Obstetric 6 Flashcards

1
Q

What is diastasis recti? (DR)

A

separation of greater than 2 fingertip widths of the 2 bellies of the RA at the linea alba

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2
Q

linea alba = this during pregnancy

A

linea nigra

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3
Q

In addition to pregnant women, who else gets DR?

A

people with

  • chronic pulmonary conditions
  • children younger than 2
  • men with beer bellies
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4
Q

DR: painful?

A

no

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5
Q

DR linked to:

A
  • LBP
  • UI
  • may be correlated to altered intra-abdominal pressure gradients
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6
Q

DR resolution

A

can spontaneously resolve

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7
Q

DR assessment

A
  • have pt perform curlup while PT palpates between 2 sides of contracted recti
  • note number of fingertips able to place within separation
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8
Q

DR tx

A
  • TrA work or other exercises that don’t result in increased intraabdominal pressure
  • should work to eliminate DR prior to beginning more intense abdominal work
  • may need to refer to WCS
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9
Q

cesarean delivery =

A

delivery through abdominal wall

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10
Q

% births done by c-section

A

~30%

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11
Q

reasons for c-section

A
  • prior c-section
  • labor dystocia
  • fetal distress
  • breech presentation
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12
Q

risk of vaginal birth after a c-section birth

A

associated with small but significant risk of uterine rupture

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13
Q

Where is surgical approach for c-section made?

A
  • transversely through lower uterine segment

- above pubic bone

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14
Q

teen pregnancy: at increased risk for

A
  • preterm labor

- psychological problems

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15
Q

teen pregnancy: complicated by

A
  • incomplete pelvic growth
  • lack of psychological maturity
  • lack of prenatal care
  • inadequate weight gain
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16
Q

Why do teen pregnancies have inadequate weight gain?

A

pregnant teens grow at slower rate as compared to peers

17
Q

mortality rates: teen vs. adult

A

pregnant adolescents have more than 2x the mortality rate of pregnant women

18
Q

precautions for exam and tx: what to avoid

abd compression

A

positions that involve abdominal compression in mid-late pregnancy (prone flat lying)

19
Q

precautions for exam and tx: what to avoid

supine

A

positions in supine longer than a few minutes after 4th month

  • supine hypotension syndrome
  • pressure on inferior vena cava
20
Q

precautions for exam and tx: what to avoid

straining

A

activities that strain the pelvic floor and abdominal muscles

21
Q

precautions for exam and tx: what to avoid

stretching

A

vigorous stretching of hip adductors (pubic symphysis)

22
Q

precautions for exam and tx: what to avoid

balance

A

positions that require rapid balance changes

23
Q

precautions for exam and tx: what to avoid

temp

A
  • overheating (fetal health concern with increased maternal core temp)
  • deep heat, estim over trunk
24
Q

postpartum issues that require special consideration for PT

A

changes in

  • strength
  • endurance
  • generalized ligamentous integrity
  • pelvic floor
  • other tissues