Midwifery Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Naegele's rule

Estimated date of birth is calculated from the first day of the last menstrual period minus three months plus seven days, adjusting the year as needed.

Gravida versus para

Gravida counts all pregnancies including the current one; para counts births at 20 or more weeks, regardless of outcome.

Physiologic anemia of pregnancy

Plasma volume increases more than red cell mass, diluting hemoglobin; normal values are lower in pregnancy than in nonpregnant adults.

Rho(D) immune globulin timing

Given to unsensitized Rh-negative patients at about 28 weeks and within 72 hours after delivery of an Rh-positive infant.

Fundal height rule

Between 20 and 36 weeks, fundal height in centimeters approximates gestational age in weeks; a discrepancy over 3 cm prompts evaluation.

First-trimester aneuploidy screening

Nuchal translucency plus free beta-hCG and PAPP-A at 11 to 14 weeks; cell-free DNA offers the highest detection rate.

Active phase labor criteria

Active phase begins at 6 cm dilation; nulliparas dilating slower than 1.2 cm per hour meet criteria for abnormally slow progress.

Fetal heart rate baseline

Normal baseline is 110 to 160 beats per minute; moderate variability is the most reassuring indicator of fetal oxygenation.

Late decelerations

Decelerations that mirror contractions and reflect uteroplacental insufficiency; respond with position change, fluids, oxygen, and stopping oxytocin.

Variable decelerations

Abrupt decelerations caused by umbilical cord compression; recurrent variables may be treated with amnioinfusion or position change.

Uterine tachysystole

More than five contractions in ten minutes averaged over thirty minutes; reduce or discontinue uterotonic agents and assess fetal status.

Bishop score

Cervical scoring using dilation, effacement, station, consistency, and position; a score of eight or more predicts successful induction.

Magnesium sulfate toxicity

Signs include loss of deep tendon reflexes, respiratory depression, and oliguria; calcium gluconate is the antidote for serious toxicity.

Postpartum hemorrhage definition

Blood loss exceeding 500 mL after vaginal birth or 1000 mL after cesarean; uterine atony is the most frequent cause.

Lochia progression

Lochia rubra occurs days one to three, serosa days four to ten, and alba after day ten; return to rubra suggests complication.

Uterine involution

The fundus is at the umbilicus after birth, descends about one centimeter daily, and is no longer palpable abdominally by ten to fourteen days.

Postpartum endometritis

Fever, uterine tenderness, and foul lochia, most often after cesarean; treated with clindamycin plus gentamicin.

Apgar score components

Heart rate, respiratory effort, muscle tone, reflex irritability, and color, scored at one and five minutes; it does not predict neurologic outcome.

Pathologic neonatal jaundice

Jaundice appearing within the first twenty-four hours of life is pathologic and requires urgent bilirubin measurement and evaluation.

Newborn vitamin K prophylaxis

One milligram intramuscular vitamin K prevents hemorrhagic disease of the newborn; erythromycin eye ointment prevents gonococcal ophthalmia.

Edinburgh Postnatal Depression Scale

A validated ten-item screening tool for postpartum depression; a score of ten or higher warrants further clinical evaluation.

Preeclampsia severe features

Blood pressure of 160/110 or higher, platelets below 100,000, transaminases over twice normal, pulmonary edema, or new renal insufficiency.

HELLP syndrome

Hemolysis, elevated liver enzymes, and low platelets; may present with right upper quadrant pain even without marked hypertension.

Placenta previa presentation

Painless bright red vaginal bleeding; digital vaginal examination is contraindicated and cesarean delivery is usually required.

Abruptio placentae presentation

Painful vaginal bleeding with a tense, tender uterus; concealed hemorrhage may underestimate blood loss and fetal compromise.

Shoulder dystocia maneuvers

McRoberts position and suprapubic pressure first, then internal rotation and delivery of the posterior arm; fundal pressure is avoided.

Umbilical cord prolapse management

Relieve pressure on the cord by elevating the presenting part or filling the bladder, then proceed to emergency cesarean delivery.

Gestational diabetes screening

A 50 g one-hour glucose challenge at 24 to 28 weeks; a positive result is confirmed by a three-hour 100 g glucose tolerance test.

Antenatal corticosteroids

Betamethasone given before 34 weeks gestation accelerates fetal lung maturity and reduces respiratory distress syndrome in preterm infants.

Oxytocin induction titration

Begin at 1 to 2 milliunits per minute and increase every 30 minutes, titrating to contraction pattern rather than a fixed maximum dose.

Terbutaline tocolysis effects

Beta-2 agonist causing maternal tachycardia, hyperglycemia, and pulmonary edema risk; not used for maintenance tocolysis.

Copper IUD emergency contraception

The copper intrauterine device is effective for emergency contraception up to five days after unprotected intercourse and is highly effective.