3rd Trimester Gestational Conditions Flashcards
➢A CONDITION IN WHICH
EXCESS AMNIOTIC FLUID
ACCUMULATES DURING
PREGNANCY
hydramnios
➢IT HAPPENS IN ABOUT 1%
OF PREGNANCIES. IT’S
ALSO CALLED
POLYHYDRAMNIOS.
hydramnios
IN THIS
CONDITION, IDENTICAL TWINS SHARE A PLACENTA.
TWIN-TO-TWIN TRANSFUSION SYNDROME.
volume of amniotic fluid of hydramnios
2L
choice diagnosing hydramnios
ultrasonography
oligohydramnios AFI
< 5
treatment of oligohydramnios
amnioinfusion
is a condition in
pregnancy
characterized by
a deficiency of
amniotic fluid. It
is the opposite of
polyhydramnios.
oligohydramnios
treatment of polyhydramnios
amniocentesis
small amount of amniotic fluid is withdrawn from the amniotic sac using a thin needle inserted through the mother’s abdomen into the uterus under ultrasound guidance.
amniocentesis
Rupture of membranes before labor begins, but at ≥37 weeks gestation.
PROM
Rupture of membranes before labor begins AND before 37 weeks gestation.
PPROM
amniorrhexis (srom)
PROM
time interval between
ROM and onset of labor
Latency period
management of
patients with the goal of prolonging
gestation (“watchful waiting” until
delivery indication arises)
expectant management
collection of amniotic fluid in the posterior vaginal fornix, observed during a sterile speculum exam. It is a primary clinical sign used to diagnose rupture of membranes (ROM).
pooling
most common diagnosis of ROM
*Nitrizine testing
*Ultrasonography
antibiotics for ROM
(Ampicillin/EES-Azithro)
*Regular contractions and cervical
change-dilation, effacement, or both
or initial presentation of regular
contractions and cervical dilation of
at least 2 cm between 20 weeks 0
days and 36 weeks 6 days.
preterm labor
3 treatment for preterm labor
magnesium, steroids, NICU consult
Stop or slow uterine contractions, delay preterm labor, or reduce contractions in tachysystole.
tocolytics
tocolytics examples
Magnesium sulfate
Nifedipine (calcium channel blocker)
Terbutaline (beta-agonist)
Induce labor or increase uterine contractions, commonly used for labor induction or postpartum hemorrhage (PPH) prevention.
uterotonics
uterotonics examples
Oxytocin
Misoprostol
Syntometrine
It is one that has lasted longer than
42 weeks or 294 days beyond the
first day of the last menstrual period
prolonged pregnancy/ postterm pregnancy postdate pregnancy
20 % cases of prolonged pregnancy (post maturity syndrome) are
associated with:
- Meconium - stained amniotic fluid
- Oligohydramnios
- Fetal distress
- Loss of subcutaneous fat
- Cracked skin
The most frequent cause of post term pregnancy
error in dating
post term pregnancy diagnosis
1.Gestational age calculation
2. Routine early pregnancy ultrasound
3. UTZ diagnosis for oligohydramnios
Because actual dates of conception are rarely
known, the LMP is used as the reference point.
gestational age calculation
The accuracy determination of gestational age
unreliable because of :
- Irregular menses .
- Recent cessation of birth control pills.
- Inconsistent ovulation times.
Reduces the number of women who require
induction of labour for apparent postterm
pregnancy .
♣ It is recommended to all pregnant women and
certainly those who do not have regular
menses, for gestational age determination,
prior to 20 weeks.
Routine early pregnancy ultrasound
The available evidences are strongly in support that dating by ___________________ alone is a very accurate method for predicting EDD.
early ultrasonography
❖ Successful management depends on _____________________________ and their full
involvement in the decision making process.
effective
counselling of women
The condition of the fetus can change
quickly → monitoring at frequent
intervals.
fetal surveillance
3 fetal surveillance
◼ biophysical profile
◼ non stress test
◼ amniotic fluid index
biophysical profiles
- fetal heart rate acceleration
- fetal breathing
- fetal active movements
- fetal tone
- amniotic fluid volume
management at 40-41 weeks
labor induction and expectant management
what do u assess prior to labor induction
cervical bishop score and ripening agent
when do u induce
at 42 weeks
expectant management tests to determine if need to induce
non stress test and amniotic fluid index
to diagnose thick
meconium, if present
amniotomy
amniotomy or meconium complication
shoulder dystocia
need for neonatal resuscitation at delivery.