Antepartum Complications

Front 1

Neonatal findings for IUGR:

Back 1

-loose, dry skin
-thin umbilical cord
-small placenta
-meconium staining
-head disproportionately large compared to rest of the body due to brain sparing

Front 2

Symptoms of hypoglycemia:

Back 2

-tachycardia
-lethargy
-respiratory distress
-jitteriness

Front 3

Gestational diabetes occurs in the ___ half of pregnancy.

Back 3

2nd

Front 4

Predisposing factors of gestational diabetes:

Back 4

-obesity
-age greater than 35
-prior history of gestational diabetes
-tocolytic drugs

Front 5

All women are screened for gestational diabetes at ___ - ___ weeks with some sort of glucose challenge.

Back 5

24;28

Front 6

Abnormal results for glucose challenge: > ___ - ___

Back 6

130;150

Front 7

Abnormal results for glucose challenge:

-FBS > ___
-1 hr > ___
-2 hr > ___
-3 hr > ___

Back 7

95; 180; 155; 140

Front 8

Medical nutritonal therapy for gestational diabtes:

___ cal/kg of actual weight per dayetes:

Back 8

25

Front 9

FACT:

Back 9

Neonatal hypoglycemia resulting from ongoing hyperinsulinemia after the placenta is removed.

Front 10

Type 1 diabetes in pregnancy:

Back 10

-Poor control in first trimester increases the incidence of anomalies n 6-8%
-N/V predisposes to hypoglycemic episodes
-Placental hormones cause a progressive increase in insulin requirements
-Ketoacidosis can develop (due to hyperglycemia)
-Placental insufficiency due to maternal vascular disease
-Infant may be macrosomic or growth retarded depending on the severity maternal vascular disease

Front 11

Complications of type 1 diabetes:

Back 11

-hyperbilirubinemia
-hypoglycemia
-macrosomia

Front 12

PIH triad of symptoms:

Back 12

-hypertension
-proteinuria
-edema

Front 13

Effects of PIH:

Back 13

-brain: seizures
-kidneys: proteinuria, glomerulosclerosis
-blood vessels: HTN
-uterus: IUGR, fetal distress

Front 14

Predisposing factors of PIH:

Back 14

-primigravida
-history of PIH in patient or family (mother or sister)
-chronic HTN
-teens, elderly gravidas
-poor nutrition
-twins
-type 1 diabetics

Front 15

Treatment of mild PIH:

Back 15

-Bed rest
-lateral position
-high protein, no salt restriction (due to decreased blood volume PIH)adequate calories
-push fluids
-serial weights (to detect excessive wt. gain resulting from edema)
-fetal movement counting
-fetal surveillance testing
-assess BP frequently
-serial sonograms for growth
-monitor reflexes (hyperreflexia is a sign of severe preeclampsia)
-dipstick urine for protein
-CBC, SMAC, clotting studies

Front 16

Treatment for severe preeclampsia:

Back 16

-hospitalized, stabilize and deliver
-prefer vaginal delivery
-MGSO4 to prevent seizures, 24-48 hr PP
-apresoline, labetalol for BP control
-treat diastolics greater than 110
-watch fluid closely, strict I&O
-epidurals used cautiously
-hemodynamic monitoring

Front 17

Magnesium sulfate:

___ g loading dose over ___ -
___ minutes

Maintain on ___ - ___/h by pump piggybacked into main line

Back 17

4; 15; 20

Front 18

What is the antagonist of magnesium sulfate?

Back 18

calcium gluconate

Front 19

HELLP syndrome is associated with ___?

Back 19

severe preeclampsia

Front 20

High dose ___ are used to enhance fetal lung maturity?

Back 20

corticosteroids

Front 21

FACT:

Back 21

Group B Streptococcus is normal flora for abou 10-30% of women

Front 22

Diagnosis of Group B streptococcus is made by a ___.

Back 22

vaginal/rectal culture

Front 23

Group B streptococcus: Treat culture moms in labor with IV ___.

Back 23

PCN

Front 24

Syphilis is treated with ___.

Back 24

Benzathine Penicillin G

Front 25

Treat gonorrhea with ___.

Back 25

ceftriaxone

Front 26

Treat chlamydia with ___ or ___ during pregnancy.

Back 26

tetracycline; azithromycin

Front 27

Hepatitis A is spread by the ___ route.

Back 27

oral/fecal

Front 28

Hepatitis B is spread like ___.

Back 28

HIV