Chapter 28 Flashcards
What are the risks associated with maternal blood loss
Hypovolemia
Anemia
Infection
Preterm labor
Impaired oxygen delivery to the fetus
What are the fetal risk from maternal hemorrhage ?
Blood loss, anemia
Hypoxemia
Hypoxia
Anoxia
Preterm birth
define miscarriage (spontaneous abortion)
a pregnancy that ends as a result of natural causes before 20 weeks of gestation
What are the types of miscarriages?
Threatened
Inevitable
Incomplete
Complete
Missed
Recurrent
What is a threatened miscarriage?
when body is showing sighs you may miscarry , vaginal bleeding that can vary in amount
lower abdominal pain present
can lasts days or weeks but cervix remains closed
pain and bleeding may go away and can still have healthy pregnancy and baby, or can get worse and have miscarriage
what is an inevitable miscarriage?
can come after threatened miscarriage or without warning,
stronger lower abdominal pain, cervical dilation, more vaginal bleeding
what is an incomplete miscarriage
some of the tissue will remain in uterus, vaginal bleeding and uterine contraction will continue as uterus tries to clear itself, D&C
what is a complete miscarriage
taken place when all pregnancy tissue has left uterus, vaginal bleeding can happen for several days, cramping pain is like labor pain or severemenstrual pain
what is a missed miscarriage ?
where baby has died but stays in uterus, brownish discharge , continued to have symptoms of pregnancy like nausea, tiredness
what is a recurrent miscarriage
after 3 or more miscarriages
why is misoprostol given for miscarriage
to help uterus contract and minimize bleeding or to get body to expel remaining tissue
also given for induction, IV or PO
what is cervical insufficiency
aka incompetent cervix
Passive and painless dilation of the cervix during the second trimester
May be either acquired or congenital
how is cervical insufficiency diagnosed
Speculum/digital pelvic exams
transvaginal U/S
Cervical funneling
How is cervical insufficiency treated?
Cerclage: may be placed either prophylactically or as a therapeutic or rescue procedure after cervical change has been identified
Removed by 36 weeks of gestation
Bed rest for a few days following cerclage
Watch for and report signs of preterm labor, rupture of membranes, and infection.
what is cerclage ?
closing the cervix by sewing it up with sutures
sutures removed when signs of labor
What is an ectopic pregnancy?
the fertilized ovum is implanted outside the uterine cavity; also called “tubal pregnancies”
symptoms of ectopic pregnancy ?
symptoms start 6 -8 weeks after the last normal period
Severe Abdominal pain
Delayed menses
Abnormal vaginal bleeding (spotting)
how is an ectopic pregnancy diagnosed
Quantitative β-hCG levels
transvaginal ultrasound examination; progesterone level
What is the treatment for ectopic pregnancy
methotrexate to dissolve fetal cells
surgery to remove fallopian tube if ruptured
what is a hydatidiform mole (molar pregnancy)?
Type of gestational trophoblastic disease
Benign proliferative growth of the placental trophoblast in which the chorionic villi develop into edematous, cystic, avascular transparent vesicles that hang in a grapelike cluster
what are the types of molar pregnancies
Complete: no embryonic or fetal parts
Partial: often have embryonic or fetal parts and an amniotic sac
symptoms of molar pregnancy
Anemia from blood loss, excessive nausea and vomiting (hyperemesis gravidarum), and abdominal cramps
how is a molar pregnancy diagnosed?
Transvaginal ultrasound and serum hCG levels
HCG levels will be elevated
What is a possible risk associated with molar pregnancies ?
increased risk for development of uterine cancer
Elevated HCG levels are used to diagnose uterine cancer
Recommended to not get pregnant for a year after molar pregnancy, will not be able to tell difference between cancer
