Flashcards in OB Test 2: High Risk Pregnancy Deck (33)
What are the biophysical risk assessment?
History of preterm labor
What are psychosocial risk factors for high risk pregnancies?
History of mental illness
What are socio-demographic risk factors for high risk pregnancies?
Lack of insurance
No prenatal care
Level of family support
What are environmental factors of high risk pregnancy?
When do kicks start?
Can be formal or instinct
What can decreased fetal movement indicate?
Gives mother anxiety
What are the different uses of obstetric ultrasound?
Confirm pregnancy: # and presentation
Evaluate placenta: location, size, grade
Amniotic fluid: placental abruption, fetal demise
Doppler blood flow
Fetal well being
When can you do an ultrasound?
16 weeks and mother drink water to raise uterus
External or transduced
What a BPP?
Evaluates fetal oxygenation & well being in utero
What is AFP?
MsAFP: maternal serum which increases neural tube defects and decreases downs
Screening tool only
When should you do an amniocentesis?
What color should it be?
What should the LS ratio be?
What d the different colors mean?
At 30-35 weeks fetal lung maturity
Yellow: increased bilirubin
What are the risks of amniocentesis?
PTL: per term labor
RH sensitization (mom may be exposed)
What is CVS?
Chorionic villus sampling
10-12 weeks, can be as early as 8 weeks
Early diagnosed for rH negative mom needs RhoGAM
What are the risks of CVS?
Miss digits & limbs
What is PUBS
Percutaneous umbilical blood sampling
Draw baby blood out from umbilical cord
Done in 2 and 3 trimester
What are other genetic tests?
Coombs test: moms blood
Fetal fibronectin: protein in fetal membranes, May predict preterm labor
What is fetal heart rate testing?
Non stress test used for at risk women such as diabetes, hypertension, decrease fetal movement, multiple gestation
Criteria: 2 accelerations of 15 bpm X 15 sec in 20 min
What is a CST?
Contraction stress test
Determines if fetus will tolerate labor
- 3 moderate contractions in 10 minutes to determine how fetus will respond
- nipple stimulation: pill roll 2 min, stop 2 min then switch nipples
- oxytocin: low levels
What are the different gestational hypertensive disorders?
What is the etiology of gestational hypertensive disorders?
Some sort of immunological problem
Only cure is delivery
What is preeclampsia?
After 20 weeks
Results in seizure
What is the prevalence of gestational hypertensive disorders?
Usually in primagravida
What are the signs and symptoms of preeclampsia?
Vasodpasm and organ perfusion
Intra vascular coagulation.
Increased permeability & capillary leakage
What is mild preeclampsia?
Blood pressure >140/90
- 1+ to 2+ on urine sample
> 300 mcg in 24 hour urine
30/15 increase from baseline blood pressure
What is severe preeclampsia?
BP > 160/110 on 2 occasions 6 hours apart
2+ to 3+
> 5 grams in 24 hour urine
What are signs of worsening preeclampsia?
Sudden severe edema
What is treatment of mild eclampsia?
Goals: prevent progression to eclampsia
Delivery: induce when feel fetus in mature is 36 or 37 do amniocentesis to see if lungs mature
What is treatment of severe eclampsia?
Quiet environment, side rails up, restrict visitors, less stimulation, always auction & oxygen in room
Medications: bethamethazone to enhance fetal lung development
Delivery: by 34 weeks or if it worsens