MARK KLIMEK LECTURES

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MARK Klimek Lectures notes Maternity and OB Lecture Latest Update 100% Complete 1 / 3

MARK KLIMEK LECTURES

Maternity and OB Lecture Pregnancy

• Know how to calculate due date.
• First day of the last menstrual period + 7 days – 3 months o

June 10 -15 th due date would be March 17 th

• Ideal total weight gain for pregnancy = week of gestation - 9 o At

week 12 (1 st trimester) = 3lbs normal

• Fundal height o Fundus not palpable until week 12 (end of the first

trimester) Client is the priority o Fundus is at the umbilicus at 20-22 weeks of gestation (end of the second trimester) o Fundus is above the umbilicus – third trimester

• Quickening (baby kicking) occurs 16-20 weeks
• Positive o Fetal skeleton on xray o Fetal presence on ultrasound
• Auscultation of a fetal heart (can hear it around 8-12 weeks)

When would u first: 8 weeks

When would u most likely (midpoint): 10 weeks

When should u auscultate (endpoint): 12 weeks o When the examiner

palpates fetal movements

• Probable/presumptive
• All urine and blood tests o

Positive preg. Tests o Chadwick’s sign Cervical color change to cyanosis o Goodell sign Softening of cervix o Hegar’s sign Softening of the lower uterine segment

• Pts should come once a month until week 28
• At week 28, she should come in once every 2 weeks until week 36
• Come once every week until delivery or week 42

- Hbg level : 12-16 (will fall to 11 in first trimester)

• How to treat morning sickness o Dry carbohydrates before u get out

of bed o Bagels, dry cereal and dry toast

• How to treat urinary continence o 1

st and third trimester problem o Baby is up higher in the abdomen in the second trimester no urinary continence in second trimester.

• Void every 2 hours all the way until 6 weeks after delivery
• Difficulty breathing o 2

nd and 3 rd trimester problem

• Teach tripod position.
• Back pain 2 / 3

• 2

nd and 3 rd trimester problem o Pelvic tilt exercises (tilt pelvis forward, Labour and Delivery

• The true and most valid sign of labor o The onset of regular

progressive contractions

• Dilation o Opening of cervix (0-10cm)
• Effacement o Thinning of the cervix
• Goes from thick and 0cm closed and she ends labor in fully dilated to 10cm dilated and 100%

effaced.

• Station is the relation of the fetal presenting heart to mom’s ischial

spine (narrowest part of the pelvis) o Negative station: baby’s

presenting part is above the ischial spine.

• Positive station: baby’s presenting part is below the ischial spine. (already made it through)
• Engagement in station 0 o The presenting part is at the ischial spine
• Fetal lie o The relationship between the spine of the mother and the

spine of the baby. o Vertical lie (good) parallel o Perpendicular (bad) transverse lie

• Presentation
• Part of the body that enters the birth canal first o

ROA/LOA

Right occiput anterior Left occiput anterior

• 4 stages of labor

o Stage 1: Labor has 3 phases

Latent active, transition o Stage 2: Delivery of baby o Stage 3:

Delivery of placenta o Stage 4:

Recovery Last 2 hours

• Purpose of uterine contractions in the first stage o Dilate and efface

the cervix

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