosa or alba beyond the normal length of time; may be accompanied by fever, pain, or abdominal tenderness

contributing factors to cord prolapse

if you palpate cord prolapse, you keep your hand there and ride with the patient to the OR

when does initial healing of perineal lacerations begin?

when does complete healing of perineal lacerations begin?

what would you apply to the perineum (indirectly) in the first 24 hrs to reduce edema and provide an anesthetic effect?

What is used on perineal lacerations to increase circulation and promote healing and comfort.

It is important to _____ the perineal area to clean it after toileting, starting from front to back

the presence and growth of endometrial tissue outside of the uterus

the most common reported STI in American women; pt rarely has manifestations; test at first prenatal visit and 3 trimester

possible manifestations of chlamydia

(tx with antibiotics + test of cure 3-4wks after completion)

primarily spread by genital-to-genital contact; also can be spread by anal-to-genital or oral-to-genital; testing at first prenatal visit + 3 trimester

complications of BOTH chlamydia and gonorrhea

UNIQUE complications of chlamydia

UNIQUE complications of gonorrhea

tocolytic (CNS depressant/SM relaxation), also neuro protectant in babies <32 wks; used for seizure protection for preeclampsia

IM glucocorticoid for FLM in premature babies; 2 injections 24 hrs apart (within 24-48 hrs of birth); may increase maternal BS

used as a cervical ripening agent or during PPH; may cause HA, N/V, chills +fever

Used for labor induction or PPH (SM contraction); may cause N/V cramping, water intoxication, low BP

side effects of mag sulfate

MAG toxicity sx

reversal agent for MAG toxicity

which patient would you hold mag sulfate for?

score that evaluates inducibility

score of 8 or more = likely success of labor with or without induction

5 or less = unfavorable ripeness; requires cervical ripening agents

early risk factors for postpartum hemorrhage

risk factors for late postpartum hemorrhage

period of emotional lability, crying, irritability, and anxiety that is very common and temporary (lasts roughly 2 weeks)

mood disorder lasting more than 2 weeks; intensive pervasive sadness with liable mood swings; requires medical tx

severe and rare psychiatric emergency; characterized by hallucinations, delusions, suspicions, confusion, paranoia, and manic or depressed moods, including thoughts of harming oneself or the baby

The placenta is attached too deeply and firmly to the uterine lining (myometrium)

The placenta invades through the uterine lining and into the muscular wall of the uterus (deep myometrium)

The placenta penetrates completely through the uterine wall and may attach to nearby organs like the bladder or bowel