Antepartum Flashcards
Spotting with cramps & a closed cervix
+ fetal heartbeat
threatened abortion
Moderate bleeding with cramping & a dilated cervix
Inevitable abortion
Heavy or profuse bleeding with severe cramps & tissue present in cervix
incomplete abortion
May have spotting or no bleeding, no cramping, cervix is closed, no fetal heartbeat present
Missed abortion
What complication is common with poor glycemic control in early pregnancy?
Congential anomalies in fetus
Preeclampsia develops when?
after 20 weeks gestation
Preeclampsia & addition of
proteinuria greater than or equal to +1
transient headaches with irritability
Preeclampsia without severe
greater 140 or greater than 90
protein urine greater than +1
Preeclampsia with severe features
greater than 160 or greater than 110
Proteinuria not required*
Preeclampsia: if multi systems involved
delivery must be performed
Preeclampsia: if multi systems not involved yet:
improve blood flow fetal oxygenation bed rest antihypertensive meds anticonvulsant meds assess edema (tremendous weight gain)
The placenta experiences ischemia because the spiral arteries of the uterus fail to reshape and increase in diameter
preeclampsia
what to also check for with preeclampsia?
Increased DTR & Clonus
Mag toxicity s/s
Depressed DTRs
Respiratory depression
oliguria <30 cc per hour
therapeutic level of mag
4-7
mag usually continues post partum why?
at least 24 hrs to prevent seizures
Signs of recovery from preeclampsia
Urinary output 4-6 L
rapid weight loss
Decreased protein in urine
BP normal within 2 weeks
what drug of choice for eclampsia
Mag Sulfate
gestational HTN is different from preeclampsia bc
no protein in urine
no organ injury: liver, brain, kidney
signs of impending seizures
Hyperreflexia Clonus Headache/visual disturbances epigastric RUQ p! Vomiting
Risks for preeclampsia
Hx of first pregnancy diabetic, lupus, high BP obese twins age <18 or >35
early pregnancy for diabetes & fuel metabolism
insulin response accelerates
hypoglycemia may occur
late pregnancy for diabetes & fuel metabolism
fetal growth accelerates
placental hormones rise sharply
GDM risk factors
overweight (BMI 26-29 or >29) chronic HTN maternal age >25 previous birth of large infant multifetal pregnancy GDM in previous pregnancy
One hour GTT (screen)
ingest 50g of oral glucose
one hour later
blood sample
Positive 1 hr GTT
glucose >130-140
3 hr glucose test (diagnostic)
fasting
ingest 100g oral glucose
glucose levels @ 1,2 & 3 hrs
3 hr glucose dx
fasting >95
1 hr >180
2 hr >155
3 hr >140
if 2 or more values elevated
testing @ 28 weeks
testing @ 34 weeks
poor glycemic control
good control
HYPOglycemia s/s
nervousness headache weakness irritability hunger blurred vision
HYPERglycemia s/s
Polydipsia polyuria polyphasia nausea abdominal p! flushed dry skin fruity breath
