Maternal fetal health 1 Flashcards Preview

Endocrine > Maternal fetal health 1 > Flashcards

Flashcards in Maternal fetal health 1 Deck (36):
1

thyroid storm clinical (5)

 

assoc

fever, tachycardia

altered mental state

diarrhea

vomitng

arrhythmia

assoc - infection, labor, hypoglycemia, DKA inciting event

1

impact of DM vs gestational diabetes

in DM, fetus experiences high glucose levels earlier

at 7wks - glucose toxic in organogenesis

1

contributing factors antepartum hemorrhage (after 20 weeks gestaion)

palcental abruption

vasa previa

uterine ruprture

placenta previa 

1

getational HTN cutoff

140/90

 

2

catalyzes iodiantion of tyrosine residues of Tg in the formation of T3/T4

thyroid peroxidase

4

fetal mortality ratio = 

# fetal deaths >20wks or 500g divinded bytotal births (still and live)

4

prolactin trends after pregenancy

return to baseline 3 months post

remain high longer in lactating women) 

5

live birth =

expulsion or extraction of fetus at any stage in which fetus breathes or has beatin heart, pulsation  of ubiical cord, or definite movemnet of voluntary mucles

5

side effects Mg Sulfate

warmth, flushing

Nausea/vomiting

Rare - loss of patellar reflex

respiratory depression

6

maternal death = 

 

maternal mortality  = 

maternal mortality ratio = 

death while pregnant or within 42 days termination of prenancy

Rate = # of deaths per 100,000 women of reproductive age 15-49yr

Ratio = maternal deats per 100,000 live births (deaths/live briths)x100,000

6

Rx for preeclamspia

seizure phrphylaxis

for fetal lung maturation

Mg sulfate for seizure proph

Betamethasone for fetal lungs dev

7

pathophys TSH drop in first try mester

hcG beta subunit has wek ability to activate TSH receptor, increased hCG leads to decreased TSH

8

fetal outcomes in gestational diabetes

macrosomia = growth beyon 4500g

polyhydramnios

neomnatal hypoglycemia

risk of brith trauma

risk of long term metabolic disorders

10

Graves in pregnancy pathophys and associations

antibodies cross placenta

risk of abortion, preterm, low birth weight, still birth, preeclampsia

11

neonatal mortality rate =

neonatal deats per 1,000 live births 

13

contributing factors to postpartum hemorrhage (4)

uterine atony

coagulaition defects

trauma

placenta accreta

14

pathophys sheehan syndrome

ischemic injury to hypothal-pituitary axis

(due to pregnancy assoc increase in pituitary size and low flow, low pressure nature of portal circullation)

15

leading cause of maernal mortality in US

CV disease

infection / sepsis

16

mother uses ____ for fuel after mels, leaving ___ for fetal growth

mother uses TAG, glyccerol, FFa

 

glucose adnd maino acids for fetal growth

17

gestational hyperthyroidism assoc

 

treatment

first half of pregnacy

associated with increased hCG or increaed thyroid stimualting activity of hCG

hyperemesis gravidarum - nausea, vomiting ,weight loss

supportive treatment - IV fluids, antiemetics

19

maternal increase in thyroid binding globulin due to

increase production and decreased clearance of TBG mediated by increse in estrogen

20

presence of Tg or TPO autoantibodies in mother associated with

pregnacy loss

recurrent miscarraiges

preterm

(thyroid destruction no suffeicient in most to casue hypothyroidism)

22

HELLP syndrome

severe HTN plus

Hemolysis

Elevated Liver enzymes

low platelets

23

stillbirh =

death of>20wk fetus

25

impact of greater fetal glucose supply in gestational diabetees

macrsomia

extra glucose sotred as fat

increased insulin production

26

hyperthyroidism and thyrotoxicosis associated with increase risk of (6)

spontaneous abortion

permature labor

low birth weight

still birth

preeclmapsia 

heart failure

27

PREECLAMPSIA = 

SEVERE htn 160/110 PLUS

proteinuria

visual disturbances, headaches

epigastric pain

thrmobocytopenia

abnl liver fxn

28

betamethasone mechanism

 

side effects

accelrate devo of type 1 and 2 pneomocytes > improve lung mehcnacis andsurfactant production

 

fluid retention in mother and transient increasse in fetal heart raet possible

29

risk factors preeclmapsia

primiparity

Hx or Fhx

Diabetes, high BMI, kidney disease, antiphospholipid ABs

multiple gestations

Maternal age below 20 or above 35

30

hypothyroidism in pregnancy most often due to (in area of adequate iodine)

presence of TPO or thryoglobulin antibodies (hashimotos)

31

indirect obstetric death

deat due to preexisting disease or new diseae aggravated by effects of pregnancy

32

heyodynamic and renal hallmarks of pregnancy

increased capactiy and reduced resistance

33

amino acid concentration fetus vs mother

hgiher in feuts

34

gestational diabetees attributed to (pathophys)

insuf compensatory capcity to increase beta cell mass and insulin secretion

pre-existing insulin resistance if obese

crculating islet cell antiboies ("latent" type 1)

35

sheehan syndrome characterized by 

failure of lactation

failure of hair growth over areas shaved for delivery

poor wound healing after C-section

weakness

36

fetal sequalae of pregnacy HTN disorders

growth restriction

oligohydramnios

indicated preterm delivery

metabolic or CV disorders