Antepartum Condiotions Flashcards
Spontaneous abortion
See terms
Cramp like lower abdominal pain similar to labor
Moderate to severe vaginal bleeding, which maybe bright to dark red
Passage of tissue or blood clots
Placenta previa
Placenta previa is the abnormal implantation of the placenta over the cervix opening (os). Placenta should be at the top of uterus.
3 types of placenta previa
Total- covers entire os. Blocks birth canal. Can prevent delivery. As cervix dialates significant bleeding may occur
Partial- not completely covering os. May prevent delivery
Marginal-implanted near neck of cervix. May cause placenta to partially tear.
(All refer to amount of os that is covered)
Predisposing factors More than 2 deliveries Rapid succession of pregnancies Older than 35 Previous placenta previa History of early vaginal bleeding Bleeding immediately after intercourse
Administer oxygen regardless of SpO2 reading 15 lpm nonrebreather, treat for shock, transport.
Abruptio Placentae
Small arteries located in lining between the placenta and uterus are prone to rupture. When they rupture and bleed the accumulating blood begins to tear and desperate the placenta from the uterine wall.
Two major problems
Poor gas, nutrient and waste exchange between fetus and placenta
Severe maternal blood loss
Two types
Complete- placenta completely separates. Carries 100% fetal death rate
Partial- not completely separate from uterine wall
Predisposing factors
Assessment
Vaginal bleeding and abdominal pain(hallmark sign)
Ab pain due to muscle spasm of the uterus mild/sharp/acute
Lower back pain
Uterine contractions
Ab tender on palpation
Signs of hypovolemic shock
Administer oxygen regardless of SpO2 reading 15 lpm nonrebreather, treat for shock, transport.
Rupture placenta
As the uterus enlarges, the uterus wall becomes extremely thin, especially around the cervix. This can lead to spontaneous or traumatic rupture of the uterine wall, releasing the fetus into the abdominal cavity. Mother death rathe 5-20%
Infant 50%
History of previous rupture History or findings of ab trauma History of a large fetus History of 2 children History of long difficult labor History of c section Tearing feeling in ab Constant severe ab pain Nausea Signs of shock Contractions Ability to palpate infant in ab cavity
Administer oxygen regardless of SpO2 reading 15 lpm nonrebreather, treat for shock, transport.
Ectopic pregnancy
The egg is implanted outside the uterus. In the Fallopian tube(90%), in abdominal peritoneal covering, on the outside of the wall of uterus, on an ovary or on the cervix
Predisposing factors Previous ectopic pregnancy Pelvic inflammatory disease (pid) Adhesions from surgery Tubal surgery Intrauterine device
Assessment Dull achy pain, poorly localized becomes sudden, sharp ab pain Shoulder pain from blood in ab cavity Vaginal bleeding Tender and bloated ab A palpable mass in ab Decreased bp Signs of shock Urge to defecate
Treat patient for shock and hypoperfusion. Administer oxygen when necessary
Preeclampsia/Eclampsia
Preeclampsia is characterized by high bp and swelling extremities.
Eclampsia is a more severe form of preeclampsia and include comas and seizures that may be life threatening.
