PRC Midwives LE 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: subtract 3 months, add 7 days, add 1 year. It assumes a regular 28-day cycle.

Gravida and para

Gravida is the total number of pregnancies, including the current one. Para is the number of births at 20 weeks or more, and twins count as one para event.

Normal fetal heart rate

The normal baseline fetal heart rate is 110 to 160 beats per minute. Rates outside this range, or repetitive decelerations, require further assessment and possible referral.

Fundal height assessment

Between 20 and 36 weeks, fundal height in centimeters roughly equals gestational age in weeks. A difference greater than 2 to 3 cm suggests growth abnormality.

Preeclampsia diagnostic threshold

Blood pressure of 140/90 mmHg or higher after 20 weeks with proteinuria defines preeclampsia. Severe features include 160/110, low platelets, and elevated liver enzymes.

Gestational diabetes screening

Routine screening occurs at 24 to 28 weeks using a 50 g glucose challenge test. Abnormal results are followed by a diagnostic 75 g or 100 g glucose tolerance test.

Rho(D) immune globulin timing

Rh-negative unsensitized women receive Rho(D) immune globulin at 28 weeks and within 72 hours after birth of an Rh-positive or unknown-status newborn to prevent sensitization.

Stages of labor

First stage runs from onset of labor to full dilation, second stage from full dilation to birth, and third stage from birth to placental delivery.

Fetal station

Station describes the level of the presenting part relative to the ischial spines, graded from minus 5 to plus 5. Station zero means the head is engaged.

Leopold maneuvers

Four abdominal palpation steps determine fetal lie, presentation, position, and engagement. They guide auscultation placement and assessment of labor progress.

Late decelerations

Late decelerations begin after the contraction peak and recover after it ends, indicating uteroplacental insufficiency. Response includes repositioning, oxygen, stopping oxytocin, and notifying the provider.

Variable decelerations

Variable decelerations are abrupt drops of varying shape and timing, usually caused by umbilical cord compression. Changing position and giving oxygen often relieve them.

Uterine tachysystole

Tachysystole is more than 5 contractions in 10 minutes averaged over 30 minutes. Management includes stopping or reducing oxytocin and repositioning the woman.

Active third-stage management

A uterotonic is given within 1 minute of birth, followed by controlled cord traction and uterine massage. This package reduces the incidence of postpartum hemorrhage.

Shoulder dystocia maneuvers

Begin with McRoberts position and suprapubic pressure, then proceed to internal rotation or posterior arm delivery. Fundal pressure is contraindicated because it worsens impaction.

Postpartum hemorrhage definition

Postpartum hemorrhage is blood loss of 500 mL or more after vaginal birth or 1000 mL or more after cesarean birth, or any loss causing hemodynamic instability.

Uterine atony management

Atony causes most postpartum hemorrhage. Treat with bimanual massage and oxytocin first, then add carboprost, methylergonovine, or misoprostol according to protocol.

Lochia progression

Lochia rubra lasts days 1 to 3, serosa days 4 to 10, and alba after day 10. Foul odor or return to rubra suggests infection or retained placental fragments.

Postpartum endometritis

Endometritis presents after the first 24 hours with fever, uterine tenderness, and foul lochia. Treatment is broad-spectrum intravenous antibiotics with continued uterine drainage.

Edinburgh depression screening

The Edinburgh Postnatal Depression Scale screens for postpartum depression. A score of 10 or more, or any self-harm response, requires prompt referral and safety assessment.

Postpartum deep vein thrombosis

Risk peaks in the first 2 weeks after birth. Unilateral calf pain, swelling, and warmth require urgent evaluation; massage is avoided until thrombosis is excluded.

Apgar score components

Apgar assesses heart rate, respiratory effort, muscle tone, reflex irritability, and color at 1 and 5 minutes. Each element scores 0 to 2, for a maximum of 10.

Newborn resuscitation sequence

Begin with warmth, drying, stimulation, and airway positioning. Start positive pressure ventilation if the heart rate is under 100 or apnea persists after stimulation.

Newborn heat loss mechanisms

Newborns lose heat by evaporation, conduction, convection, and radiation. Skin-to-skin contact, drying, and a hat reduce heat loss and prevent hypothermia.

Physiologic versus pathologic jaundice

Physiologic jaundice appears after 24 hours and peaks at days 3 to 5. Jaundice within the first 24 hours is pathologic and requires urgent investigation.

Newborn weight change

Loss of up to 7 to 10 percent of birth weight in the first week is normal. Birth weight is typically regained by 10 to 14 days with adequate feeding.

Vitamin K prophylaxis

A single intramuscular dose of vitamin K 1 mg is given after birth to prevent hemorrhagic disease of the newborn caused by physiologic deficiency of clotting factors.

Midwife scope of practice

Midwives provide care for normal pregnancy, birth, postpartum, and newborn periods. Complications require consultation, referral, or transfer to medical care under regulation.

Prenatal visit schedule

Visits are monthly until 28 weeks, every 2 weeks until 36 weeks, then weekly until birth. High-risk pregnancies require more frequent monitoring and referral.

Danger signs in pregnancy

Immediate referral is needed for vaginal bleeding, severe headache with visual change, fever, reduced fetal movement, fluid leakage, or convulsions. These signal life-threatening complications.

Informed consent elements

Valid consent requires disclosure of risks, benefits, and alternatives, plus voluntary decision-making by a competent client. The discussion and consent are documented.

Negligence four elements

A negligence claim requires a duty of care, a breach of the standard of care, causation linking the breach to harm, and actual damages. All four must be proven.