c section and systemic disorders of pregnancy Flashcards
(25 cards)
estimated due date?
since LMP, 40 weeks
initial counseling
violence
tobacco/drug use EtOH
weight gain recs
exercise (NO HOT things)
dietary restrictions?
raw dairy, deli meat, fish
initial test:
Blood and RH
AB screen
Hep A SAg
Rubella, HIV, Chalmydia, Gonorrhea
A1C
optional: trisomy, CF, Fragil X
prenatal visits 1-2 trimester?
1/4weeks
prenatal visits in 3rd trimester?
1/2weeks
prenatal visits
FHR, fundal height, glucose
Dx eval
US survey every 20 weeks
flu vaccine
AFP measure to screen for
neural tube defects etc
preeclampsia?
proteinuria, after New onset 20 weeks htn (>140/90), increased FHR
HELLP syndrome?
hemolysis
elevated liver enzymes, low platelets
MAY NOT HAVE HTN and PROTEINURIA BEFOREHAND
headache that isn’t going away
edema?
severe preeclampsia
abnormal _____invasion of the spiral arteries and consequent secretion of _____ factors
trophoblast invasion
placental secretion of angiogenic factors
systemic _______ dysfunction caused by preeclampsia?
endothelial dysfunction
mgmt of preeclampsia
magnesium sulfate
magnesium sulfate to prevent
seizures
Ddx 3rd trimester bleeding
MAIN ONES
Placental abruption
PRevia
Vasa Previa
Uterine rupture
Ultrasound or digital exam for bleeding in 3rd trimester?
US always first
causes of placental abruption?
htn, cocaine/smoking, abdominal trauma
placenta previa risk factors
prior uterine surgery, many pregnancies, mutliple gestations, smoking, older moms
Vasa previa presentation and risk factors
painless vaginal bleeding
multiple gestations
VERY EMERGENT
what type of plancental abnormality common to see in preeclampsia?
placental abruption
c section indications
breech presentation
abnormal placentation
prior myometrial surgery
macrosomia (over 5000 grams)
HIV
Active Herpes outbreak
C section tries to avoid what layer of the uterus?
Myometrium which is why it is done int he lower uterine segment
