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OB - Kaitlyn > Pregnancy complications > Flashcards

Pregnancy complications Flashcards

1
Q

What is an ectopic pregnancy

A

fertilized egg implants outside of the uterine cavity - usually fallopian tube

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2
Q

what are some of the treatments for ectopic pregnancy

A

laproscopy, salpingostomy (removal of fallopian tube), partial salpingostomy, or methotrexate

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3
Q

what does methotrexate do

A

stops fetal growth

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4
Q

what is another name for gestational trophoblastic disease

A

molar disease

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5
Q

what is molar disease

A

fluid filled grape like clusters rather then fetus

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6
Q

who is a risk for having a molar pregnancy

A

high maternal age, previous molar pregnancy

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7
Q

what are the ss of a molar pregnancy

A

absence of FHR, high hcg, low maternal alpha- fetoprotein, looking further along, higher BP before 24 weeks

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8
Q

what is an inevitable SAB

A

no expulsion of contents but bleeding and dialation of cervix cants stop it

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9
Q

what is the treatment for SAB if they dont pass it on their own

A

DNC (dilation and curettage - scraping contents out), DNE (dilation an evaluation - sucks it out)

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10
Q

what is a missed SAB

A

death of fetus but contents retained

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11
Q

what is cervical insufficiency

A

structural inability of cervix to remain closed in absence of preterm labor

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12
Q

who is at risk for cervical insufficiency

A

cervical trauma, hx of LEEP, family hx DES

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13
Q

what is a recurrent SAB

A

3 or more SAB could be because of genetics, anatomical, chromosomal

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14
Q

who is at risk for a ectopic pregnancy

A

hx of STI, past ectopic pregnancy, use of IUD, endometriosis, assisted reproduction

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15
Q

what are the ss of a ectopic pregnancy

A

Unilateral stabbing abdominal pain, lower quadrant pain, vaginal bleeding, could have shoulder pain from referred bleeding

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16
Q

what is a complete SAB

A

complete expulsion of contents

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17
Q

what is an incomplete SAB

A

partial expulsion of contents

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18
Q

what is the treatment for a molar pregnancy

A

removal of uterine contents

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19
Q

why is there lots of follow up for a molar pregnancy

A

because of the high hcg levels if they dont go down they may need chemo - bc of that dont get pregnant again for a year

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20
Q

what is a SAB

A

Miscarriage less then 20 weeks

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21
Q

what is a potential cause for 1st trimester SAB

A

chromosomal abnormalities, infection, maternal anatomical defects, immunological, endocrine factors

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22
Q

what is a threatening SAB

A

signs of SAB without dilation- fetus is still alive and attached

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23
Q

what are the ss of SAB

A

vaginal bleeding, cramping, decrease ss of pregnancy

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24
Q

what is a potential cause for 2nd trimester SAB

A

chronic infection, maternal uterine/cervical defects, exposure to fetotoxic substance, drug use, trauma/shock

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25
Q

what is a septic SAB

A

Content and/or uterus becomes infected during abortion process

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26
Q

what can be done for cervical insufficiency

A

placement of clerclage at cervical/vaginal opening

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27
Q

when would a clerclage be removed

A

at 37 weeks to give birth

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28
Q

what could be some adverse effects for hyperemesis

A

alkalosis, ketouria, decreased weight, potential fetal growth restrictions, dehydration

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29
Q

who is at risk for hyperemesis

A

increase placental mass, molar pregnancies, thimaine and vitamin D deficiency, increase hormones

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30
Q

what is placental previa

A

implantation of placenta in lower uterine segment

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31
Q

what is a complete placenta previa

A

covers entire opening of cervix

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32
Q

what is a partial placenta previa

A

covers part of cervix opening

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33
Q

what is a marginal placenta previa

A

placenta is approaching cervical opening but not covering it

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34
Q

what is a low lying placenta previa

A

in between normal level and marginal level (aka not covering but not where its suppose to be)

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35
Q

what are the ss of placenta previa

A

painless, can have bright red bleeding

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36
Q

what is a placental abruption

A

premature seperation of placenta from uterine lining

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37
Q

what are the ss of placental abruption

A

3rd trimester bleeding with sudden severe abdomen pain, uterine tenderness, may or may not have bleeding (concealed or revealed)

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38
Q

what is the treatment for placental abruption

A

depends on degree, hospitalization, continuous monitoring, if severe may need immediate c -section

