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Flashcards in OB Test 2: High Risk Pregnancy Deck (70)
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0

What are the biophysical risk assessment?

Hero-placental perfusion
Preeclampsia
Diabetes
History of preterm labor
Diseases

1

What are psychosocial risk factors for high risk pregnancies?

History of mental illness
Depression
Substance use
Family violence

2

What are socio-demographic risk factors for high risk pregnancies?

Poverty
Lack of insurance
No prenatal care
Level of family support
Age
Education level

3

What are environmental factors of high risk pregnancy?

Saftey
Home
Workplace
Exposure
Pollution

4

When do kicks start?

28 weeks
Can be formal or instinct

5

What can decreased fetal movement indicate?

Chronic hypoxia
Gives mother anxiety

6

What are the different uses of obstetric ultrasound?

Confirm pregnancy: # and presentation
Evaluate placenta: location, size, grade
Fetal anomalies
Fetal maturity
Complications
Amniotic fluid: placental abruption, fetal demise
BPP testing
Fetal procedures
Doppler blood flow
Fetal well being

7

When can you do an ultrasound?

16 weeks and mother drink water to raise uterus
External or transduced

8

What a BPP?

Biophysical profile
Evaluates fetal oxygenation & well being in utero

9

What is AFP?

Alpha fetoprotein
MsAFP: maternal serum which increases neural tube defects and decreases downs
Screening tool only

10

When should you do an amniocentesis?
What color should it be?
What should the LS ratio be?
What d the different colors mean?

15-20 weeks
Clear color
Chromosomal analysis
At 30-35 weeks fetal lung maturity
2:1

Yellow: increased bilirubin
Green: meconium
Bloody: placenta

11

What are the risks of amniocentesis?

Spontaneous abortion
Trauma
Bleeding
PTL: per term labor
Infection
RH sensitization (mom may be exposed)

12

What is CVS?

Chorionic villus sampling
Genetic testing
10-12 weeks, can be as early as 8 weeks
Early diagnosed for rH negative mom needs RhoGAM

13

What are the risks of CVS?

Miss digits & limbs
Spontaneous abortion
Limb reduction

14

What is PUBS

Percutaneous umbilical blood sampling
Draw baby blood out from umbilical cord
Done in 2 and 3 trimester

15

What are other genetic tests?

Coombs test: moms blood
Fetal fibronectin: protein in fetal membranes, May predict preterm labor
Endocervical length
L:S ratio
PG

16

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

17

What is a CST?

Contraction stress test
Determines if fetus will tolerate labor

Contraction:
- 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

18

What are the different gestational hypertensive disorders?

Preeclampsia
Eclampsia
Prevalence

19

What is the etiology of gestational hypertensive disorders?

No cause
Some sort of immunological problem
Only cure is delivery

20

What is preeclampsia?

Hypertension
Proteinuria
After 20 weeks

21

Eclampsia

Results in seizure

22

What is the prevalence of gestational hypertensive disorders?

3-7%
Usually in primagravida

23

What are the signs and symptoms of preeclampsia?

Vasodpasm and organ perfusion
Intra vascular coagulation.
Increased permeability & capillary leakage

24

What is mild preeclampsia?

Blood pressure >140/90
Proteinuria:
- 1+ to 2+ on urine sample
> 300 mcg in 24 hour urine

30/15 increase from baseline blood pressure

25

What is severe preeclampsia?

BP > 160/110 on 2 occasions 6 hours apart

Proteinuria
2+ to 3+
> 5 grams in 24 hour urine

26

What are signs of worsening preeclampsia?

Severe headache
Hyper reflexia
Visual disturbances
Epigastric pain
Sudden severe edema
Oliguria
Pulmonary edema
Fetal distress
Seizures
Stroke

27

What is treatment of mild eclampsia?

Goals: prevent progression to eclampsia
Limit activity
Environment
Delivery: induce when feel fetus in mature is 36 or 37 do amniocentesis to see if lungs mature

28

What is treatment of severe eclampsia?

Hospitalization
Bed rest
Quiet environment, side rails up, restrict visitors, less stimulation, always auction & oxygen in room
Seizure precautions
Medications: bethamethazone to enhance fetal lung development
Delivery: by 34 weeks or if it worsens

29

What are medications for preeclampsia?

Betwmethosone 12.5mg IM x 2 doses 24 hours apart
Magnesium sulfate 4-6 g loading dose IVPB