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High risk pregnancy Flashcards

(65 cards)

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1
Q

What are the components of the APGAR scale?

A

Appearance
Pulse
Grimace
Activity
Respiratory effort

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2
Q

What should you be evaluating for the A portion of the APGAR scale?

A

Appearance
Skin Color

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3
Q

Describe how an infant would present with the score of 1, and 2 on the APGAR scale for category A

A

0 - Pale blue
1 - body pink, extremities blue
2 - Body and extremities pink

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4
Q

Describe how an infant would present with the score of 0, 1 and 2 on the APGAR scale for the category of P

A

0 - no heart rate
1 - <100 bpm
2 - >100 bpm

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5
Q

Describe the G category of the APGAR scale

A

reflex irritability in response to stimuli
Basically does the baby respond if you piss it off

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6
Q

Describe how an infant would present with the score of 0, 1 and 2 on the APGAR scale for the category of G

A

0 - No response
1 - Grimace
2 - Cry cough sneeze

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7
Q

Describe how an infant would present with the score of 0, 1 and 2 on the APGAR scale for the category of A

A

0 - Limp
1 - some flexion
2 - well flexed

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8
Q

Describe how an infant would present with the score of 0, 1 and 2 on the APGAR scale for the category of R

A

0 - none
1 - weak or irregular
2 - strong cry

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9
Q

What can an ultrasound assess?

A

Fetal structure and activity

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10
Q

What can an ultrasound evaluate?

A
  1. Amniotic fluid level
  2. Placenta location
  3. fetal abnormalities
  4. Fetal Size and position
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11
Q

Why is it important to measure the heart rate of the fetus during delivery?

A

To ensure that the decelerations of the fetal heart rate are synchronized with the maternal contractions

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12
Q

What are early decelerations associated with?

A
  1. Associated with fetal head compression during contractions
  2. Lowest heart rate is at the peak of the contraction
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13
Q

T/F: early decelerations are not normal

A

False. Early decelerations are normal and indicate a proper response to the stimuli

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14
Q

What can cause late decelerations?

A
  1. Increase in fetal systemic blood pressure causes a drop in heart rate
  2. problems with chemo and baroreceptors
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15
Q

What is a fetal BPP?

A

fetal biophysical profile

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16
Q

What are the assessments of the fetal biophysical profile?

A
  1. Fetal tone
  2. fetal breathing movements
  3. Fetal body movements
  4. Amniotic fluid volume
  5. Results of the non-stress test
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17
Q

What tools are used to perform the fetal biophysical profile?

A

Ultrasound and non-stress test

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18
Q

What scores on the fetal BPP are indicative of good outcomes?

A

> 8

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19
Q

What scores on the fetal BPP are indicative of fetal compromise?

A

<4

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20
Q

What is an amniocentesis?

A

Invasive diagnostic test performed by inserting a needle into the uterus into the amniotic sac to withdraw amniotic fluid

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21
Q

What can an amniocentesis identify?

A
  1. Chromosome abnormalities
  2. Lung Maturity
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22
Q

When can an amniocentesis be performed?

A

16-18 weeks gestation

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23
Q

What information would we gather when assessing whether or not a patient is high risk pregnancy?

A
  1. Chronic conditions
  2. Past pregnancies
  3. Maternal Age
  4. Infections
  5. Pregnancy complications
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24
Q

