Class 2 - Treatment Considerations in Pregnancy Flashcards

1
Q

Contraindications for _________ massage include:
- First trimester of pregnancy
- High risk pregnancies
- Problems with cervix & placenta
- Pre-term labour/threat of pre-term labour
- Vaginal/uterine bleeding
- Health of fetus is in question

A

Abdominal Massage

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2
Q

T/F - Light abdominal techniques would never cause a miscarriage or still birth, however we want to eliminate the association and ease the mind of the RMT.

A

True

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3
Q

Abdominal massage is _________ and greatly beneficial for connection with baby, tissue and fascial stretch in the ______ and _____ trimesters to enhance birth parent’s connection with baby and increase tissue stretch.

A

Indicated
Second & Third

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4
Q

T/F - Always massage the abdomen in a medial to lateral direction so you are not increasing the possibility or severity of diastasis recti.

A

True

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5
Q

Some contraindications for ______ massage include:
- High risk pregnancies
- Mastitis
- Breast cancer/undiagnosed lump
- Post-surgical infection
- Current active infection
- Abscess

A

Breast Massage

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6
Q

T/F - Since we are never touching the areola or nipple in our breast massage, there is no way nipple stimulation can induce contractions.

A

False - ALTHOUGH we are never touching the areola or nipple in our breast massage, there is A POSSIBILITY THAT nipple stimulation can induce contractions.

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7
Q

Onsite work and direct pressure to the breasts is _______________ as mastitis is a bacterial _________.

A

Contraindicated
Infection

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8
Q

T/F - Manual techniques to a breast with mastitis cannot cause damage to blood vessels, thrombophlebitis and increase abscess size.

A

False - Manual techniques to a breast with mastitis CAN cause damage to blood vessels, thrombophlebitis and increase abscess size.

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9
Q

Milk that remains in the breast after a feeding can back up into a ____, inflaming the surrounding tissue and causing a blockage. This is a common cause of ________.

A

Duct
Mastitis

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10
Q

T/F - A small, hard lump that’s sore to the touch, or a very tender spot in the breast indicates there may be a clogged duct.

A

True

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11
Q

Applying ____ compresses/packs between feedings may ease the pain of mastitis. Applying a ____ compress just before breastfeeding may help with milk flow.

A

Cold
Warm

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12
Q

Always wrap a clean cloth/towel to prevent skin damage when applying compresses, especially with mastitis because it can affect the skin’s ability to gauge ___________.

A

Temperature

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13
Q

Indications for ______ massage during pregnancy include:
- High level of change in breast tissue
- Pain
- Congestion
- Structural imbalances due to pregnancy posture, TrPs and increased MRT in pectorals
- TOS due to pregnancy posture

A

Breast Massage

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14
Q

Indications for ______ massage during breastfeeding include:
- Pain
- Congestion
- Structural imbalances due to breastfeeding positions
- TOS due to breastfeeding positions

A

Breast Massage

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15
Q

T/F - Varicosities don’t usually appear for the first time in pregnancy.

A

False - Varicosities MAY appear for the first time in pregnancy.

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16
Q

With severe ____________, there may be clots in deeper veins.

A

Varicosities

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17
Q

Some symptoms of _____ _____ include:
- Sudden/severe pain, swelling, heat & redness
- Decreased circulation to affected limb
- Pain upon palpation

A

Blood Clots

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18
Q

T/F - 80-90% of blood clots occur in the right leg or iliofemoral vein.

A

False - 80-90% of blood clots occur in the LEFT leg or iliofemoral vein.

19
Q

T/F - Blood clots can be asymptomatic.

A

True

20
Q

Some risk factors for _____ _____ include:
- Cesarean section or other recent hip, pelvic and/or knee surgery
- Bedrest & immobility
- Leg injury
- History of previous DVT
- Smoking
- Age greater than 40 years
- Obesity
- Family history

A

Blood Clots

21
Q

DVT’s are __ times more likely to occur in pregnant patient’s.

