Complications of antepartum Flashcards
gestational diabetes, first trimester
Decreased need for insulin due to hormonal, enhance production and tissue responses to insulin
gestational diabetes after first trimester
Increased need for insulin, hormones acting like insulin antagonists
Maternal risks for gestational diabetes
Polyhydramnios
Preeclampsia
Keto acidosis
Dystocia
Increased susceptibility to infection’s
neonatal risks of gestational diabetes
Mortality
Congenital anomalies
Macrosomia
IUGR, RDS
polycythemia
Decreased blood sugar
Increased BilliRubin
One hour glucose tolerance test
50 g glucose drink within 10 to 15 minutes
Draws blood one hour later
Greater than 140 requires further testing
three hour glucose tolerance test
One hour, two hour, three hour markers
Gestational diabetes diagnostic, if two levels exceeded
goals for gestational diabetes treatment
fasting glucose less than 95
Two hours after meal less than 120
when should blood glucose be reassessed postpartum?
Six weeks
What should be given for prophylaxis in HIV positive moms?
Antiretroviral therapy ZDV
Signs of cardiac decomposition
cough
Dyspnea
Rales
Weight gain
Murmur
Palpitations
cardiac management
8–10 hours sleep per day
Frequent visits Q2 weeks
Halfway through pregnancy Q1 week
Increase iron and protein in diet
Decrease sodium in diet
Side lying/semi-Fowlers
Shorter, moderate, pushing with periods of rest
should Valsalva maneuver be performed in cardiac patients?
No
recurrent miscarriages
Greater than or equal to three consecutive losses
Greater than or equal to two if advanced maternal age
ectopic pregnancy
Fertilized egg deposits other than uteruses endometrium
Sharp one sided pain, serial hCG doesn’t double per day, decreased progesterone
IM Methotrexate
Gestational trophoblastic disease
Complete mole– ovum containing no DNA fertilized by normal sperm
partial mole normal ovum is fertilized by two sperm
Increased risk of pulmonary embolism and choriocarcinoma
hydratiform mole
Dark brown, vaginal bleeding
Anemia
Grape like vessels
Uterine enlargement
Absence of, FHT’s
Increased hCG for dates
Very low MSAFP
hyperemesis gravidarum
excessive vomiting, impacting hydration and nutrition, causing nutritional deficit
Treat with thiamine supplement, TPN, anti-emetics
Rh alloimmunization
Rh negative mom
Rh positive baby
when should RhoGAM be administered for RH allimmunization?
28 weeks prophylaxis
if alloimmunization not treated, what can occur?
Hydrops fetalis
CHF
Jaundice
Kernicterus
Severe hemolytic syndrome
postpartum management of Rh alloimmunization
Direct coombs test within 72 hours administer RhoGAM
If negative no RhoGAM
kleihaur betke test
Determines how much Rh positive blood is present in maternal circulation
ABO incompatibility
Mom type O, no antigens
Infant a, B, AB
Hemolysis of fetal RBCs