Give some examples of indications of a high risk pregnancy

A
  1. Advanced maternal age
  2. Maternal hypertension
  3. Diabetes
  4. Placental disorders
  5. Umbilical cord disorders
  6. abnormal amniotic fluid
  7. substance abuse
  8. multiples
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25
What are examples of viral infections that can result in a high risk pregnancy?
Hepatitis and HIV
26
What is the most common bacterial infection that indicates a high risk pregnancy?
Group B streptococci
27
What maternal habits could result in a high risk pregnancy?
1. Smoking 2. Alcohol 3. Opioids
28
Describe placenta previa
implantation occurs abnormally low in the uterus partially or completely obstructing the cervix
29
What is a placental abruption?
the placental partially or completely separates from the uterine wall
30
What are maternal complications associated with placental abruption?
1. Hemorrhage 2. Preterm delivery 3. Shock 4. Acute renal Failure 5. DeathW
31
What are fetal complications associated with placental abruption?
1. Insufficient blood supply to the fetus 2. Hypoxia 3. death
32
Describe preclampsia?
chronic hypertension due to pregnancy
33
What are symptoms associated with preclampsia?
headache, blurry vision, stomach pain
34
What blood pressures are required for preclampsia?
>140/>90
35
What is the only known cure for preclampsia?
yeetus the fetus/ delivery
36
Describe eclampsia
Hypertension with seizures
37
What is HELLP syndrome?
Life threatening pregnancy condition
38
What are the components of HELLP?
Hemolysis Elevated liver enzymes Low platelets
39
What is gestational diabetes?
insulin resistance due to pregnancy hormones that resolves after pregnancy
40
What are treatment options for gestational diabetes?
Diet and insulin
41
What are are some maternal complications associated with gestational diabetes?
1. Spontaneous abortion 2. Preclampsia 3. preterm labor or delivery 4. Polyhydramnios
42
What are are some fetal complications associated with gestational diabetes?
1. Congenital anomolies 2. Macrosomia 3. Intrauterine growth restriction 4. delayed lung maturity 5. respiratory distress
43
What is polyhydramnios?
more than the normal amount of amniotic fluid
44
What is oligohydramnios?
lower than normal amniotic fluid
45
What is PROM
pre-labor rupture of membranes = water broke
46
What are the 3 umbrella terms for fetal orientation?
Cephalic-head first Breech - butt or feet first Transverse - shoulder first
47
What is the application of corticosteroids in preterm labor?
antenatal corticosteroid therapy leads to improvement in lung function by enhancing lung maturation
48
What can antenatal corticosteroid therapy reduce the instance of?
1. RDS 2. Intracranial ventricular hemorrhage 3. necrotizing enterocolitis 4. Sepsis 5. Neonatal mortality
49
What steroids are generally given in preterm labor?
Betamethasone and dexamethasone
50
What are the tests to determine lung maturity?
1. Shake test/ Foam stability index 2. L/S ratio 3. PG 4. PC or DPPC
51
What does the foam stability index test?
1. Assess total surfactant activity 2. Mix amniotic fluid sample with ethanol and shake, if a stable ring forms, surfactant is present
52
What lamellar body count indicates immature lungs? Mature lungs?
<15000 = immature lungs >50000 = mature lungs
53
What does the L/S ratio examine?
lecithin/sphingomelin
54
What L/S ratio is associated with good outcomes?
2:1
55
What does a L/S ratio of less than 2:1 indicate?
hyaline membrane disease or RDS
56
If a infant has an L/S ratio of less than 2:1, what treatment is recommended?
Surfactant replacement
57
What compound in the alveoli indicates that the fetal lung development has reached an advanced state?
PG phosphatidyglycerol
58
At what point does PG appear in the amniotic fluid?
about 35 weeks
59
When is a pregnancy considered post term?
>42 weeks
60
What factors could contribute to a post term pregnancy?
1. Prior post term pregnancy 2. maternal obesity 3. Increasing maternal Age 4. Nullparity- hasnt given birth before
61
What problems are associated with post term pregnancy?
1. Fetal asphyxia secondary to hypoxemia 2. decreased tolerance for labor and delivery 3. Meconium aspiration syndrome 4. Persistent pulmonary hypertension of the newborn
62
What are maternal risks associated with post term birth?
1. C-section 2. Dysfunctional labor 3. Infection 4. Postpartum hemorrhage
63
What are fetal risks associated with post term birth?
1. Still birth 2. Neonatal seizures 3. Meconium aspiration 4. Lower APGAR scores 5. Umbilical cord compression
64
When is labor considered preterm?
when uterine contractions occur between 20 and 37 weeks gestation
65
When is a delivery considered preterm?
Delivery occurring after 20 weeks gestation but prior to 37 weeks

Pediatrics (17 decks)

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