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39
Q

what are some ss of DIC

A

bleeding from gums, mouthm nose, decrease platelets, decrease fibrogen

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40
Q

who is a risk for placental previa

A

multiple pregnancies, previous scaring of uterus, smoking, drug use, hx of SAB, maternal age

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41
Q

why could complete/partial not be vaginally birthed

A

because the placenta would come out first and cut off o2 supply to the baby

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42
Q

what are the interventions for placenta previa

A

VS Q 15min, iV fluids, 02 given, no vaginal exams because it could irritate it more and cause more bleeding

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43
Q

who is at risk for placental abruption

A

maternal hypertension, smoking, SAB, short umbilical cord, domestic violence

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44
Q

what is disseminated intravascular coagulopathy (DIC)

A

bleeding disorder (caused by something else) but all the clotting factors go to placenta leaving rest of mom defenseless

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45
Q

what are some interventions for DIC

A

strict I/O, side laying to increase blood flow to baby,

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46
Q

when does preterm labor happen

A

between 20-37 weeks

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47
Q

what are some ss of preterm labor

A

can be painful/painless contractions, pelvic pressure, vaginal discharge (could have blood), water may break, “i just dont feel right”

48
Q

what are some late term complications of preterm labor

A

cerebral palsy, intellectual & developmental issues, retinopathy

49
Q

what is the goal of preterm labor

A

inhibit/reduce contractions, stop dilation, optimize fetal status

50
Q

what does the tocolytic: BIfedipine/procardia do

A

calcium channel blocker, watch for decrease BP from vasodialation

51
Q

what does Bethamethasone do

A

IM if fetus is 24-34 weeks, it increases fetal lung maturity series of 2 shots 24 hours apart it works for 48hrs -7 days after 7 days if another preterm labor risk you can give the shots again

52
Q

what are some causes for PROM

A

infection in genital tract, smoking, multibaby

53
Q

what increases risk for preterm labor

A

could be unknown, abruption, uterine over distension, hormonal changes, , bacterial infection

54
Q

what are some short term complications of preterm labor

A

respiratory distress, intraventricular hemorrhage, necrotizing enterocolitis, patent ductus arterioles

55
Q

what does tocolytic: magnesium sulfate do

A

decreases BP and seizures in pre eclampsia

56
Q

what do you need to monitor for magnesium sulfate

A

urine output, BP, deep tendon reflexes, magnesium levels

57
Q

what do you need to keep on you when your patient is taking magnesium sulfate

A

calcium gluconate to reverse adverse effects

58
Q

what is PROM

A

premature rupture of membrane before labor

59
Q

what are the ss of PROM

A

vaginal leaking of fluid

60
Q

how do you confirm PROM

A

ferning (microcope looking at fluid), Nirogene (cotton color changing thing), aminosure kit

61
Q

what teaching is involved for PROM

A

no baths, no sex, nothing in the vagina

62
Q

what does SPASM stand for (pre eclampsia)

A

significant Bp changes, protienuria, arterioles, significant lab changes, multi organ systems, before 24 weeks

63
Q

what is eclampsia

A

progression from pre-elcampsia involves CNS aka seizures

64
Q

what increases the risk for hypertensive disorders

A

smoking, obesity, diabetes, family hx,

65
Q

what are the ss of severe hypertensive disorders

A

HELLP (hemolysis, elevated liver enzymes, low platelet count)

66
Q

when does postpartum pre eclampsia

A

usually develops 48hrs to 6 weeks after delivery

67
Q

how much proteinuria needs to exist to fall into hypertensive disorders

A

excretion of 300mg ever 24 hours, or 1+ in 2 random urine samples 4-6 hours apart

68
Q

what can hypertensive disorders cause

A

abruption, preterm labor, low birth weight, poor fetal growth, hepatic failure

69
Q

what is chronic hypertension and when does it show up

A

before pregnancy or before 20 weeks - over 140/over 90

70
Q

what is gestational hypertension

A

new onset hypertension after 20 weeks without proteinuria

71
Q

what is gestaional pre - elampsia

A

> 140/>90 x2 4 hours apart, with proteinuria

72
Q

what position can help gestational hypertension

A

left side laying

73
Q

what is the only cure for pre-elcampsia/ eclamspia

A

delivery

74
Q

what are the ss of HELLP syndrome

A

pre- eclampsia, n/v, hepatic dysfunction, acute renal failure

75
Q

how many calories do you need to increase for 2 babies

A

600-900cal/day

76
Q

what does TORCH stand for

A

toxoplasmosis, other, rubella, cytomegalovirus, herpes simplex virus

77
Q

what does toxoplasmosis do to a developing fetus

A

ventricularomegaly, intracranial calcifications, IUGR, hepatosplenomegaly

78
Q

what does cytomegalovirus do to a developing fetus

A

deafness, blindness, intellectual/ developmental disabilities, jaundice

79
Q

what does cytomegalovirus do to a mom (ss)

