Term
| Presumptive Manifestations of Pregnancy: |
|
Definition
- Amenorrhea
- N/V (2-12 weeks)
- Breast changes
- Quickening (16-20 weeks)
- Urinary tract
- Basal body temperature
- Skin changes |
|
|
Term
| Probable Manifestations of Pregnancy: |
|
Definition
- Pelvic Organs: Chadwicks sign (blue purple cervix b/c pelvic congestion), Leukorrhea, Hegar's sign (isthmus), Pelvic bones and ligaments
- Abdominal enlargement
- Contractions (Braxton Hicks 28 weeks and on) |
|
|
Term
| Positive Manifestations of Pregnancy: |
|
Definition
- fetal heart tones
- palpation (22 weeks)
- ultrasound (5-6 weeks)
- pregnancy test: urine, serum (quantitative,qualitative) |
|
|
Term
| Beta-hcG is produced days after fertilization. It is detected in maternal serum ___ days after ___. It ___ every 1-2 days. It peaks at ___ weeks. |
|
Definition
- 8-11 days after conception
- doubles every 1-2 days
- peaks at 10-12 weeks |
|
|
Term
| Beta hcG decreases in the __ and __ __. |
|
Definition
| second and third trimesters |
|
|
Term
| hcG is low in __ or __ abortions. |
|
Definition
|
|
Term
| hCG is high with __ or __ __. |
|
Definition
| twins or trophoblastic disease |
|
|
Term
| Average gestational duration: |
|
Definition
- 40 weeks= 280 days= 10 lunar months
OB wheel
Nagele's Rule
Calculators |
|
|
Term
|
Definition
| EDC= [(LMP + 7 days) - 3 months] + 1 year |
|
|
Term
| The uterus becomes palpable at __ weeks. |
|
Definition
|
|
Term
| FIGURE OUT IF WE NEED TO KNOW WHATS HAPPENENING EACH WEEK/MONTH OF PREGNANCY. SKIPPED THIS WHEN MAKING CARDS. SLIDES 16-23 OF SELF STUDY PREGNANCY POWERPOINT. |
|
Definition
|
|
Term
| Expected changes in pregnancy: |
|
Definition
Weight
Skin/Connective Tissue
Breast
Cardiovascular
Gastrointestinal
G/U
Other |
|
|
Term
| Weight changes with pregnancy: |
|
Definition
Additional pregnancy energy demands an estimated extra 300 kcal/day
Increase in weight attributable to:
the uterus
uterine contents (fetus and placenta account for approx. 9 lbs)
increase in blood volume
extracellular fluid
(lesser so to cellular water and deposition of fat and protein)
Average amt of extra water retained is about 6.5L
3.5L in uterus
3.0L in blood volume and breasts
Average weight gain 27.5 lbs
Recommended weight gain 25-35 lbs |
|
|
Term
| Cardiovascular changes with the heart include increased ___ __ by __ to __ weeks (40-45% increase). Systemic vascular resistance ___. Heart rate __ by ___. This all results in an increased ___. Later in pregnancy, when supine, the large uterus can impede cardiac venous return. |
|
Definition
- cardiac output by 20-24 weeks
- resistance decreases
- increases by 10 bpm
- increased preload |
|
|
Term
| A __ murmur is present in 90% of pregnant women. |
|
Definition
|
|
Term
| During pregnancy it is normal to have increased __ __ size, so that the PMI is ___ displaced. |
|
Definition
- increased left ventricular size
- laterally displaced |
|
|
Term
| During pregnancy there is a 50% blood volume increase. Also all the estrogen stimulates the RAS system which increases ___ causing __ and __ resportion. |
|
Definition
- aldosterone
- sodium and water |
|
|
Term
Blood Pressure:
Affected primarily by posture
↓ BP by 6-10 mmHg during pregnancy
↑ BP at end of pregnancy |
|
Definition
|
|
Term
Rise in venous pressure to pelvis and LE’s leads to:
Dependent pedal edema
Varicose veins in legs and vulva
Hemorrhoids
↑ risk of thrombosis in lower extremities due to said stagnation
↑ in venous pressure below level of uterus and ↓ interstitial osmotic pressure often results in pedal edema late in pregnancy |
|
Definition
|
|
Term
Blood
Red cells increase by 33%
Increase in plasma volume accounts for anemia of pregnancy
Increased utilization of iron
WBC’s increase
4.5-4.5 prepregnant average
