Complications of Maternity

Question 1

S/S of Miscarriage

Answer 1

spotting and cramping (combination of both is more indicative of a miscarriage)

Question 2

Treatment for a Miscarriage

Answer 2

measures HCG levels (worry when levels drop), bedrest and pelvic rest(no sex), if miscarriage imminent (IV, Blood, D&C)

Question 3

Patho of Hydatidiform mole (molar pregnancy)

Answer 3

benign neoplasm, can turn malignant; grape like clusters of vesicles; may/may not have fetus involved

Question 4

How does pregnancy start in molar pregnancy?

Answer 4

uterus enlarges too fast

Question 5

S/S of Molar Pregnancy

Answer 5

absence of FHTs, bleeding (sometimes vesicles)

Question 6

Diagnosis for molar pregnancy:

Answer 6

confirmed with u/s

Question 7

Patho of Hyperemesis Gravidarum:

Answer 7

starts like regular morning sickness, excessive vomiting (dehydration, starvation, death)

Question 8

Causes of hyperemesis gravidarum

Answer 8

r/t high levels of estrogen and HCG

Question 9

S/S of Hyperemesis Gravidarum

Answer 9

BP drops, H/H increase, UO decrease, K+ decrease, weight decrease

Question 10

What will patients with Hyperemesis Gravidarum have in urine?

Answer 10

ketones (because breaking down body fat)

Question 11

Treatment for Hyperemesis Gravidarum:

Answer 11

NPO for 48 hrs, IVFs 3000 ml for 1st 24 hrs, antemetic, vitamins, quiet environment, oral hygiene, don’t talk about food, keep emesis basin out of view, icy cold or steamy hot food/liquids, well ventilated room

Question 12

S/S of Hyperemesis Gravidarum

Answer 12

rigid board like abd, w/wo vaginal bleeding, abd pain and uterine tone, difficult to palpate fetus

Question 13

Incompetent Cervix Patho:

Answer 13

This is what cervix dilates prematurely; occurs in fourth month of pregnancy; hx of repeated, painless, 2nd trimester miscarriages

Question 14

What causes incompetent cervix?

Answer 14

weight of baby causes pressure on cervix causing it to prematurely dilate

Question 15

Treatment of Incompetent Cervix

Answer 15

purse string suture (cerclage) at 14-18 wks-reinforces cervix; may have C-section to preserve suture; 80-90% chance of carrying baby to term after cerlage

Question 16

Fetal Complications with Incompetent Cervix:

Answer 16

preterm delivery, intrauterine growth retardation, fetal distress, anemia

Question 17

Maternal Complications with Incompetent Cervix:

Answer 17

hemorrhage, potential DIC risk

Question 18

Abruptio Placenta Patho:

Answer 18

placenta implanted normally, may be partial or complete, separates prematurely (bleeds), seen in last half of pregnancy, u/s to confirm diagnosis

Question 19

Causes of Abruptio Placenta:

Answer 19

motor vehicle crash, domestic violence, previous C-section, rapid decompression of uterus (membranes rupture), associated w/cocaine, PIH, and smoking

Question 20

Patho of Placenta Previa:

Answer 20

most common cause of bleeding in later mnths (usually 7th); placenta has implanted wrong; an u/s will be done to confirm placental location