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Pathology Medical (MD/DO) School Study Aid


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Delivery & Postpartum Complications
19 Picmonics to Learn | 40 mins

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True vs. False Labor
Bloody Show
True Labor
Regular, Strong Contractions
Progressive Effacement and Dilation
Engagement of Presenting Part
False Labor
Irregular Contractions
Cervix Soft
No Engagement of Presenting Part
1 min
Mechanism of Labor
Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation (Restitution)
Expulsion of Infant
1 min
Premature Rupture of Membranes (PROM)
Pathophysiology
Rupture > 1 Hour Before Labor
Risk Factors
Infection
PROM History
Incompetent Cervix
Diagnosis
Fern Test
Nitrazine Paper Test
Ultrasound
Treatment
Consider Tocolytics
Consider Antibiotics
< 34 Weeks Gestation
Corticosteroids
> 34 weeks Gestation
Induction of Labor
2 mins
Induction of Labor
Indications
Premature Rupture of Membranes
Danger to Fetus or Mother
Prolonged Gestation
Contraindications
Placenta Abnormalities
Transverse Fetal Position
Prolapsed Umbilical Cord
Active Genital Herpes Infection
Uterine Muscle Incision
Hemorrhage
2 mins
Prolapsed Umbilical Cord
Mechanism
Cord Prolapses
Signs and Symptoms
Visualization of Cord
Prolonged or Variable Decelerations
Considerations
Hips Elevated
Insert 2 fingers in Vagina
Saline Towel on Cord
Oxygen
1 min
Incompetent Cervix
Mechanism
Premature Cervical Dilation
Assessment
Recurring Miscarriage
Short Cervix
Considerations
Cervical Cerclage
Rest
Labor
1 min
Decelerations (and Accelerations) Overview
VEAL CHOP
Variable Deceleration
Cord Compression
Early Deceleration
Head Compression
Acceleration
Okay
Late Deceleration
Placental Insufficiency
2 mins
Early Decelerations
Cause
Fetal Head Compression
Occurs During
Uterine Contractions
Placement of Internal Mode of Monitoring
Vaginal Examination
Fundal Pressure
Considerations
Normal Pattern
1 min
Variable Decelerations
Mechanism
Umbilical Cord Compression
Occurs During
Abnormal Cord Position
Considerations
Transition Phase
Interventions
Oxygen with Non-Rebreather (8-10 L/min)
Change Maternal Position
Discontinue Oxytocin
1 min
Late Decelerations
Cause
Uteroplacental Insufficiency
Occurs During
Disruption of Oxygen Transfer to Fetus
Considerations
Abnormal Pattern
Interventions
Discontinue Oxytocin
Oxygen with Non-Rebreather (8-10 L/min)
Side-lying Position
Elevate Legs
Increase Rate of IV Solution
2 mins
Cesarean Section - Indications
Maternal Indications
Active Genital Herpes Infection
Cervical Cancer
Eclampsia (Preeclampsia)
History of Uterine Surgery
History of C-section (Vertical)
Fetal Indications
Malpresentation
Fetal Distress
Cord Compression/Prolapse
Other Indications
Failed Vaginal Delivery
Cephalopelvic Disproportion
Abruptio Placentae or Placenta Previa
2 mins
Postpartum Infection
Diagnosis
Fever > 100.4F After 24 Hours (38 C)
Risk Factors
Multiple Vaginal Examinations
Vaginal Trauma
Prolonged Rupture of Membranes
Cesarean Birth
Anemia of Pregnancy
Retained Placental Fragments
Poor Health Status
2 mins
Postpartum Hemorrhage
Mechanism
Uterine Atony
Lacerations
Retained Placenta
Signs and Symptoms
Bleeding
Hypotension
Boggy Uterus
Considerations
Oxytocin
Bimanual Compression of Uterus
Surgery
Blood Transfusion
2 mins
Uterine Atony
Pathophysiology
Most Common Cause of Postpartum Hemorrhage
Uterine Overdistention
Exhausted Myometrium
Uterine Infection
Presentation
"Boggy" Uterus
Treatment
Resuscitation with IV Fluids and Transfusions
Bimanual Uterine Massage
Oxytocin
Methergine
Prostaglandins
1 min
Newborn Assessment
APGAR
Umbilical Cord
2 Arteries 1 Vein
Eye Prophylaxis
Fontanels
Vitamin K Injection (Phytonadione)
Gestational Age Assessment (GAA)
Measurements
Birthweight
Head Circumference
Length
Considerations
Keep Warm
ID Bands
2 mins
APGAR Score
1 and 5 Minutes
Appearance
Pulse
Grimace
Activity and Muscle Tone
Respiration
Total Scores
Gentle Stimulation
Oxygen
2 mins
Neonatal Respiratory Distress Syndrome
Cause/Mechanism
Fetal Lung Immaturity
Lack of Surfactant
Assessment
Respiratory Distress
Nasal Flaring
Retractions
Grunting
Interventions
Surfactant
Oxygen
Mechanical Ventilation
Considerations
Total Parenteral Nutrition (TPN)
2 mins
Hyperbilirubinemia
Cause/Mechanism
Increased Unconjugated Bilirubin
Assessment
Jaundice
Kernicterus
Interventions
Early Feedings
Heme Oxygenase Inhibitors
Phototherapy
Protect Eyes
Monitor for Dehydration
Considerations
Monitor Bilirubin Levels
2 mins
Breastfeeding
Benefits
Complete Nutrition
Antibody Protection
Bonding
Convenient
SIDS Risk Reduced
Possible Enhanced Cognitive Development
Long-Term Health Benefits
1 min

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