5-12 in third trimester on average
Platelets decrease below 150 in 6% of pregnancies
↑ in concentrations of all clotting factors |
|
Definition
|
|
Term
Kidneys
Enlarge ~ 1-2cm in length
GFR ↑ by 40-65%
Renal plasma flow also increases
Renal pelvis dilates
BUN and Cr levels decrease
Creatinine clearance increases by 30%
Proteinuria and hematuria are not normal (except at delivery)
Protein loss should not exceed 300 grams/24 hours
Mild glucosuria can be normal but suspicion of GDM should not be ignored |
|
Definition
|
|
Term
| during prregnancy BUN and creatinine levels ___ and creatinin clearance ___ by 30%. |
|
Definition
|
|
Term
Creatinine clearance increases (best test of kidney function in pregnancy)
Creatinine clearance increases (best test of kidney function in pregnancy)
Creatinine clearance increases (best test of kidney function in pregnancy) |
|
Definition
|
|
Term
| What is the best test of kidney function in pregnancy? |
|
Definition
| creatinine clearance (increases 30% with pregnancy) |
|
|
Term
| Urine is checked for __ and __ at every OB visit. |
|
Definition
|
|
Term
| During pregnancy,what happens to liver size? |
|
Definition
|
|
Term
Gallbladder
contractility is reduced
results in increased residual volume and stasis
along with cholesterol increase during pregnancy, this leads to increased prevalence of cholesterol stones |
|
Definition
|
|
Term
Colon
displaced laterally and superiorly
hypoperistalsis = constipation
appendix displaced upward and laterally |
|
Definition
|
|
Term
Lower quad. pain
Differentiate round ligament pain with UTI, constipation, appendicitis, etc.
Hemorrhoids are very common due to
Constipation
Elevated venous pressure in LE’s |
|
Definition
|
|
Term
Chloasma or Melasma – brown patches
Diastasis Recti (yes, the picture below left is of a man)
Striae gravidarum
Linea nigra (linea alba in nonpregnant state)
Angiomas
Palmar erythema (2/3 white women; 1/3 black women)
Cutis marmorata (mottling)
Nails become brittle
Hair thickens (caused by increased number of follicles)
http://www.gynaeonline.com/images/stria.jpg
http://bader-gottlieb.net/pregnant/Dec_7a.jpg |
|
Definition
|
|
Term
Connective tissue of the reproductive tract remodels
Cervix softens
Progressive lordosis
Increased joint mobility of:
Sacroiliac
Sacrococcygeal
Pubic
The mobility not correlated with maternal estradiol, progesterone, or relaxin levels
Therefore:
increased back pain
“waddle” gait |
|
Definition
|
|
Term
Breasts enlarge 2-3 x prepregnancy size
- hyperplasia of breast tissue
- tenderness and tingling noticed in early weeks
- after 2nd month breasts increase in size
↑ fullness, tingling, tenderness, nodular
Tissue softer and looser
Striae
↑ Mammary vascularization
Colostrum
accumulates in the alveoli
colostrum crust on the nipple
Areolae - ↑diameter, darker, erectile
Montgomery glands are more prominent (hypertrophic sebaceous glands of areolae)
Gigantomastia: life threatening breast enlargement |
|
Definition
|
|
Term
Uterus:
Nonpregnant uterus: 70g (capacity of 10mL)
Uterus at end of pregnancy: 1100g (capacity of 5L to 20L) |
|
Definition
|
|
Term
Cervix:
At 1 month, cervix undergoes softening and cyanosis due to increased vascularity and edema
A major component of the cervix is connective tissue helping
Cervical glands undergo hypertrophy and hyperplasia
As a result, cervical secretions increase considerably
The vagina undergoes changes, too:
Considerable increase in thickness of the mucosa
Loosening of connective tissue
Hypertrophy of smooth muscle |
|
Definition
|
|
Term
Endocrine:
Pituitary gland enlarges with ensuing hormone fluctuations
Prolactin (lactation)
Growth hormone
Thyroid enlarges
Increased TBG
Stimulated by placenta
Decreased iodine availability
Hypothyroidism common in pregnancy
Investigate goiters!!!
