CH 19 - HIGH RISK

Question 1

High risk is what?

Answer 1

when it causes jeopardy to mother, fetus, or both

Question 2

Pregnancy Complications (9):

Answer 2

1. bleeding during pregnancy - can be spontaneous abortion or something else
2. hyperemesis gravidarum - excessive vomiting
3. gestational hypertension
4. HELLP syndrome
5. Gestational diabetes
6. blood incompatibility
7. amniotic fluid imbalances
8. multiple gestation
9. premature rupture of membranes (PROM)

Question 3

Early Bleeding During Pregnancy Caused By:

Answer 3

-spontaneous abortion
-ectopic pregnancy
-cervical insufficiency

Question 4

Spontaneous Abortion:

Answer 4

-most common complication of early preg

1st trimester = due to fetal genetic abnormalities

2nd trimester = maternal conditions

CHECK FOR:
vaginal bleeding, cramping/contractions, VS, pain level

Question 5

Types of Spontaneous Abortions (6):

Answer 5

1. Threatened - problem like cramping, bleeding, but NOT expelling products
2. Inevitable - bleeding, ruptured membranes, just waiting for it to occur
3. Incomplete - partial expelling of products. Baby can have came out, maybe hasnt delivered placenta
4. Complete - products completely expelled
5. Missed - non viable fetus, but has not been passed. ex: 13 wks preg, cant find heartbeat, give meds or D&E (dilation/evacuation)
6. Habitual - 3 or more losses in a row

Question 6

Ectopic Pregnancy is what?

Answer 6

-implantation outside uterus, painful, have to get rid of it

Meds: methotrexate, prostaglandins, misoprostol, actinomycin

-surgery if rupture

-Rh immunoglobulin if woman Rh neg

-hallmark sign = abdominal pain 6-8 weeks after missed period

-do labs and hcg to make sure its not a tumor

Question 7

Cervical Insufficiency/ Incompetent Cervix:

Answer 7

-premature dilation of cervix

-bed rest, pelvic rest, avoid heavy lifting

• cervical cerclage - sew cervix closed

-pink tinged vaginal discharge - need to let MD know right away

Question 8

Placenta Previa

Answer 8

-painless, bright red vaginal bleeding
-placenta implants over cervical os

Risk factors: previous c section, advanced age, multiparity, smoking, DM, previous uterine surgery

-can’t deliver vaginally

-avoid vaginal exams

Question 9

Placenta Accreta:

Answer 9

placenta attaches itselft DEEPLY INTO the wall of the uterus but does not penetrate uterine wall

Question 10

Placenta Increta

Answer 10

placenta INVADES MYOMETRIUM

Question 11

Placenta Percreta

Answer 11

placenta EXTENDS THRU the myometrium and uterine serosa and can ATTACH to BLADDER