candace ch 26
Terms
undefined, object
copy deck
- diabetes screening is done when
- week 24-28, if it is greater than 140 u have to do a 3 hour glucose test
- cytomegalovirus
- member of the herpes virus family, extensive damage to fetus, infants skin may be a large petechiae, diagnosis establised in maternal serum
- preeclampsia
- >140/90 that develops after 20 weeks of preg that is accompanied by proteinuria >0.3g in a 24 hr urine collection
- external hemorrhage
- overt, placenta seperates along lower edges, blood escapes behind the fetal membranes, and is discharged vaginally, pain, boardlike abd, s/s shock
- complications of abortion/hemorrhage
- saturate 1 pad/hr, passing large clots, coagulation defect, active bleedin/massage the fundus, d&c
- abrupto placentae
- primary cause is unknown***factors- HTN, PIH, trauma, pressure on vena cava, 6th or more preg, cocaine use, membranes rupture
- management of hypermesis
- hospitalzation at least 24 hrs, eval i&o, daily weights, blood chemestries, po fluids and solids withheld, iv fluids adm with antiemetic, no vomiting after 24 hrs advance diet slowly, if vomiting occurs TPN may be required
- ectopic pregnancy
- implantation of fertilized ovum in an area outside uterine cavity, 95% in fallopian tube
- incomplete abortion
- not all products expel, usually the placenta remains, active uterine bleedin, severe abd cramping, d&c if prior to 14 weeks
- gestational trophoblastic disease
- villi become filled with fluid and form grape like clusters, embyo fails to develop, occurs in 1:2000 preg
- maternal and fetal complications in eclampsia
- eclampsia, pulm edema, cva, chf, arrthmias, mi, dic, hellps, ards, aspiration pneumonia, abrupto placenta, iugr, acute hypoxia, interuterine death
- complete abortion
- all products are expelled, bleeding stops, contrations stop, cervix closes
- complications of abortion/infection
- due to blood loss, fever, local tenderness, foul vag discharge, e-coli
- sicle cell anemia
- autosomal recessive gene, frequent hgb monitoring, blacks, freq uti, increace folic acid, lots of fluids, rest, no iron
- s/s ectopic preg
- missed period, abd, pelvic pain, spotting
- hyperemesis gravidarum
- pernicious vomiting, begins first few weeks of preg and may cont duration of preg, cause unknown, incidnece 1 in 200 to 300 women, women may experience social isolation, inrauterine growth retardation
- group b strept
- colonizes over cervix, asymptomatic, neonatal sepsis
- abruptio placentae
- occurs after 20-24 weeks, premature seperation of a normally situated placenta, usually beginning of labor or near term
- low lying previa
- placenta is situated in the lower uterine segment but away from the os
- risk factors of preeclampsia
- 1st preg, >35, blacks, family hx, htn, obesity, diabetes, multifetal preg, lupus, ra
- recurrent abortion
- loss of 3 or more pregnancys, needs to be investigated as to a probable cause
- causes of recurrent spontaneous abortion
- abnormal fetal formation due to chrom/teratogenic factors, abnormal implantation, corpus luteum failure to produce progesterone, trauma, infection, immunologic rejection
- eclampsia/seizing
- cerebral edema results in convusion, fetal prognosis is poor
- rubella
- causes a mild rash, fetus has deafness, mental, motor challanges, cataracts, cardiac defects, clef lip and palate
- drug for eclampsia
- mag sulfate
- concealed hemorrhage
- placenta seperated in the center and blood is trapped b/w the uterus and placenta, no visible blood is lost, pain abd is boardlike, may have signs of shock (decreased bp, increased pulse
- spontaneous abortion/miscarriage
- interuprion of pregnancy before 20 weeks gestation or less than 500 grams
- missed abortion
- fetal death in utero without expulsion, pt has decreased signs of pregnancy- complications are dic ans infection
- s/s abrupto placnetae
- sharp stabbing pain, heavy bleeding, boardlike abd, high uterine resting tone, signs of shock
- dx of ectopic preg
- transvag us, serum hcg levels
- risk factors for ectopic preg
- h/o std, h/o pid, h/o ectopic preg, iud, multiple induced ab, maternam age >35, smoking, douching
- meds for preeclampsia
- apresoline, normodyne
- marginal previa
- attached close to the os
- placenta previa
- placenta usually implants in the upper uterine segment, instead it may implant near the bottom and occlude the internal cervical os
- gestational diabetes
- 2-3% of woman, risk for developing type 2 later in life, risk factors are obesity, >25, history of large babies, hisory of fetal loss, family history of diabetes
- megaloblastic anemia
- folacin in one if b vitamins, less common than iron anemia, sore tounge, make sure they take folic acid
- most signifficant sign of a previa
- painless bright red bleeding anytime during 3rd trimeter
- partial pervia
- small portion of placenta lies over the internal os
- complications of abortion/powerless,grief
- expect feelings of sadness/loss, period of adjustment
- complications of abortion/septic
- usually attempts at self abortion, life threatning
- normal h&h
- 12-16 **35-45
- complete/total previa
- placenta completly covers the internal os
- what is the only way to cure preeclampsia
- deliver the fetus
- inevitable abortion
- persistant cramping w/ increased bleeding w/ cervical dialation, uterus partically or totally empties, save all tissue fragments, d&c usually performed
- toxoplasmosis
- protoxoan infection, uncooked meat, cat poopoo, no symptoms, infant born with cns damage, hydrocephalous, microcephaly, intracerebral calcifications, retinal deforaties
- complications of abortion/isoimmunization
- Rh- mom with Rh+ fetus
- complete abruption
- placental prolapse, excessive vaginal bleeding
- threatened abortion
- intermittent bleeding, slight to no cramping, cervix closed