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Problems In pregnancy Flashcards

(58 cards)

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1
Q

What are good food sources for iron?

A

Prune juice
Raisins
molasses
pumpkin seeds
sesame seeds
sunflower seeds
beans
dark greens
organic beef liver

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2
Q

What week gestation does HGB/HCT readings often dip because of increase in blood volume?

A

28 weeks

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3
Q

What levels for HCT/HGB should a mother try to maintain throughout most of her pregnancy?

A

HCT 34
HGB 11.5

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4
Q

What does MCV (mean corpuscular volume) indicate?

A

The average size of her red blood cells

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5
Q

What does MCH (mean corpuscular hemoglobin) indicate?

A

Her average amount of hemoglobin per cell.

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6
Q

What is microcytic(small cell) anemia?
[Iron deficiency]

A

The MCV is normal but the MCH is lower than usual.

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7
Q

What is macrocytic or megaloblastic(large cell) anemia?
[B-12 + folate anemia]

A

The MCV is elevated but the MCH is normal.

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8
Q

What are good food sources for folate?

A

Egg yolks
Orange juice
Melons
Strawberries
Dark greens

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9
Q

What are good food sources for vitamin B-12?

A

Dairy Foods
Animal Products

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10
Q

What are two types of hereditary, microcytic anemias?

A

Thalassemia
Sickle cell anemia

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11
Q

How much weight gain is normal/average in pregnancy?

A

At least 10 lbs by 20 weeks and about 1 lb per week thereafter.

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12
Q

What is it called when there is a miscarriage before 20 weeks?

A

Spontaneous Abortion

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13
Q

What is it called when there is a miscarriage after 20 weeks?

A

Fetal Demise

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14
Q

What is it called when there is bright red bleeding dramatic or slight and continuous for days or weeks?

A

Threatened Abortion

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15
Q

What is it called when membranes rupture or cervix dilates in first half of pregnancy?

A

Inevitable Abortion

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16
Q

What is an ectopic pregnancy?

A

Implantation occurring outside the uterine cavity. (Majority occur in the fallopian tubes-tubal pregnancy)

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17
Q

What is the outcome of a tubal pregnancy?

A

The fetus may be expelled into the abdominal cavity as it grows too large, or may cause the tube to rupture between 10-13 weeks.

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18
Q

What can a tubal pregnancy be mistaken for?

A

Pelvic Inflammatory Disease
Sever GI upset
Appendicitis

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19
Q

What is the primary cause of tubal pregnancy?

A

Pelvic Inflammatory Disease
(Leaves scar tissue that may partially occlude the tube and cause reduced cilliation or the formation of blind pockets)

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20
Q

What predisposes women to ectopic pregnancies?

A

STDs
Trauma from IUDs
Progesterone-based contraception
Infection following abortion
Prior tubal rupture
Reconstructive surgery

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21
Q

What are symptoms of tubal pregnancy?

A

Pelvic pain(consistent and more intense than cramping)
Spot bleeding

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22
Q

What are the signs of tubal pregnancy rupture?

A

Pain becomes more severe and may be referred to the shoulder area.
The degree of shock far exceeds what would normally be expected for the amount of blood loss.

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23
Q

What is the treatment of tubal pregnancy?

A

Surgical Removal of the pregnancy
Methotrexate(dissolves pregnancy)

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24
Q

What is hydatiform mole(molar pregnancy)?

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A

When the chorionic villi which usually forms the membranes and placenta, instead develops into a mass of clear, grape-like vesicles that fill the uterus.