Parathyroid hormone decreases in response to increase in serum calcium
Adrenal glands undergo little change; hormones slightly increased if anything |
|
Definition
|
|
Term
Neuro:
Memory decline often reported
Difficulty going to sleep
Frequent awakenings
Fewer hours of sleep
Reduced sleep efficiency |
|
Definition
|
|
Term
| Uterine Size (FHR after 8 wks trans-vaginally, after 12 weeks trans-abdominally) |
|
Definition
|
|
Term
| READ ABOUT GENETIC DISORDERS IN BOOK |
|
Definition
|
|
Term
| Fetal heart rate is detectable after 8 weeks ___ or after 12 weeks ___. |
|
Definition
- transvaginally
- transabdominally |
|
|
Term
| The fundal height is measured from the __ __ to the __ __. The fundus should be at the umbilicus at __ weeks (most accurate 20-30 weeks). __ cm/week is expected. |
|
Definition
- from the symphisis pubis to the superior pubis
- at the umbilicus at 20 weeks
Larger = multiple, GDM
Smaller = IUGR
- 1 cm/week |
|
|
Term
Watch for:
obesity
amniotic fluid amount
myoma (uterine fibroid)
multiple gestations
fetal size
uterine position |
|
Definition
|
|
Term
| Heart sounds can first be heard with the doppler at __ weeks. Heart sounds are first heard with the fetoscope at __ weeks. Normal is ___ bpm. |
|
Definition
- 9 weeks with the doppler
- 15-16 weeks with the fetoscope
- 120-160 bmp |
|
|
Term
|
Definition
1. Using two hands and compressing the maternal abdomen, a sense of fetal direction is obtained (vertical or transverse).
2. The sides of the uterus are palpated to determine the position of the fetal back and small parts.
3. The presenting part (head or butt) is palpated above the symphysis and degree of engagement determined
4. The fetal occipital prominence is determined. |
|
|
Term
| Do a pelvic exam at ___ weeks to determine pelvic shape. |
|
Definition
|
|
Term
| Early signs of pregnancy detected between 6 and 14 weeks: |
|
Definition
- Goodell: softening of the cervix at 4-6 weeks (cervix feels like lips instead of nose)
- Hegar sign: softening of the uterine isthmus at 6-8 weeks
- Chadwick sign: vascular congestion and bluish purple color of vagina/cervix, 8-12 weeks
- McDonald sign: fundus flexes easily on the cervix, 7-8 weeks
- Von Fernwald: fullness and softening of the fundus at the implantation site, 7-8 weeks |
|
|
Term
| Initial blood screens in pregnancy: |
|
Definition
- Blood type (Rh+ or Rh-)
- CBC (hemoglobin)
- Rubella Ab
- Pap test
- STDs: G&C, RPR, HIV, Hep B&C)
- PPD in high risk individuals |
|
|
Term
| Maternal blood type is performed to prevent the potentially fatal disease of the newborn called ___ ___ and ___ __ of the newborn. This results in __ and __ __. |
|
Definition
- fetal erythroblastosis and hemolytic disease of the newborn (hydrops fatalis, enlarged abdomen and liver)
- anemia and heart failure |
|
|
Term
Rh Negative
15% of the US population is Rh negative
When to be concerned
If MOB’s blood type is Rh negative
Baby's blood type COULD BE Rh positive (inherited from the father)
MOB may make antibodies (immunoglobulin G [IgG]) that can cross over the placenta into the baby's blood stream and attack the baby's red blood cells.
