Maternal Newborn Exam 2 Study Guide – Part 1
Leopold’s Maneuvers:
- Determines fetal position, presentation, and engagement using four palpation steps.
Fetal Heart Rate (FHR) Monitoring:
- Priority: Always assess FHR first.
- External: Ultrasound transducer over fetal back.
- Internal: Fetal Scalp Electrode (FSE), avoid in HIV cases.
FHR Patterns:
- Baseline: 110–160 bpm.
- Variability: Moderate (6–25 bpm) is reassuring.
- Accelerations: Temporary ↑ in FHR, reassuring.
- Decelerations:
VEAL CHOP MINE:
Variable = Cord → Move mom,
Early = Head → Identify labor progress,
Late = Placenta → Intervene.
Contraction Monitoring:
- External (Toco): Measures frequency and duration.
- Internal (IUPC): Measures strength.
- Hyperstimulation (>5 in 10 mins): Stop Pitocin, give Terbutaline.
Maternal Newborn Exam 2 Study Guide – Part 2
Antepartum Bleeding:
- Spontaneous Abortion Types: Threatened, Inevitable, Incomplete, Complete, Missed, Recurrent.
- Incompetent Cervix: Treated with Cerclage.
- Ectopic Pregnancy: Unilateral pain; methotrexate or surgery.
- Molar Pregnancy: Grape-like clusters, high hCG.
- Placenta Previa: Painless bleeding, NO vaginal exams.
- Placental Abruption: Painful bleeding, emergency C-section.
Infections:
- TORCH: Toxoplasmosis, Other, Rubella, CMV, Herpes.
- GBS: Treat with Penicillin in labor.
Hyperemesis Gravidarum:
- Severe N/V, treat with fluids, antiemetics, nutrition.
Hypertension:
- Types: Chronic, Gestational, Preeclampsia, Eclampsia.
- MgSO4: Prevent seizures, watch for toxicity.
- HELLP: Hemolysis, Elevated Liver enzymes, Low Platelets.
Diabetes:
- GCT at 24–28 weeks. GTT if GCT abnormal.
- Risks: Macrosomia, hypoglycemia.
Preterm Labor:
- <37 weeks; treat with Terbutaline, Indomethacin, MgSO4.
- PPROM: Manage infection risk, fetal lung maturity (Betamethasone).
Maternal Newborn Exam 2 Study Guide – Part 3
Labor & Birth:
- Signs: True vs False labor.
- 5 Ps: Power, Passageway, Passenger, Position, Psyche.
- Stages: 1st (Dilation), 2nd (Delivery), 3rd (Placenta), 4th (Recovery).
- Cardinal Movements: Engagement to Expulsion.
Perineal Trauma:
- Laceration vs Episiotomy; monitor bleeding.
PPH:
- Vaginal: >500 mL, C-section: >1000 mL.
- Meds: Oxytocin, Misoprostol, Methergine, Hemabate.
Newborn Care:
- Dry/stimulate, skin-to-skin, Apgar scoring.
Labor Management:
- RhoGAM if Rh–, GBS+ = Penicillin.
- Amniotomy: COAT (Color, Odor, Amount, Time), monitor FHR.
Emergencies:
- Cord Prolapse: Lift head off cord, knee-chest position.
- Shoulder Dystocia: Turtle sign, McRoberts, suprapubic pressure.
- Uterine Rupture: Pain, bleeding, loss of station.
- Placenta Accreta: Deep attachment, risk of hysterectomy.
Medications:
- Know generic/brand, use, side effects.
- Common: Pitocin, Cytotec, Terbutaline, MgSO4, Betamethasone.