C-section, dystocia, and ToRCH Flashcards Preview

Summer FDTN Exam 3 > C-section, dystocia, and ToRCH > Flashcards

Flashcards in C-section, dystocia, and ToRCH Deck (29)
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1
Q

What is a Cesarean section

A

delivery of fetus through incision in abdominal wall (laparotomy) and uterine wall (hysterotomy)

2
Q

What are different types of C-sections

A
Low transverse (MC): incision in lower uterine segment 
Classic: vertical incision in upper contractile portion of uterus (best if premature or if baby's position demands it)
3
Q

What are indications for a C-section

A
fetal distress 
Hx of breech 
Transverse lie 
Dystocia (failure to progress) 
Hx of C-section 
uterine malformation (placenta previa)
4
Q

What is dystocia

A

During labor, cervix fails to dilate over time, and fetus fails to descend

5
Q

Causes of Dystocia (3 P’s)

A

Pelvis: pelvis isn’t big enough to let baby pass
Power: inadequate uterine contractions
Passenger: abnormal lie, presentation, or large head

6
Q

RF for dystocia include

A

prolonged interval between pregnancy
primigravid brith
Hx of multiple births

7
Q

Complications if you dont hurry and deliver baby

A

fetal death
respiratory depression
hypoxic ischemis encephalopathy
brachial nerve damage

8
Q

How do you manage Dystocia

A

oxytocin
forceps
vacuum
c-section

9
Q

What is ToRCH

A

infection acquired in utero or during delivery that cause significant fetal or neonatal mortality

10
Q

The organisms in ToRCH are

A
Toxoplasmosis (undercooked meat, cat poop)
other (syphillis) 
Rubella 
CMV 
HSV
11
Q

How can you prevent toxoplasmosis

A

Avoid undercooked meat
strict hand hygiene
avoid changing litter box

12
Q

Sx of toxoplasmosis are

A

*chorioretinitis + hydrocephalus + intracranial calcifications
Fever, jaundice, seizure, exanthematous rash

13
Q

How do you Tx toxoplasmosis

A

Pyrimethamine x 1 year
Sulfadiazine x 1 yr
Folinic acid x 1 yr

14
Q

How do you diagnose toxoplasmosis

A

anti-toxoplasma IgM and IgG

15
Q

What is the transmission rate of syphilis

A

100%!

dont fuck with treponema pallidum

16
Q

Early syphilis presentation is

A

blood tinged nasal mucus
diffuse osteochondritis
saddle nose (2/2 rhinitis)

17
Q

Late syphilis presents as

A
Hutchinson teeth (notched permanent incisors) 
anterior bowing of tibia (saber shins)
18
Q

How do you diagnose syphilis

A

RPR/VDRL + fluorescence treponemal antigen (FTA) in MOM

19
Q

How do you treat infant syphilis

A

Procaine Penicillin G x 10-14 d

20
Q

How likely is it mom transfers Rubella to infant

A

80% in first trimester, 50% in second trimester

esp. if not immunized (hematogenous spread)

21
Q

How does rubella present

A

*Hearing loss
*blueberry muffin rash
cataracts, jaundice, thrombocytopenia, hepatosplenomegaly

22
Q

How do you diagnose and treat rubella

A

IgM rubella Ab

NO TREATMENT

23
Q

CMV is a member of

A

herpes family
transmitted by body fluids
Diagnosed by + CMV in urine or saliva

24
Q

What is the #1 cause of congenital infection

A

CMV

25
Q

What is the #1 cause of sensorineural hearing loss in newborn

A

CMV

26
Q

How does CMV present

A
Microcephaly 
intracranial calcifications 
IUGR 
chorioretinitis 
severe mental retardation
27
Q

How can you prevent fetal transmisison of herpes

A

C section if a woman has active lesions

can only have vaginal birth if mom is on valtrex for the first trimester, and has NO current lesions

28
Q

How does herpes in neonates present

A
seizures 
respiratory distress 
mucocutaneous vesicles 
meningitis 
encephalitis 
conjunctivitis
29
Q

How do you treat neonatal herpes

A

Acyclovir for baby