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24 Cards in this Set
- Front
- Back
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Most common complication of pregnancy?
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Spontaneous abortion
-defined as the passing of a pregnancy prior to completion of the 20th gestational week |
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Define:
Complete Incomplete Inevitable Threatened and Missed Abortion |
Complete Abortion
Complete expulsion of pregnancy tissue Incomplete Abortion Partial expulsion of POC Inevitable Abortion No expulsion yet, but bleeding and dilation of cervix present Threatened Abortion Any vaginal bleeding due to intrauterine source Missed Abortion Death of fetus without symptoms or expulsion of POC |
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most common causes of abortion in 1st trimester?
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chromosomal
in the second it is normally unknown |
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where do 95% of ectopic pregnancies occur?
risk factors? |
Fallopian tubes
tubal factors: hx of salpingitis, endometriosis; zygote abnormalities, ovarian factors, exogenous hormones: progesterone-only ocp; IUD in place; tobacco; advance maternal age. |
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what is a fetal non-stress test?
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mom put on monitoring system
over 20-30 minute period want to access basline, variability, accel and decels have to have 2 acels 15 beats by 15 seconds in 20 minutes=reactive (baby looks good, have about 3 or 4 days of clean bill of health) |
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what happens in incompetent cervix?
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PAINLESS dilation and effacement of cervix
Usually during second trimester ~20-24 wks Cerclage (pursestring suture place into the cervix to hold it shut ) can be placed emergently and followed by expectant management If history of preterm delivery without contractions, a prophylactic cerclage can be placed at 12-14 weeks OR can follow with transvaginal US for cervical shortening < 2.5cm and then place cerclage Much debate if this is a true process or preterm labor variant |
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Define preterm labor
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contractions that are regular at frequent intervals with cervical dilatation and effacement prior to 37 weeks
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number 1 cause of neonatal morbidity and mortality?
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Preterm Labor
contractions that are regular at frequent intervals with cervical dilatation and effacement prior to 37 weeks |
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what substance, if negative can tell you that delivery will NOT occur in the next 2 weeks (even if there is cervical dilation)
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Fetal fibronectin (fFN)
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define premature/preterm/prolonged rupture of membranes
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Premature rupture of membranes –
Rupture 1hr prior to onset of labor Preterm rupture of membranes – Rupture of membranes prior to 37 weeks Prolonged rupture of membranes – Rupture of membranes longer than 18 hours |
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important sequela of PROM?
What else can PROM cause? |
Chorioamnionitis
Important cause of preterm labor, prolapsed cord, placental abruption, intrauterine infection |
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how do you test for Gestational diabetes?
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1-hr Glucola testing greater than 130 – 140 mg/dl (50gm challenge)
if greater than 130 then you do a 3-hr testing challenge at 100mg Fasting <100 1-hour <190 2-hour <165 3-hour <145 If 2 or more abnormal then gestational diabetic |
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what is gestational HTN?
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140/90
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Mild Preeclampsia findings? (BP, protein, physical)
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BP > 140/90,
proteinuria >300mg/24hr, edema |
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Severe Preeclampsia findings (BP, protein, physical)
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BP>160/110,
proteinuria >1gm/24hr, headache, rt upper quad pain, renal failure |
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what is eclampsia?
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Eclampsia: elevated BP with seizure (and protenuria)
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what is HELLP syndrome?
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Hemolysis, elevated liver enzymes, low platelets
varient of preeclampsia |
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152/92 is what kind of eclampsia?
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Mild Preeclampsia
BP > 140/90 |
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Head and abdomen are both smaller than expected
Heritable factors, immunological abnormalities, chronic maternal disease, fetal infection, multiple pregnancies describes? |
Early – onset / symmetrical IUGR
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Head is appropriate size / abdomen is smaller
Main cause is uteroplacental insufficiency Hypertensive disorders of pregnancy Poor nutrition or weight gain Diabetes Smoking, alcohol, drug use describes? |
Late – onset / asymmetrical IUGR
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what are the W's of postpartum infection?
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Wind: POD1-2: the lungs, i.e. pneumonia, aspiration, and pulmonary embolism.
Water: POD3-5: UTI, related to indwelling catheter (during surgery or currently i.e. Foley catheter ) Walking: POD4-6: deep vein thrombosis or pulmonary embolism Wound: POD5-7: surgical site infection / uterus. Wonder drugs or “What did we do?”, POD7+: drug fever, infections related to intravenous lines Numerous variants on the same theme may exist: sometimes another W for "Wonder why" may indicate an abscess somewhere in the body or the site of surgery. |
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pt calls in with flu like symptoms and high fever... you ask them to check the breast and they have a tender hot red spot...what is going on? can they continue to breast feed?
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Mastitis
yes |
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most common complication of postpartum phase? hallmark sign?
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Endometritis
Fever you will see uterine tenderness and tx is broad spectrum (IV) usually clindamycin and gentamycin |
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pt presents with pain on upright positioning and wicked headaches shortly after giving birth...what does she have? tx?
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she is having a complication of anesthesia...namely the epidural
tx: Lie flat, hydrate, caffeinate, consider blood patch* |