A

asymptomatic

80
Q

what is antepartal HIV vertical transmission

A

virus crosses placenta

81
Q

what is intrpartal HIV vertical transmission

A

travels from vagina up into uterus during labor or after rupture of membrane

82
Q

what are some potential complications of multibaby

A

preterm labor, diabetes, increase risk for UTI, umbilical prolapse

83
Q

what group beta strept (GBS)

A

normal flora for many women

84
Q

what do you treat group beta strept (GBS) with

A

penicillin antibiotics

85
Q

what can group beta strept (GBS) affect

A

labor/ birth

86
Q

when is screening done for group beta strept (GBS)

A

36-37 weeks

87
Q

what is toxoplasmosis

A

spread via cat feces or undercooked meats

88
Q

what are some maternal ss for toxoplasmosis

A

fatigue, muscle pains, myocarditis, lymphadenopathy

89
Q

what does rubella do to a developing fetus

A

deafness, eye defects, CNS abnormalities, cardiac malfunction

90
Q

what are some maternal ss of rubella

A

rash on face/neck/arms/legs lasting 3 days

91
Q

what is isoimmunization

A

development of maternal antibodies destorying fetal RH+ blood

92
Q

what 3 things need to happen for isoimmunization

A

fetus must have RH+ and mom Rh-, significant amount of fetal blood entering maternal blood (0.1), mom has capacity to produce antibodies

93
Q

when do you give Rhogam

A

RH - mom at 28 weeks and within 72 hours after delivery to RH+ baby

94
Q

what is pregestational diabetes

A

hyperglycemia resulting from limited or absent insulin production, deficent insulin or combo of both

95
Q

what are the risks for getting gestational diabetes

A

ovre 25 years old, obesity, insulin resistance,

96
Q

if a women has gestational diabetes what are the more likely to get as awell

A

pre eclampsia/ eclampsia

97
Q

what kind of diet should someone with gestational diabetes be on

A

low carb diet

98
Q

what kind of diagnostic procedures can confirm embolism

A

doppler US, MRI, CT

99
Q

is the 1st RH+ baby affected

A

rarely affected

100
Q

is RH+ dominant or recessive

A

dominant

101
Q

who doesnt need RHogam

A

mom with RH+ blood, Mom with RH- and baby with Rh-

102
Q

what is gestational diabetes

A

Impairment in carbohydrate metabolism

103
Q

how does glucose work during preganancy

A

glucose levels decrease in mom during 1st trimester, during 2nd and 3rd trimester insulin requirements slowly increase

104
Q

what is the 1st half of pregnancy for gestational diabetes called

A

anabolic phase= maternal hyperinulinemia

105
Q

what is the 2nd half of pregnancy for gestational diabetes called

A

catabolic phase= fetal hyperinsulinemia

106
Q

does glucose and insulin cross the placenta

A

insulin doesnt glucose does

107
Q

what are the fetal effects of gestational diabetes

A

5x more likely of perinatal death, 2x more likely in congential malformations, sudden intrauterine death, respiratory distress

108
Q

what are some ss of thromboembolism

A

pain, tenderness, warmth, swelling color change

109
Q

what are some ss of pulmonary embolism

A

tachypnea, dyspnea, pleurtic chest pain, anxious

110
Q

what meds do you give someone with a emoblism

A

anticoagulant

111
Q

what is a doppler ultrasound blood flow studies

A

study of blood vessels in umbilical vessels

112
Q

what is a contraction stress test

A

evaluates FHR reasponse to uterine contractions

113
Q

what is a negative contraction stress test

A

desired - no significant decels in FHR

114
Q

what is a positive contraction stress test

A

late decels with 50% on contractions

115
Q

what is a reactive non stress test

A

15x15 in 20 mins

116
Q

what is a non reactive non stress test

A

absence of accels or less then 2 accels. in 20 minutes

OB - Kaitlyn (6 decks)

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