Sensitization can occur at any time:
Spontaneous abortion
Bleeding during pregnancy
At delivery
First pregnancy – no problems
Subsequent pregnancies are at risk
Give RhoGAM (Rh immunoblobulin)
prevents the mother from forming antibodies
Given at 28 weeks and at delivery |
|
Definition
|
|
Term
| What is RhoGAM and when is it given? |
|
Definition
- RhoGAM is Rh immunoglobulin that prevents the Rh negative mother from forming antibodies to her baby's Rh positive blood
- given at 28 weeks and at delivery |
|
|
Term
| Rubella is aka __ __. Congenital Rubella Syndrome (CRS) can cause: |
|
Definition
- German measles
- growth retardation
- malformations of the heart, eyes, or brain
- deafness
- liver, spleen, and bone marrow problems
- characteristic blueberry muffin appearance= thrombocytopenia purpura |
|
|
Term
| Rubella causes baby to have __ __. |
|
Definition
|
|
Term
| At __to __ weeks you do the triple/quad/penta screen. |
|
Definition
|
|
Term
| What 4 things do the quad and penta screens include? |
|
Definition
- hCG
- Unconjugated estriol (uE3)
- Alpha feto protein (AFP)
- Dimeric inhibin A (DIA)
(HUAD)
- |
|
|
Term
| The triple/quad/penta screen is NOT mandatory but should be offered to all pregnant women. |
|
Definition
|
|
Term
| The triple/quad/penta screen is a screen not ___. |
|
Definition
|
|
Term
| What does the penta screen have that the quad screen does not? |
|
Definition
| Invasive trophoblast Antigen (ITA) |
|
|
Term
| The results of quad screen are based on __ __. |
|
Definition
|
|
Term
| Elevated AFP may indicate what 3 things? |
|
Definition
- baby is further along that originally thought
- twins
- neural tube defect |
|
|
Term
|
Definition
|
|
Term
| Low estriol indicates what? |
|
Definition
|
|
Term
| what three things are included in the triple screen |
|
Definition
|
|
Term
| Chorionic villus sampling is offered at __ to __ weeks. |
|
Definition
|
|
Term
Chorionic villus sampling (CVS)
Performed at 10-12 weeks
Transabdominal or transcervical
Complication of rate of <1%
Essentially a biopsy of the placenta
After 14 weeks, the amount of amniotic fluid makes procedure difficult
Can diagnose
Tay-Sachs Disease
Hemophilia
Down’s syndrome
Cannot diagnose
Neural tube defects
Lung maturity |
|
Definition
|
|
Term
| chorionic villus sampling should not be done after __ weeks. |
|
Definition
|
|
Term
| Amniocentesis is offered at __ to ___ weeks. |
|
Definition
|
|
Term
Amniocentesis
Offered at 15-20 weeks
Complication rate <1%
Amniotic fluid contains fetal skin cells and hormones
Can detect
Chromosomal abnormalities
Neural tube defects
Fetal lung maturity (3rd trimester)
Infection
Cannot detect
Birth defects like cleft palate, club feet, etc |
|
Definition
|
|
Term
| what chance of amniocentesis have of terminating a pregnancy? |
|
Definition
|
|
Term
| Pregnant women should be screened for GDM between __ and __ weeks. Give a __g __ hour glucose tolerance test. If greater than __, do more workup. Check __ __ __ and then do a __ gram __ hour glucose tolerance test where you check bs at __,__, and __hours. If any two of these are positive, __ is diagnosed. |
|
Definition
- 24 and 28 weeks
- 50 gram 1 hour glucose tolerance test
- 130
- fasting blood glucose
- 100 gram 3 hour glucose tolerance test
- 1,2, and 3 hours
- GDM |
|
|
Term
| Diet controlled GDM is called: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Gestational DM continued: |
|
Definition
Frequent BS testing
Fasting am
1 hour after meals
NST/BPP’s
Twice weekly starting at 32 weeks
Maternal monitorin (kick counts)
Risks of:
Bactiuria
Thyroid disease
Edema
Preeclampsia
Preterm labor
LGA |
|
|
Term
|
Definition
- bactiuria
- thyroid disease
- edema
- preeclampsia
- preterm labor
- LGA |
|
|
Term
| Screening for Group B streptococcus occurs at __ to __ weeks. |
|
Definition
|
|
Term
Group B Streptococcus (GBS)
Streptococcus agalactiae (beta-hemolytic streptococci.)
Tested from cervix, vagina, rectum, or vaginal introitus
Cause of potentially dangerous maternal and fetal infections
Neonatal sepsis, pneumonia, meningitis
Maternal Metritis
Risks
premature delivery
prolonged rupture of membranes
fever while in labor
positive cultures for GBS during pregnancy
Who to treat
Presentation during preterm labor
History of positive culture for GBS during pregnancy
Spontaneous, premature membrane rupture
Membrane rupture for longer than 18 hours
Presentation with fever
History of previous delivery of a newborn with GBS disease
Treatment is IV PCN or Amp and 48 hours Obs of baby |
|
Definition
|
|
Term
| Treatment of group B strep is : |
|
Definition
- IV penicillin or ampicillin
- 48 hour observation of baby |
|
|
Term
Umbilical cord blood storage
Collected at delivery
large number of hematopoietic progenitor cells
can be used as a source of stem cells for treatment of hematological disorders and malignancies.
saving cord blood for many years is extremely costly.
odds of needing a stem cell transplant are low—estimated at between 1 in 1000 and 1 in 200,000 by age 18 years.
