Ob Ch 21

Front 1

Why is vaginal bleeding during pregnancy always serious until ruled otherwise?

Back 1

Because it has the potential to diminish the blood supply of both the mother & fetus.

Front 2

As a rule, how should women with bleeding be placed and why?

Back 2

On their side to improve placental circulation.

Front 3

What is spontaneous miscarriage?

Back 3

Loss of a pregnancy before viability of the fetus (20 to 24 weeks).

The majority of these early pregnancy losses are attributed to chromosomal abnormality.

Front 4

How are miscarriages classified?

Back 4

threatened, imminent, complete, incomplete, missed, or recurrent pregnancy loss.

Women who have had a spontaneous miscarriage at home should bring any tissue passed to the hospital for an analysis for gestational trophoblastic disease.

Front 5

Ectopic Pregnancy

Back 5

Pregnancy implantation outside the uterus, usually in a fallopian tube.

If discovered before the tube ruptures, this can be treated with methotrexate or miferpristone. If not discovered early, it produces sharp lower quadrant pain at about 6 to 12 wks as the tube ruptrues. Surgery is needed to remove the fetus and repair the tube to stop bleeding.

Front 6

What is Gestational Trophoblastic Desease?

Back 6

Abnormal overgrowth of teh trophoblast tissue.

If not discovered by sonogram before this, bleeding usually occurs at about teh 16th week of pregnancy. Women need close follow-up after this because it can lead to choriocarcinoma, a malignancy.

Front 7

How does premature cervical dilation occur?

Back 7

It occures when the cervix dilates early in pregnancy, before viability of teh fetus. Sutures can be placed to prevent the cervix from dilating prematurely this way again in a second pregnancy.

Front 8

What is Placenta Previa?

Back 8

It is a low implantation of the placenta so that is crosses the cervical os.

If it is not discovered before labor, cervical dilation may cause the placenta to tear, causing severe blood loss.

Women with symptoms (painless vaginal bleeding in the third trimester) should not have vaginal examinations done to prevent disruption of the low-implanted placenta.

Front 9

What is premature separation of the placenta (abruptio placentae)?

Back 9

Placental separation from the uterus before the fetus is born, usually occures late in pregnancy.

It immediately cuts off blood suply to the fetus.

S/S = sudden, sharp fundal pai, then a continuing dull pain and vaginal bleeding.

Front 10

What is disseminated intravascular coagulation?

Back 10

Blood disorder that may occur with any trauma, so it can accompany things like premature separation of the placenta & pregnancy-induced hypertension.

Heparin is used to stop the local coagulation.

Front 11

What is preterm labor?

Back 11

Labor that occures after 20 weeks & before teh end of teh 37th week of pregnancy.

When a woman has uterine contractions every 10 minutes for 1 hr and the cervix dialates.

Front 12

Explain preterm rupture of the membranes.

Back 12

Tearing of the fetal membranes with loss of amniotic fluid before teh pregnancy is at term.

After rupture, there is a high risk of fetal & uterine infection (chorioamnionitis) & preterm birth.

Front 13

What is pregnancy-induced hypertension?

Back 13

Three classic symptoms: hypertension, edema & proteinuria.

Categorized as preeclamsia or eclampsia.

Tx - BP 140/90 = bed rest
BP 160/110 = magnesium sulfate

Front 14

What is the HELLP syndrome

Back 14

Unique form of pregnancy-induced hypertension marked by hemolysis of RBC's, elevated liver enzymes, and low platelet count.

Front 15

What is postterm pregnancy?

Back 15

Pregnancy that extends beyond 42 weeks.

Placenta deteriorates = fetus receives less nutrients.

Front 16

Explain what isoimmunization (Rh incompatibility) is and complications.

Back 16

Woman who is Rh neg and fetus is Rh positive.

Maternal antibodies form & destroy fetal RBCs, leading to anemia, edema, and jaundice in the newborn.

Women needs to be screened for blood type and antibody titer early in pregnancy.

Front 17

Ankle Clonus

Chorioamnionitis

Couvelaire Uterus

Back 17

Ankle Clonus = continued motion of the foot.

Chorioamnionitis = infection of the fetal membranes & fluid

Couvelaire Uterus = uteroplacental apoplexy due to blood entering the uterine musculature.