25
What is a complete mole?
When an abnormal sperm inactivate the chromosomes of the ovum. There is no fetus.
26
What is partial mole?
There is fetal tissue present, though chromosomes from sperm and ovum are abnormal in number and the fetus almost never survives.
27
What are symptoms of hydatiform mole?
-Light brown bleeding persisting for weeks or months(though rarely past the first trimester) -Uterus is large for dates -Uterus is woody, hard, doughy to touch -High HCG levels
28
What are the complications of elevated HCG levels?
Taxes the livers HTN Proteinuria Hyperemesis(later in pregnancy)
29
Bleeding in late pregnancy: What is bleeding from a ruptured cervical polyp like?
Sudden and somewhat dramatic but tends to resolve quickly.
30
Bleeding in late pregnancy: What is a marginal placental abruption?
Separation at the edge of the placenta only, causing bright red blood to flow from the vagina but pain is less intense.
31
Bleeding in late pregnancy: What is a concealed placental abruption?
Separation of the central portion of the placenta while margins remain attached, so bleeding is concealed. Acute, consistent abdominal pain(or back pain if placenta is implanted posteriorly) that is nonrhythmic and does not change with movement, with uterus woody hard and exceedingly tender.
32
Bleeding in late pregnancy: What is a complete placental abruption?
A total separation of the placenta. Vaginal bleeding is profuse and mother will rapidly go into shock.
33
Bleeding in late pregnancy: What is placenta previa?
Placenta implanted low in the uterus. Blastocyst seeks an unused/unscarred site in which to imbed.
34
Bleeding in late pregnancy: What are the risk factors for placenta previa?
Previous uterine surgeries History of PID Endometritus Multiparty Pregnancies with short intervals between Large placenta(twins, etc)
35
Elevated blood sugar in early pregnancy is linked to?
Birth defects Miscarriage
36
What are the risks for baby with elevated blood sugar levels as pregnancy advances?
Macrosomia(growth in chest region) -prolonged labor -shoulder dystocia Respiratory Distress Hypoglycemia Hypocalcemia
37
What are the risks for mother with elevated blood sugar levels as pregnancy advances?
Preeclampsia Polyhydraminos Postpartum hemorrhage
38
What are symptoms of type 2 diabetes?
Increased thirst Increased urinary output Recurrent or chronic yeast infections Acetone breath Ketonuria Persistent glucosuria
39
What is protocol for women with diabetes risk factors or symptoms?
HgbA1c screen in first trimester Additional screening at 24-28 weeks
40
What is the glucose challenge test? (GCT)
The mother ingests 50mg liquid glucose/orange pop with a blood draw 1 hour later. R/c carb loading for 3 days prior and have it performed at 24 weeks.
41
If glucose levels exceed 140mg/dl with GCT, what is the next test?
Oral glucose tolerance test(OGTT) Mother carb loads for 3 days before Fast overnight for baseline Ingest 75mg glucose Blood draws repeated at 1 and 2 hours During this time, no eating but light exercise.
42
What are max sugar levels with OGTT?
Fasting: above 90 mg/dl One hour: above 180 mg/dl Two hours: above 155 mg/dl
43
What is the standard treatment for HTN in the hospital?
IV mag sulfate
44
What is severe gestational hypertension linked to?
Placental abruption and intrauterine growth restriction, as vasoconstriction affects uterine circulation and the flow of oxygen to the baby.
45
What are early signs of preeclampsia?
Hemoconcentration Hypertension Protein in urine Elevated liver enzymes BUN Uric acid
46
What indicates a more serious sign of preeclampsia?
Hyperreflexia -check for clonus(while sitting, lift and support calf, then dorsiflex foot, maintain the release. If jerking is noticed while dorsiflexed, or oscillation as it falls, the test is positive)
47
What are signs the preeclampsia has worsened?
Severe headache Epigastric pain Visual disturbances Decreased output of urine Extreme nervous irritability Decrease in fetal movement
48
What can polyhydraminos lead to?
Premature Labor Uterine Dysfunction Placental Abruption Postpartum Hemorrhage (All from over-distention of the uterus) Also, cord prolapse and fetal malpresentation.
49
With oliohydraminos, the resulting cord compression leads to which complications?
IUGR Postmaturity syndrome Fetal distress/hypoxia in labor
50
What are identical(monozygotic) twins?
The union of one egg and one sperm, with the fertilized ovum separating into two. Share a placenta and may share a sac.
51
What are fraternal(dizygotic) twins?
The union of two eggs and two sperm, that is two pregnancies occurring simultaneously. Separate placentas and separate sacs.
52
What are the risks of twin births?
Cord prolapse Hypoxia(less uterine volume can cause constriction on placenta vessels) Placental abruption Postpartum hemorrhage
53
Prematurity is defined as birth prior to how many weeks?
37 weeks
54
What are the main risks of prematurity?
Polycythemia Immature lungs resulting in RDS
55
What are the causes of prematurity?
Vaginal Infection UTI resulting in chorioamnionitis and ROM Incompetent cervix Polyhydramnios Multiple pregnancy Uterine anomalies Faulty implantation of placenta Substance abuse Short interval between pregnancies Malnutrition Fetal Death Extreme or chronic stress Strenuous physical activity Chronic gum disease Maternal dehydration
56
What are the causes for IUGR?
Malnutrition Severe anemia Chronic hypertension Substance abuse Fetal malformation or infection Placenta and cord abnormalities Prolonged pregnancy Chronic stress and overwork
57
The current definition of postdatism is pregnancy progressing past how many weeks?
42 weeks
58
What is fetal dysmaturity syndrome?
When maternal malnutrition and chronic dehydration lead to reduced blood volume and oliohydraminos, which in turn can cause cord compression and fetal compromise.

Midwifery (4 decks)

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