A

6 times

22
Q

DVT’s are 5 times more likely to occur in the __________ time period and the patient has a ___ times greater risk for developing a pulmonary emboli in comparison to pregnancy.

A

Postpartum
15 times

23
Q

_________________ for varicosities/DVT include:
- No massage over varicosities, known blood clots or phlebitis
- No deep pressure to the adductors or inguinal region
- No massage to legs if there are known clots

A

Contraindications

24
Q

Some early warning signs and symptoms of ____ ____ __________ include:
- Pain
- Swelling
- Warmth
- Redness
- Leg cramps, often starting in the calf
- Leg pain that worsens when dorsiflexing the foot
- Blue/white skin discolouration

A

Deep Vein Thrombosis (DVT)

25
Q

T/F - The level of blood-clotting proteins decreases during pregnancy, while anti-clotting protein levels increase.

A

False - The level of blood-clotting proteins INCREASES during pregnancy, while anti-clotting protein levels DECREASE.

26
Q

T/F - Possibility of too much bleeding at childbirth tends to increase the blood’s clotting ability around birth, occasionally too much.

A

True

27
Q

An enlarged ______ increases pressure on the veins that return blood to the heart from the lower body, leading to potential blood clots.

A

Uterus

28
Q

_______ increase as pregnancy progresses, as it is needed for labour and delivery.

A

Relaxin

29
Q

T/F - Stability is usually more of an issue than mobility in pregnant patients, and should play a large role in your treatment plan.

A

True

30
Q

Relaxin and ____________ soften connective tissue in the body and this commences from ___ weeks gestation onwards and continues until __ months postpartum.

A

Progesterone
10 weeks
6 months

31
Q

What are the 2 structures most affected by relaxin and progesterone?

A

1) Pelvis
2) Lumbar Spine

32
Q

T/F - Relaxin and progesterone affect some ligaments and joints, as well as tendons and fascia.

A

False - Relaxin and progesterone affect ALL ligaments and joints, as well as tendons and fascia.

33
Q

T/F - Muscles will increase in MRT to support unstable structures during pregnancy, and this places a great deal of strain on them, especially weight bearing structures.

A

True

34
Q

It is not uncommon to see dysfunction of the _____ symphysis, low back pain and SI joints, and joints may even feel “______”.

A

Pubic
“Wobbly”

35
Q

Some ________ related to ligament laxity include:
- Joint mobilizations (use low grade application)
- Rhythmic mobilizations
- Passive stretching (no overpressure)
- Prior dislocations

A

Cautions

36
Q

Pelvic or ______ joint mobilizations are completely contraindicated as they may induce pre-term ______.

A

Sacral
Labour

37
Q

For pregnant patients, we want to use ___-_____, gentle stretches and for self-care, we should instruct them to perform stretching ______ using their breath.

A

Mid-Range
Slowly

38
Q

Contraindications for __________ include:
- High risk pregnancies (potential to destabilize pelvis & induce pre-term labour)
- Pubic symphysis dysfunction (avoid psoas and other hip flexors)

A

Stretching

39
Q

Contraindications for ______ work include:
- No deep prolonged/pointed pressure work
- No joint mobilizations to this area

A

Sacral

40
Q

T/F - Any sacral work is completely contraindicated for high risk pregnancies.

A

True

41
Q

T/F - We can use general broader massage techniques to the sacrum in a healthy pregnancy.

A

True

42
Q

Many pregnant individuals have heard your ______, back and ____ should not be massaged because it’s possible to cause uterine contractions and pre-term labour. It is ________ we can actually do this.

A

Ankles
Feet
Unlikely

43
Q

___________ encompasses focused, intent based, deep sustained pressure.

A

Acupressure

44
Q

The following ___________ points should be avoided:
- Large intestine 4
- Spleen 6
- Kidney 3
- Urinary bladder 60 & 67
- Liver 3
- Gallbladder 21
- Bladder 31-34

A

Acupressure