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28 Cards in this Set
- Front
- Back
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TRIAD: Hypertension, proteinuria, edema during preggo. |
Pre-eclampsia |
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When does pre-eclampsia arise during preggo? |
Third trimester |
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Etiology of pre-eclampsia |
abnormality of maternal-fetal vascular interface in placenta, involving fibrinoid necrosis of placental vessels. Abnormal placental spiral arteries, resulting in maternal endothelial dysfunction, vasoconstriction, or hyperreflexia. Vessels become leaky and may cause reduced plasma volume. This causes proteinuria and edema. |
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COMPLX of pre-eclampsia |
(1) eclampsia (= pre-eclampsia + seizures) (2) placental abruption (3) coagulopathy, cerebral hemorrhage, circulatory collapse (4) renal failure (5) uteroplacental insufficiency (6) DIC |
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Definition of pre-eclampsia (lab values) |
HTN >140/90 + proteinuria (>300 mg/24 hr after 20th week gestation to 6 wks postpartum) |
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What does pre-eclampsia occurring @ < 20 weeks gestation suggest? |
MOLAR PREGNANCY |
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Risk factors for pre-eclampsia |
pre-existing HTN in mom pre-existing diabetes in mom chronic renal disease in mom autoimmune disorders in mom |
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Rx for pre-eclampsia |
(1) antihypertensives (2) deliver @ 34 wks if severe (BP>160/110), headache, scotoma, oliguria, inc AST/ALT, thrombocytopenia) (3) IV magensium sulfate --> prevents seizure |
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What is eclampsia? |
pre-eclampsia + maternal seizures |
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What can cause death during eclampsia? |
maternal death due to stroke leading to intracranial hemorrhage or acute respiratory distress syndrome |
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What is HELLP syndrome? |
Hemolysis, Elevated Liver enzymes, Low Platelets Manifestation of SEVERE PRE-ECLAMPSIA, but may occur w/ or w/o hypertension. Pre-ecamplsia + thrombotic microangiopathy involving the liver |
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sudden infant death syndrome (SIDS) |
death of HEALTH INFANT w/p a cause, 1 month --> 1 yr infants usually die during sleep risk factors = sleeping on stomach, smoking in household, prematurity |
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What are three common placental pregnancy complications and a brief description. |
placental abruption --> placenta separates from decidua prior to delivery. placenta accreta - placenta improperly implants into myometrium placenta previa - attachment of placenta to lower uterine segment, placenta overlies (or partially covers or completely covers) the internal cervical os. common signs: 3rd trimester bleeding, fetal distress |
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32 y/o pregnant woman in 24th week of preggo presents with painless vaginal bleeding. Fetus is present and healthy. What would you expect to find in this patient's history (+what is the likely diagnosis?) |
Prior hx of C-section. This is placenta previa |
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Risk factors for placental abruption |
trauma smoking HTN pre-eclampsia cocaine abuse |
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Presentation of placental abruption |
ABRUPT, painful bleeding (concealed OR apparent) in 3rd trimester. possible DIC, fetal distress (cut off fetal O2), maternal shock. Common cause stillbirth. |
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Is placental abruption serious for mother? Is it serious for baby? |
YES, it is very serious for both. It is life-threatening for BOTH mother and baby. It is a common cause of stillbirth. |
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Placenta attaches to myometrium WITHOUT PENETRATING IT. |
Placenta accreta most common type. |
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placenta penetrates into myometrium |
placenta increta |
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placenta penetrates/perforates thru the myometrium and into uterine serosa. Common complications? |
placenta percreta can result in placental attachment to rectum or bladder |
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Presentation of placenta accreta? |
No separation of placenta after deliver. MASSIVE BLEEDING postpartum. Life threatening for mom. |
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Is placenta accrete life-threatening for the mother? Is it life-threatening for the fetus? Can you treat it? |
It IS life-threatening for mom but not for fetus. It is treated by HYSTERECTOMY! |
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Most common cause endometritis |
Retained placental tissue following delivery. |
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Complx of retained placental tissue. |
Increased risk infection (endometritis). May cause postpartum hemorrhage. |
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Ectopic pregnancy (1) most common site (2) risk factors (3) commonly mistaken with? (4) lab tests? |
(1) most common site = ampulla of fallopian tube (2) risk factors = history of infertility, salpingitis (PID - fluid in fallopian tube IE due to chlamydia/gonorrhea), ruptured appendix, prior tubal surgery, endometriosis into fallopian tube (3) commonly mistaken with? - appendicitis (4) lab tests? - lower than expected rise in HCG based on dates |
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causes of polyhydramnios? |
duodenal atresia esophageal atresia anencephaly due to inability for fetus to SWALLOW AMNIOTIC FLUID |
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causes of oLIGOHYDRAMNIOS? |
bilateral renal agenesis placental insufficiency posterior urethral valves (males) --> due to inability to excrete urine --> causes Potter sequence (clubbed feet, cranial anomalies, pulmonary hypoplasia) |
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What are the histological signs of complete hydatidiform mole? |
Trophoblastic hyperplasia. Edematous villi with central cavitations (cisterns). |