ACOG believes that many questions about this technology remain unanswered and asks that parents should not be sold this service without a realistic assessment of their likely return on the investment. |
|
Definition
|
|
Term
The best counseling is preconception counseling
PNV’s
Maternal age
Vaccinations
Smoking/EtOH cessation
Risk factors
FHx and Genetic Hx |
|
Definition
|
|
Term
25-35 pound weight gain
Weight loss not recommended
Average woman (acc to CMDTOG)
2300 kcal/day
+300 during pregnancy
+500 during breastfeeding (800 extra total)
Protein is essential
Vitamins and minerals (begin 1-3 months prior to pregnancy)
Folic acid
Calcium and iron |
|
Definition
|
|
Term
|
Definition
Organism
Listeria monocytogenes
food born or found in veterinary clinics
loves refrigerator temperatures
Symptoms
mild to more moderate gastrointestinal
illness with nausea, vomiting, and diarrhea
can cause fetal damage or miscarriage |
|
|
Term
| To avoid listeriosis, what should a pregnant woman avoid? |
|
Definition
- unpasteurized milk
- soft cheeses (feta, brie, Camembert, Roquefort, blue veined, or mexican style)
- cold meats, pates, or meat spreads
- undercooked or raw animal foods like meat, fish, shellfish, or eggs
- refrigerated smoked seafood (canned versions are okay)
- wash all fruits and vegetables thoroughly
- reheat until steaming hot dogs, sausages, and luncheon meats |
|
|
Term
Cook properly
Ground beef should be cooked to at least 160°F, roasts and steaks to 145°F, and whole poultry to 180°F.
Eggs should have a firm yolk and white after cooking.
Eggnog and hollandaise sauce have raw or partially cooked eggs and are not considered safe. |
|
Definition
|
|
Term
Moderate intake of fish consumption (exposure to mercury)
Tuna, shark, swordfish, king mackerel, and tilefish
8-12 ounces per week (FDA, EPA)
Some sources say once per week no matter the fish |
|
Definition
|
|
Term
| Caffeine during pregnancy: |
|
Definition
Right now sources say to avoid it
Definitely no more than 1-2 servings/day
Nervous system stimulant that is found in many plants and is present in many foods
Increases blood pressure and heart rate
Stimulates urination; may cause dehydration
Some studies speculate increase the risk of miscarriage |
|
|
Term
| If pregnant woman is smoking what drug can you give her to help her stop? What drug is CONTRAINDICATED for this purpose? |
|
Definition
- can give her Wellbutrin
- CANNOT give her Chantix |
|
|
Term
|
Definition
- Category A: no fetal risk
- Category B: Animal studies show no fetal risk, no studies in women
- Category C: Animal studies show adverse fetal effects, no studies in women
- Category D: some fetal risk, benefits may outweigh risks
- Category X: fetal risk not outweighed by benefit, contraindicated |
|
|
Term
| What is the only antihypertensive class of medications that is contraindicated in pregnancy? |
|
Definition
LOOK THIS UP
I think its ACE inhibitors (prils) |
|
|
Term
| Exercise during pregnancy: |
|
Definition
May reduce complications
May affect labor to be shorter, easier, better newborn health and higher IQ of newborn
Usually low impact exercise (pulse <140bpm)
If a prepregnant woman already participating in an exercise program, continue with minor alterations.
Restriction may be necessary if bleeding, premature labor, or have other high-risk concerns.
