Ch 21 pregnancy at risk book key points

Question 1

Vaginal bleeding during pregnancy is always serious until ruled otherwise because it has the potential to ___.

Answer 1

diminish the blood supply to both the mother and fetus

Question 2

The amount of bleeding that is evident may not be truly indicative of the amount of bleeding occurring because __.

Answer 2

hidden, internal bleeding may also be happening.

As a rule, position women with bleeding during pregnancy on their side to improve placental circulation and prevent supine hypotension syndrome.

Question 3

Spontaneous miscarriage is the loss of a pregnancy before viability of the fetus (20 to 24 weeks). The majority of these early pregnancy losses are attributed to chromosomal abnormalities. They are classified as (6).

Answer 3

threatened, imminent, complete, incomplete, missed, or recurrent pregnancy loss

Question 4

Women who have a spontaneous miscarriage at home should bring any tissue passed to the hospital for an analysis for __.

Answer 4

gestational trophoblastic disease.

APS is an autoimmune disease that may contribute to recurrent miscarriages; therapy is SQ heparin and low-dose aspirin.

Question 5

__ is implantation outside the uterus, usually in a fallopian tube.

Answer 5

Ectopic pregnancy

If discovered before the tube ruptures, methotrexate can be administered to cause the conceptus to be reabsorbed.

If not discovered early, sharp lower quadrant pain occurs at about 6 to 12 weeks as the tube ruptures. A laparoscopy is necessary to remove the conceptus and repair the tube to halt bleeding.

Question 6

___ is abnormal overgrowth of trophoblast cells. If not discovered by an ultrasound early in pregnancy, bleeding and expulsion of the abnormal growth occur at about the 16th week of pregnancy.

Answer 6

Gestational trophoblastic disease

Women need close follow-up after this because it can lead to choriocarcinoma, a malignancy.

Question 7

__ occurs when the cervix dilates early in pregnancy before viability of the fetus. __can be placed to prevent the cervix from dilating prematurely this way again in a second pregnancy.

Answer 7

Premature cervical dilatation

Sutures (cervical cerclage)

Question 8

__ is low implantation of the placenta so that it crosses the cervical os. If this is not discovered before labor, cervical dilatation may cause the placenta to tear, causing severe blood loss.

Answer 8

Placenta previa

Question 9

Women who have symptoms of placenta previa -___-should not have vaginal examinations done to prevent disruption of the low-implanted placenta.

Answer 9

painless vaginal bleeding in the third trimester

Question 10

__ or a premature separation of the placenta usually occurs late in pregnancy and cuts off blood supply to the fetus.

Answer 10

abruptio placentae

Women with increased parity, those with previous uterine surgery, and those who are cocaine dependent are at highest risk for this.

Question 11

Abruptio placentae is often manifested by ___.

Answer 11

sudden, sharp fundal pain and then a continuing dull pain and vaginal bleeding.