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CMCRP: SUDDEN PREGNANCY COMPLICATIONS > A. BLEEDING DURING PREGNANCY > Flashcards

A. BLEEDING DURING PREGNANCY Flashcards

1
Q

5 leading complications related directly to the pregnancy are

A
  1. thromboembolism
  2. hemorrhage
  3. infection
  4. pregnancy-induced hypertension
  5. ectopic pregnancy
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2
Q

Hypovolemic shock
occur when ___% of blood volume, or approximately ______________, have been lost;

A

10%
2 units of blood

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3
Q

fetal distress occurs when ___________ is lost.

A

25% of blood volume

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4
Q

What do you need to assess to prevent a pregnant patient on having hypovolemic shock?

A

It is important to know the baseline BP of the patient

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5
Q

What are the Signs and Symptoms of Hypovolemic Shock?

A
  1. Increased pulse rate
  2. Decreased BP
  3. Cold clammy skin
  4. Decreased urine output
  5. Dizziness or decreased level of consciousness
  6. Decreased central venous pressure
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6
Q

Heart is attempting to circulate decreased blood volume

A

Increased pulse rate

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7
Q

Less peripheral resistance because of decreased blood volume

A

Decreased BP

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8
Q

Vasoconstriction occurs to maintain blood volume in central body core

A

Cold clammy skin

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9
Q

Inadequate blood is entering kidneys because of decreased blood volume

A

Decreased urine output

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10
Q

Inadequate blood reaching cerebrum because of decreased blood volume

A

Dizziness or decreased level of consciousness

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11
Q

Decreased blood is returning to heart because of reduced volume

A

Decreased central venous pressure

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12
Q

the medical term for any interruption of a pregnancy before a fetus is viable

A

Abortion

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13
Q

is usually defined as a fetus of more than 20 to 24 weeks of gestation or one that weighs at least 500 g

A

viable fetus

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14
Q

viable fetus is usually defined as a fetus of more than ______ weeks of gestation or one that weighs at least ____

A

20 to 24 weeks and weighs at least 500 g

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15
Q

A fetus born before ________ point is considered a miscarriage or premature or immature birth

A

before 20 to 24 weeks of gestation

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16
Q

If a viable fetus is interrupted spontaneously

A

miscarriage

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17
Q

Spontaneous miscarriage occurs in ____________ of all pregnancies and arises from ______ causes

A

15% to 30% and

arises from natural causes

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18
Q

______ miscarriage if it occurs before week 16 of pregnancy

A

early miscarriage

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19
Q

a late miscarriage if it occurs between weeks ______

A

16 and 24 weeks

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20
Q

most frequent cause of spontaneous miscarriage

A

abnormal fetal development (teratogenic or chromosomal)

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21
Q

implantation abnormalities, as up to 50% of zygotes probably never implant securely because of

A

inadequate endometrial formation or from an inappropriate site of implantation

22
Q

Miscarriage may also occur if the __________ on the ovary fails to produce enough _________ to maintain the ___________

A

corpus luteum

progesterone

decidua basalis

23
Q

what infections or diseases cross the placenta that may cause early miscarriage

A
  1. Rubella
  2. syphilis
  3. poliomyelitis
  4. cytomegalovirus
  5. toxoplasmosis infections
24
Q

Low production of estrogen and progesterone may cause __________________________,

PG are released and contractions and cervical dilatation occur

A

endometrial lining to slough off

25
Intake of _________________ in first tri may cause miscarriage or fetal abnormality
Isotretinoin
26
may cause abnormal fetal growth and lead to miscarriage
alcohol
27
Assessment of Spontaneous Miscarriage: _________________________ Treatment: Depends of symptoms
Presence of vaginal spotting
28
HCG levels may be tested (should be doubled, if not, poor placental function may be suspected)
Threatened Abortion
29
What should be avoided for a threatened abortion?
Avoid strenuous activities for the next 48 hrs
30
What is restricted for a threatened abortion?
Coitus is restricted for two weeks
31
Types of Abortion/Miscarriage
1. Spontaneous Miscarriage 2. Threatened Abortion 3. Imminent/Inevitable Miscarriage 4. Complete Miscarriage 5. Incomplete Abortion 6. Missed Miscarriage 7. Habitual Aborters
32
(-) FHT, (-) fetus on UTZ = ______________
Vacuum extraction or D&C Imminent/inevitable Miscarriage
33
After D&C, woman should be monitored for bleeding (# of pads used)
Imminent/inevitable Miscarriage
34
the entire products of conception (fetus, membranes, and placenta) are expelled spontaneously without any assistance.
Complete Miscarriage
35
bleeding usually slows within 2 hours and then ceases within a few days after passage of the products of conception.
Complete Miscarriage
36
part of the conceptus (usually the fetus) is expelled, but the membrane or placenta is retained in the uterus
Incomplete Abortion
37
there is a danger of maternal hemorrhage as long as part of the conceptus is retained in the uterus because the uterus cannot contract effectively
Incomplete Abortion
38
AKA early pregnancy failure
Missed Miscarriage
39
fetus dies in the utero but not expelled
Missed Miscarriage
40
In a missed miscarriage, fetus died ___________ before the onset of miscarriage (spontaneously occurs within two weeks)
4-6 weeks
41
if pregnancy is at 14 weeks, PG or cytotec may be given to induce labor.
missed miscarriage
42
Possible causes of Habitual Aborters
a. Defective spermatozoa or ova b. Endocrine factors c. Deviations of the uterus d. Resistance to uterine artery blood flow e. Chorioamnionitis or uterine infection f. Autoimmune disorders
43
Possible causes of Habitual Aborters b. Endocrine factors
1. lowered levels of protein-bound iodine (PBI), butanol-extractable iodine (BEI), and globulin-bound iodine (GBI) 2. poor thyroid function; or luteal phase defect
44
Possible causes of Habitual Aborters c. Deviations of the uterus
as septate or bicornuate uterus
45
Possible causes of Habitual Aborters f. Autoimmune disorders
involving lupus anticoagulant and antiphospholipid antibodies
46
Complications of Miscarriage
1. Hemorrhage 2. Infection 3. Septic Abortion 4. Isoimmunization 5. Powerlessness or Anxiety
47
T or F In spontaneous complete miscarriage, hemorrhage is very common
FALSE - hemorrhage is rare in spontaneous complete miscarriage
48
In an Incomplete Abortion, there can be a major hemorrhage if with coagulation disorders like _________
Disseminated Intravascular Coagulation (DIC)
49
WOF signs of Shock
1. Unusual odor or passing of large clots 2. Bleeding – dark color to color serous fluid
50
3. Physician may give __________ for uterine contraction
Methergin

CMCRP: SUDDEN PREGNANCY COMPLICATIONS (1 decks)

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