Don’t start new exercise programs in pregnancy
Walking and swimming often considered the best
Avoid sports where prone to injury |
|
|
Term
| Intercourse during pregnancy: |
|
Definition
Not considered abortifacient
Late in pregnancy, may induce contractions (orgasm)
“pelvic rest” considered in patients with previous premature delivery and incompetent cervix |
|
|
Term
| Vaccinations during pregnancy must be __, __, or ___. Avoid live attenuated vaccines. |
|
Definition
| - killed, toxoid, or recombinant |
|
|
Term
Dental visits
Gum hypertrophy normal
Normal procedures okay
Periodontal disease associated with preterm birth |
|
Definition
|
|
Term
|
Definition
| 10 kicks in 2 hours is good |
|
|
Term
|
Definition
| - 2 fetal accelerations at least 15 bpm above baseline for at least 15 seconds |
|
|
Term
| Biophysical Profile (BPP) considers what factors: |
|
Definition
- NST
- fetal breathing movements
- fetal movement
- fetal tone
- Amniotic fluid volume
2 points for each, so possible score of 10 |
|
|
Term
| DDx of bleeding in the first trimester: |
|
Definition
Implantation bleeding
Common
minimal bleeding at about the time of the first missed menstrual period and generally lasts a very short time
may be present for 1 to 2 days, with a flow similar to that of a menstrual period
20% to 25% of all pregnant women spot or bleed in the first trimester
OR:
threatened, inevitable, complete, or incomplete abortion
ectopic pregnancy
molar pregnancy |
|
|
Term
| Risk factors for ectopic pregnancy: |
|
Definition
- nonwhite race
- older age
- h/o STD/PID
- infertility treatment
- IUD
- BTL or tubal repair
- previous ectopic pregnancy
- DES exposure |
|
|
Term
|
Definition
Severe, sharp constant pain at affected side
more diffuse abdominal pain with intraperitoneal hemorrhage
shock may be present (hypovolemia due to hemorrhage)
+/- cervical motion tenderness
+/- vaginal bleeding (Ectopic pregnancies cause vaginal bleeding because of the separation of the decidua from the endometrium as the ectopic pregnancy dies )
Diagnostics:
bHCG for all women of childbearing ages (10–55)
U/S, preferably transvaginal (determine intratuterine vs. ectopic)
Culdocentesis (to determine if in fact it is hemorrhage)
VERY BAD:
Intraperitoneal hemorrhage
infection |
|
|
Term
| A __ __ allows you to see if pregnancy is ectopic or uterine. |
|
Definition
|
|
Term
| ___ lets you see if there is hemorrhage with ectopic pregnancy. |
|
Definition
|
|
Term
| 83% of ectopic pregnancies are ampullary |
|
Definition
|
|
Term
Threatened Ab
bleeding observed and the cervix is closed
appropriate uterine size
+/- uterine tenderness |
|
Definition
|
|
Term
Complete Ab
the uterus has expelled its contents
cervical os is closed, bleeding is minimal, and the uterus is near normal size
little or no uterine pain or cramping unless a uterotonic agent is used such as ergonovine maleate (Ergotrate) or methylergonovine maleate (Methergine) |
|
Definition
|
|
Term
Incomplete Ab
part of the products of conception have been expelled but some remains within the uterus
cervix is generally dilated, there is usually bleeding (may be profuse)
uterus is generally enlarged
uterine cramping and pain
more common at > 6 wks gestation |
|
Definition
|
|
Term
Missed Ab
embryo dies but the products of conception are not expelled from the uterus
uterus involutes so that it is smaller than expected by dates
dark red or brown vaginal bleeding, often minimal in amount
pregnancy tests may remain positive for quite some time in the face of a missed abortion |
|
Definition
|
|
Term
Septic Ab:
Infection occors concurrently with Ab
Temperature elevation; elevated WBC and ESR |
|
Definition
|
|
Term
| Most trophoblastic tumors are __ __. |
|
Definition
|
|
Term
| Symptoms of trophoblastic disease: |
|
Definition
- vaginal bleeding
- enlarged uterus beyond the size expected for gestational age
- may pass grape-like structures
- hypertension
- edema
- proteinuria |
|
|
Term
| Diagnostics for trophoblastic disease: |
|
Definition
- elevated hcG > 100,000
- ultrasound |
|
|
Term
| Molar pregnancies are suggested by vaginal bleeding, uteri larger than gestational age, and serum hCG levels of 100,000 mIU/ml or greater |
|
Definition
|
|
Term
Other causes of abnormal vaginal bleeding
coagulopathies
blood dyscrasias
endocrinopathies |
|
Definition
|
|
Term
| HTN in pregnancy is bp of 140/90. Treatment is indicated at ___, usually ___. ___ are contraindicated. Most __ are NOT recommended. Fetal monitoring at ___ weeks. |
|
Definition
- 160/100
- Labatolol
- ACE_I
- diuretics
- 34-36 weeks |
|
|
Term
| 2 criteria for preeclampsia: |
|
Definition
| PIH (140/90 or higher) + proteinuria |
|
|
Term
| Signs and Symptoms of preeclamsia: |
|
Definition
- Scotomata
- Intractable headaches
- RUQ pain
- hyperreflexia or clonus |
|
|
Term
| Labs expected with preeclampsia: |
|
Definition
- elevated uric acid
- elevated Hb
- elevated liver function test |
