Exam 3 Abn Preggo 2 Flashcards Preview

Q4 Women's Health > Exam 3 Abn Preggo 2 > Flashcards

Flashcards in Exam 3 Abn Preggo 2 Deck (26):
1

HTN in preggos: Chronic?

HTN before preggo or before 20 wks

2

Preeclampsia is?

HTN after 20 wks
+ proteinuria

3

HELLP Synd is?

Severe preeclampsia w/:
Hemolysis
Elevated liver enz
Low platelets

4

Preeclampsia risk factors? (9)

< 20 or > 35 yo
Nulliparity (no babies)
Many preggos
DM
Thyroid dz
Chronic HTN
Renal dz
Collagen vascular dz
FHx

5

Preeclampsia presentation? (8)

HTN + Proteinuria
Edema
HA
N/V
Hyperreflex
Oliguria
Blurred vision
Epigastric pain

6

Preeclampsia: Mild? (2)

SBP 140+ or DBP 90+ (2 reads)
AND 300+mg in 24hr urine

7

Preeclampsia: Severe? (4)

ANY of:
SBP 160+ or DBP 110+ (2 reads)
Severe proteinuria
Signs of end-organ damage (olig, plum edema, RUQ pain, liver enz, severe HA)
Restricted fetal growth

8

Preeclampsia labs? (6)

CBC for hct
Platelet count: thrombocytopenia = worse
PT/PTT
LFT
Cr
Fetal studies

9

Preeclampsia mgmt? (5)

↓ activity
Serial CBC/CMP/Uric acid
Glucocorts < 34 wks
Labetalol
Fetal studies

10

Eclampsia?

Superimposed?

Preeclampsia with new-onset convulsions

Pre/eclamp with pre-existing HTN

11

Intrauterine Growth Restriction (IUGR) is?

Why do we care?

Birth weight < 10th%

Vulnerable to asphyxia, acidemia, labor intolerance
Low APGAR, many issues
As adult: HTN, CVdz, obesity, dyslipidemia

12

IUGR caused by? (5)

Very young or very old mother
Smoking, drugs, HTN, anemia, DM, etc
Primary placental dz
Abn uterus
Multiples, genetics, infection, teratogens

13

TORCH infections include?

Toxoplasmosis
Other
Rubella
CMV
HSV

14

IUGR assessment includes? (2)

Fundal height
US

15

IUGR mgmt? (6)

Watch fetus:
Non-stress test
Biophysical Profile w/ dopler 1-2 x wks
Glucocorts < 34 wks
P bed rest
Deliver when fetal death > neonate risks

16

Gestational HTN is?

HTN after 20 wks
No proteinuria

17

Gestational DM hallmark?

Risk factors? (7)

Insulin resistance

FHx of DM
BMI >30
>25 yo
Hx of macrosomia (big baby)
Polycystic Ovary
Hx unexplained stillbirth
Prior HTN

18

Gestational DM complications? (6)

Preeclamp
Stillbirth
Macrosomia
C-section
Mom -> develops DMII
Baby: hypogly/Ca2+, hyperbili, resp distress

19

Gestational DM screening?

@ 24-28 wks
1 hr Glucose test: if > 130, get 3hr
3hr: if any > 200 or 2 are elevated = GDM

20

Gestational DM mgmt? (4)

Monitor glucose before and after each meal: goal 70-95 fasting, <120 post meal

Health diet
Exercise
P insulin

21

Gestational DM: if baby >4500gms, what next?

What test should be done @ 6 wks postpartum?

C-section

2hr GTT on mom

22

Preterm Labor is?

Regular contractions after 20 wks and before 37 wks
Result in cervix changes

23

Preterm Labor risk factors? (5)

Previous pre-term
Multiples
FHx
Smoking/drugs
Dental infect

24

Preterm Labor sxs? (5)

Cramps
Backache
Abd/pelvic pressure
Vag d/c change
Painless contractions

25

Preterm Labor exam? (6)

r/o membrane rupture
Digital cervical exam
US for cervical length
UA C&S
B Strep cx
Non-stress test
Fetal Fibronectin: + = risk of delivery

26

Preterm Labor mgmt? (3)

Corticosteroids 24-34 wks: speed fetal lung maturation, decrease hemorr
Stop smoking
Progesterone