>20h nulliparous
>14h multiparous
1. Power: dysfunctional contractions
2. Passenger: foreshadowing - abnormal fetal presentation
3. Passage: foreshadowing - cephalopelvic disproportion
*Note --> r/o false labour here
Tx
1. Education, pain management (IM morphine), send home
2. Membrane sweep
,- Prostaglandin release
- Stretch internal os: signal to brain to release oxytocin
Give this one a try later!
Abnormal latent phase (0 to 3-4cm)
- causes (3)
- Tx (2)
q4w until 32w
32-36w q2w
36w-birth q1w
Give this one a try later!
monitoring for pre-eclampsia in women Dx with gestational HTN
LOW dose estrogen
Would NOT use combined method for vasomotor symptoms --> do NOT need these
high doses to shut things off
Give this one a try later!
Vasomotor Sx
- what Tx would be indicated?
- An overgrowth of endometrium caused by chronic elevated unopposed estrogen
levels
,Associations:
1. Obesity
2. PCOS
3. Unopposed estrogen therapy
4. Tamoxifen
5. Estrogen producing tumours
Sx
1. Perimenopausal or postmenopausal abnormal uterine bleeding (menorrhagia,
intermenstrual bleeding)
2. Unexplained persistent vaginal discharge
Types
- Simple (cystic) or glandular
- Complex glandular
1. Without cellular atypia
2. With cellular atypica
- 20-70% develop adenocarcinoma
- 25% will already have adenocarinoma
Give this one a try later!
Endometrial Hyperplasia
- Definition
- Associations (5)
- Symptoms (peri vs. postmenopausal) - 2
- Types (2)
Immediate delivery
1. Chorioamnionitis
2. FHR abnormalities
3. Cord prolapse
Others: Expectant management (<34w)
1. Abx (IV --> po 5d)
- PROLONGS PREGNANCY
- Also reduces maternal/neonatal mortality
, - This also covers GBS
- Ampicillin 2g IV q6h + erythro 250mg IV q6h x 48h
- Followed by: amox 250mg po q8h + erythro 333mg po q8h x5d
2. Corticosteroids (<34w + 6 days)
- Optimize fetus in case it comes early
*Monitor for signs of infection/labour
- Deliver if >34w
Give this one a try later!
PPROM
- indications for immediate delivery (3)
- Tx otherwise (2)
External tocodynanometer --> CANNOT measure strength (event & time marker only)
Strength measurement:
1. Palpation
- When someone is doing the contraction, see how well the muscle squeezes
- If it can be indented --> weak contraction
2. Pressure catheter
- Inserted into the uterus, transducer tip in amnio fluid
- Used for obese women or women where it is hard to feel contractions through the
abdomen
Give this one a try later!
monitoring contraction strength
- 1 thing that is CANNOT measure strength
- 2 methods of measuring strength
>14h multiparous
1. Power: dysfunctional contractions
2. Passenger: foreshadowing - abnormal fetal presentation
3. Passage: foreshadowing - cephalopelvic disproportion
*Note --> r/o false labour here
Tx
1. Education, pain management (IM morphine), send home
2. Membrane sweep
,- Prostaglandin release
- Stretch internal os: signal to brain to release oxytocin
Give this one a try later!
Abnormal latent phase (0 to 3-4cm)
- causes (3)
- Tx (2)
q4w until 32w
32-36w q2w
36w-birth q1w
Give this one a try later!
monitoring for pre-eclampsia in women Dx with gestational HTN
LOW dose estrogen
Would NOT use combined method for vasomotor symptoms --> do NOT need these
high doses to shut things off
Give this one a try later!
Vasomotor Sx
- what Tx would be indicated?
- An overgrowth of endometrium caused by chronic elevated unopposed estrogen
levels
,Associations:
1. Obesity
2. PCOS
3. Unopposed estrogen therapy
4. Tamoxifen
5. Estrogen producing tumours
Sx
1. Perimenopausal or postmenopausal abnormal uterine bleeding (menorrhagia,
intermenstrual bleeding)
2. Unexplained persistent vaginal discharge
Types
- Simple (cystic) or glandular
- Complex glandular
1. Without cellular atypia
2. With cellular atypica
- 20-70% develop adenocarcinoma
- 25% will already have adenocarinoma
Give this one a try later!
Endometrial Hyperplasia
- Definition
- Associations (5)
- Symptoms (peri vs. postmenopausal) - 2
- Types (2)
Immediate delivery
1. Chorioamnionitis
2. FHR abnormalities
3. Cord prolapse
Others: Expectant management (<34w)
1. Abx (IV --> po 5d)
- PROLONGS PREGNANCY
- Also reduces maternal/neonatal mortality
, - This also covers GBS
- Ampicillin 2g IV q6h + erythro 250mg IV q6h x 48h
- Followed by: amox 250mg po q8h + erythro 333mg po q8h x5d
2. Corticosteroids (<34w + 6 days)
- Optimize fetus in case it comes early
*Monitor for signs of infection/labour
- Deliver if >34w
Give this one a try later!
PPROM
- indications for immediate delivery (3)
- Tx otherwise (2)
External tocodynanometer --> CANNOT measure strength (event & time marker only)
Strength measurement:
1. Palpation
- When someone is doing the contraction, see how well the muscle squeezes
- If it can be indented --> weak contraction
2. Pressure catheter
- Inserted into the uterus, transducer tip in amnio fluid
- Used for obese women or women where it is hard to feel contractions through the
abdomen
Give this one a try later!
monitoring contraction strength
- 1 thing that is CANNOT measure strength
- 2 methods of measuring strength