|
|
Term
|
Definition
| - preeclampsia + seizures |
|
|
Term
| HELLP syndrome is a severe complication of ___. What does it stand for? |
|
Definition
- severe complication of preeclampsia
- Hemolysis
- Elevated Liver enzymes
- Low Platelets |
|
|
Term
| HELLP syndrome occurs in 10% of preeclampsia and 50% of eclampsia. __ may be helpful. |
|
Definition
|
|
Term
| Placenta previa is a complication of the 3rd trimester, but can also occur as early as 20 weeks. There is __ __ blood in the vagina. |
|
Definition
- bright red blood
- Instrumentation, digital examination of the cervix, and speculum examination can provoke severe, exsanguinating hemorrhage
can occur at 20 weeks' gestation (1/3 of PP cases are <30wks)
admission and obstetric consultation are indicated |
|
|
Term
| Abruptio Placentae often has __ __ __ and __ in the vagina. This ranges in severity and amount of bleeding does not correlate to severity. |
|
Definition
|
|
Term
| Most common cause of intrapartum fetal death: |
|
Definition
|
|
Term
| Previa is ___, Abrupto placentae is __ __. |
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Definition
- Previa is painless
- Abrupto placentae is very painful |
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Term
| Abrupto placentae is associated with __. |
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Definition
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Term
| Monitoring for abrupto placentae: |
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Definition
| U/S, fetal monitoring, fibrin and platelet count |
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Term
| round ligament pain is more common on the __ side. |
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Definition
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Term
Round ligament pain
Refers to a type of pelvic pain caused by stretching of the round ligaments (more common on the right than the left)
Etiology
Two thick ligaments (the round ligaments) hold the uterus in suspension within the pelvis and abdomen; during pregnancy, these ligaments become long and thin like rubber bands
Ligaments pull on nearby nerve fibers causing pain, usually sharp pain
Can awaken a patient from sleep after rolling over
Can be brought on by exercise
Pain often eases as pregnancy progresses
Treatment
Applying heat to the area may relieve pain:
Hot soaks
A heating pad
A hot bath
Lying on the opposite side
Moving gradually rather than suddenly
Tylenol (acetaminophen) |
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Definition
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Term
| Premature labor is defined as __ __ with __ __ before __ weeks. This is the leading cause of neonatal mortality. Occurs in 8-10% of all pregnancies. |
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Definition
| - uterine contractions with cervical changes before 37 weeks |
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Term
| Risk factors for preterm delivery: |
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Definition
- Lower SES
- Extremes of age
- tobacco or cocaine use
- h/o preterm delivery
- infections (UTI, genital, etc.) |
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Term
| Diagnostics for preterm labor: |
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Definition
- fetal monitoring
- ultrasound
- fetal fibronectin (fFN) |
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Term
| ___ like __ __ and __ __ such as __ and __ can prolong gestation if the fetus is viable and the mother is healthy. |
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Definition
- Tocolytics like magnesium sulfate
- B-mimetics such as Terbutaline and Ritodrine |
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Term
| Criteria for delivery when preterm labor is occuring: |
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Definition
- maternal illness: Eclampsia (PIH, proteinuria, grand mal seizures)
- fetal demise
- congenital anomalies |
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Term
| PROM is aka ____. Avoid digital examination of cervix. |
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Definition
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Term
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Definition
Nitrazine paper testing reveals a pH of 7.1 to 7.3 typical of amniotic fluid (normal vaginal pH in pregnancy is 3.5 to 6.0)
Ferning: when amniotic fluid turns white and crystallizes on a slide after heating
Vaginal secretions caramelizes and turns brown after heating on a slide
Cultures for group B streptococci, Chlamydia, and gonorrhea should be obtained. |
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Term
Third trimester bleeding
Placenta previa
Placental abruption
Uterine rupture |
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Definition
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