Flashcards in Maternal Complications Deck (66):
The rate of ______ in a diabetic is 3-5%
The risk of major fetal anomaly is _______.
_________ plays a major role of monitoring in a pregnant diabetic.
Diabetes is usually a ______ occurrence, __% of the time.
The other 10% are caused by related _______,______, and _______.
pancreatic disease, hormone imbalance, drug reactions.
What are the two types of diabetes mellitus?
Type 1-juvenile onset, (insulin dependent)
Type 2-adult onset, (non-insulin dependent)
Serum marker for how well a diabetic is controlled in pregnancy, a poorly controlled diabetic is most frequently associated with fetal anatomic anomalies.
Glucose intolerance of pregnancy
Gestational diabetes usu. occurs in ____, and ____, trimesters. Is usu. associated with ______ ______.
2nd, 3rd, fetal macrosomia
What congenital anomalies arise due to the increased risk associated with diabetes mellitus?
neural tube defects
Single umbilical artery
What are the fetal complications affected by DM?
Respiratory distress syndrome
What is associated with Gestational Diabetes
still birth trauma
What is fetal macrosomia?
Fetal weight greater than 4000 g or greater than 90 percentile for gestational age.
Fetuses of gestational diabetic mother can have which other two conditions
What is involved with Hypertension in mothers.
Systolic pressure gradient and 140 mmHg
Increase in systolic pressure greater than 130 mmHg over the pregnancy
Diastolic pressure greater than 90 mmHg
Increase in diastolic pressure greater than 15 mmHg over prepregnancy state
Describe essential hypertension
pre-existing hypertension not related to the pregnancy. ( Also called chronic hypertension)
Hypertension that occurs during pregnancy without signs of preeclampsia
Pregnancy induced hypertension/gestational hypertension PIH
A disorder of pregnancy which is characterized by proteinuria and neurologic symptoms.
GEPH--Gestational edema proteinuria hypertensive syndrome--otherwise called (Toxemia of pregnancy)
GEPH or toxemia of pregnancy is most common in ________, _______, and _______.
1st time mothers (most common)
patients with a family history
What are the two classifications of toxemia of pregnancy
Symptoms associated with Preeclampsia
Rapid weight gain which is secondary to Edema
Symtoms associated with Eclampsia
Same as seen in preeclampsia but with seizures
List what Pathology of GEPH leads to:
necrosis of tissue
premature placental aging
renal cellular damage
disseminated intravascular coagulopathy DIC
Portal hemorrhagic necrosis in the liver
What are the Sono findings of GEPH
Increase of abruptio placentae
______ is used to track fetal growth and monitor the pregnancy
______ _____ is a complication of preeclampsia.
What does HELLP stand for
Elevated liver enzymes-EL
List 3 complications associated with severe maternal infection.
Premature labor and delivery
Name the most common significant utero infections.
What does TORCH stand for.
Other/syphilis and parvovirus
This protozoan is found in cat feces and undercooked meat, name it.
Toxoplasmosis---****Maternal infection crossed the placental barrier and results in fetal infection.
Name 8 results of Toxoplasmosis
An extremely teratogenic infection for the fetus, name this.
Rubella or German Measles
Defects of Rubella are:
Congenital heart disease
The most common infection in pregnancy.
CMV may cause _____ _____ if exposure occurs in 1st trimester. Other findings are:(6)
Spontaneous abruption of placenta
______ can be transmitted to the fetus during vaginal delivery.
Herpes can cause a woman to have ___ _____.
Women with Herpes may also cause (3)
CNS, eye, visceral involvement
Generalized multiple organ involvement
Common respiratory viral infection
Parvovirus can lead to the following (2)
Pancytopenia/anemia which can lead to fetal hydrops
Percutaneous umbilical cord sampling or fetal transfusion may become necessary
Refers to premature dilation and efacement of uterine cervix
****May be congenital or acquired and is mc related to prior cx trauma i.e. cervical surgery for cervical carcinoma.
What happens with an incompetent cervix?
Cervix unable to prevent premature expulsion of pregnancy
How is imcompetent cervix prevented?
Cerclage-- stitch to keep the cx closed.
Name the cerclage procedure.
McDonald or Shirodkar procedure
Features of incompetent Cx. (3)
shortened cervix, < 2.5 cm
Dilation of the cervix greater than 2cm in 2nd Trimester--(Most reliable sign)
Bulging membranes into the dilated cervix--hourglass sign.(Poor prognostic indicator)
The stages of incompetent cervix--TYVU- which stands for
Trust Your Vaginal Ultrasound
Y-internal os slightly dilated
U-extremely short, thin cx
The need for increased perfusion to a highly vascularized placenta results in a __% increase in blood volume.
Because increased plasma volume accounts for much of the increase, _____ and ______ values are much lower during pregnancy than in the nonpregnant state.
Clinical signs of anemia
Hemoglobin less than 10 g per 100 ML's
Hematocrit less than 30%
Types of anemia
Iron deficiency (95%)
Folic acied deficiency
Drug-induced hemolytic anemia
Thalassemia and Sickle Cell Anemia
This is a rare and catastrophic cause of maternal death
Name the clinical signs of Uterine rupture
Sudden increase in fetal station
Define preterm labor
The onset of labor prior to 37 weeks gestation
What can cause preterm labor
Previous uterine surgery
Heavy cigarette smoking
Percentile previous or abruption,source of bleeding
Premature rupture of membranes
What is found on Ultrasound when membranes rupture prematurely?
Most common mass of uterus
Myeloma or leiomyoma
______ and ______ types of masses will be prone to torsion
Submucosal and surserosal types
_______ may cause obstruction of vaginal delivery.
They are also known to cause _____ ______
What are the Ultrasound findings of Leiomyomas
solid, hypoechoic uterine mass which distorts with uterine contour
How to differentiate between focal myometrial contraction and leiomyoma?
Focal myometrial contraction will change with time, a leiomyoma will not.
What type cyst often found during pregnancy.
Name the most common cyst.