Complications of antepartum Flashcards

1
Q

gestational diabetes, first trimester

A

Decreased need for insulin due to hormonal, enhance production and tissue responses to insulin

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2
Q

gestational diabetes after first trimester

A

Increased need for insulin, hormones acting like insulin antagonists

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3
Q

Maternal risks for gestational diabetes

A

Polyhydramnios
Preeclampsia
Keto acidosis
Dystocia
Increased susceptibility to infection’s

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4
Q

neonatal risks of gestational diabetes

A

Mortality
Congenital anomalies
Macrosomia
IUGR, RDS
polycythemia
Decreased blood sugar
Increased BilliRubin

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5
Q

One hour glucose tolerance test

A

50 g glucose drink within 10 to 15 minutes

Draws blood one hour later

Greater than 140 requires further testing

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6
Q

three hour glucose tolerance test

A

One hour, two hour, three hour markers

Gestational diabetes diagnostic, if two levels exceeded

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7
Q

goals for gestational diabetes treatment

A

fasting glucose less than 95

Two hours after meal less than 120

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8
Q

when should blood glucose be reassessed postpartum?

A

Six weeks

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9
Q

What should be given for prophylaxis in HIV positive moms?

A

Antiretroviral therapy ZDV

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10
Q

Signs of cardiac decomposition

A

cough
Dyspnea
Rales
Weight gain
Murmur
Palpitations

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11
Q

cardiac management

A

8–10 hours sleep per day
Frequent visits Q2 weeks
Halfway through pregnancy Q1 week
Increase iron and protein in diet
Decrease sodium in diet
Side lying/semi-Fowlers
Shorter, moderate, pushing with periods of rest

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12
Q

should Valsalva maneuver be performed in cardiac patients?

A

No

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13
Q

recurrent miscarriages

A

Greater than or equal to three consecutive losses

Greater than or equal to two if advanced maternal age

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14
Q

ectopic pregnancy

A

Fertilized egg deposits other than uteruses endometrium

Sharp one sided pain, serial hCG doesn’t double per day, decreased progesterone

IM Methotrexate

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15
Q

Gestational trophoblastic disease

A

Complete mole– ovum containing no DNA fertilized by normal sperm

partial mole normal ovum is fertilized by two sperm

Increased risk of pulmonary embolism and choriocarcinoma

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16
Q

hydratiform mole

A

Dark brown, vaginal bleeding
Anemia
Grape like vessels
Uterine enlargement
Absence of, FHT’s
Increased hCG for dates
Very low MSAFP

17
Q

hyperemesis gravidarum

A

excessive vomiting, impacting hydration and nutrition, causing nutritional deficit

Treat with thiamine supplement, TPN, anti-emetics

18
Q

Rh alloimmunization

A

Rh negative mom
Rh positive baby

19
Q

when should RhoGAM be administered for RH allimmunization?

A

28 weeks prophylaxis

20
Q

if alloimmunization not treated, what can occur?

A

Hydrops fetalis
CHF
Jaundice
Kernicterus
Severe hemolytic syndrome

21
Q

postpartum management of Rh alloimmunization

A

Direct coombs test within 72 hours administer RhoGAM

If negative no RhoGAM

22
Q

kleihaur betke test

A

Determines how much Rh positive blood is present in maternal circulation

23
Q

ABO incompatibility

A

Mom type O, no antigens
Infant a, B, AB

Hemolysis of fetal RBCs