Labor, Delivery, and Post-Partum Care

  1. What is the tx for pre-term labor?
    • Mg sulfate
    • Nifedipine (used most)
    • Terbutaline
    • Indomethacin
  2. What is the purpose of tx for pre-term labor?
    to allow time for administration of corticosteroids and transfer to another facility if needed
  3. What is the tx for labor induction?
    Oxytocin (pitocin - most used)
  4. What is the tx for labor pain?
    • IV narcotics (meperidine, morphine, fentanyl)
    • Epidural (fentanyl and/or bupivacaine)
    • Spinal analgesia
    • Nerve block
  5. What is the tx for group B Strep infection in pregnancy?
    • Pen G
    • Ampicillin
    • Cefazolin
    • Clindamycin
  6. What is the non-pharmacological tx for labor pain?
    • Labor support via doula/nurse, other caregiver
    • Warm water bath
    • Intradermal injections of sterile water
  7. What are the non-pharmacological tx to induce labor?
    • Warm bath
    • Intercourse
  8. What is the tx for post-partum depression?
    • SSRI (DOC, esp. Sertraline)
    • TCA
    • Venlafaxine
    • Bupropion
  9. What are the benefits of breastfeeding for the infant?
    • Optimal source of nutrition
    • Complete composition of nutrients, growth factors, enzymes, immune factors, and hormones
    • May decrease infection rate
    • Decrease allergies, otitis media, lymphoma, and gastroenteritis
    • Decreased incidence of constipation
    • May improve cognitive function later in life
    • Enhanced maternal bonding
  10. What are the benefits of breastfeeding for the mother?
    • Faster recovery from pregnancy
    • Faster wt reduction
    • Decreased chance of breast and ovarian cancer
    • Decreased chance of osteoporosis
    • Postponement of menses
    • Economic benefit
    • Enhanced bonding
  11. What factors affect drug tx during lactation?
    • Drug dose and duration
    • Route and frequency
    • Maternal metabolism
    • Maternal clearance
    • Blood flow to breasts
    • Milk pH
    • Milk composition
    • Maternal plasma level
    • Bioavailability
    • Molecular weight
    • pKa
    • Lipid solubility
    • Protein binding
    • Age of baby
    • Feeding pattern of baby
    • Amount of milk ingested
    • Drug ADME of baby
  12. What are some ways to reduce infant exposure to drugs during breastfeeding?
    • Drug selection
    • Avoid nursing during peak drug concentration
    • Plan feeding before next dose
    • Take qd meds at night or during longest sleeping period
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Labor, Delivery, and Post-Partum Care
Labor, Delivery, and Post-Partum Care