Complications of pregnancy Flashcards
Pregestational or over diabetes
A woman diagnosed with diabetes prior to becoming pregnant
Gestational diabetes
A woman with glucose intolerance first diagnosed while pregnant
Glucose screening
Short glucose tolerance test
Full glucose tolerance test
Short glucose tolerance test
No fasting
50g glucose drink
Blood sugar taken in one hour
If result 7.2 mmol/l for FGTT
Full glucose tolerance test
Fasts for 12-14 hours
Fasting blood sugar taken
Drinks 100 g drink
Blood taken at one hour, two hours and three hours
What maneuver is used for shoulder dystocia?
Mcroberts maneuver
Risks in pregnancy of Type 1 Diabetes
Birth defects
Ketoacidosis
Pregnancy loss
Name of (3) members of the Multidisciplinary team who share the management of the Diabetic mother
Obstetrician
Dietician
Anesthetist
Describe the main treatments for Type 2 Diabetes and GDM
Blood sugar is controlled by diet and oral hypo-glycemics.
Metformin is an example of oral hypoglycemics which are frequently used in women with insulin resistance, infertility etc./
What are the risks to the mother for uncontrolled Hyperglycaemia
Risk for stroke
High blood pressure
Visual disturbances
What are the risks to the fetus
for uncontrolled Hyperglycaemia
Early onset jaundice
Respiratory distress
Brachial plexus injury
Chronic hypertension
Onset of hypertension before 20 weeks of pregnancy
Gestational hypertension
New onset of hypertension AFTER 20 weeks of pregnancy
With No proteinuria
BP returns to normal before 12 weeks postpartum
Can develop into Superimposed Pre-eclampsia
Pre-eclampsia
New onset hypertension with significant proteinuria
BP > 140/90 after 20 weeks
Proteinuria > 300 mg/24 hours or >1+ dipstick
Severe pre-eclampsia
BP > 160/110
Proteinuria > 2.0g/24 hours or >2+ dipstick
Serum creatinine > 1.2 mg/dL
Platelets < 100,000/ul
Elevated liver enzymes
Super-imposed pre-eclampsia
New onset proteinuria > 300 mg/24hrs in hypertensive woman but no proteinuria before 20 weeks gestation
HELLP SYNDROME
Hemolysis
Elevated
Liver enzymes
Low
Platelet count
Management of pre-eclampsia
Anti-hypertensive medication e.g., Aldomet to lower blood pressure
Bedrest
4 hourly blood pressures
Blood screening for Liver function, Kidney function
24-hour urine and dipstick for protein
Fetal heart monitoring per shift
Daily weight (hidden oedema)
Teach client how to recognizeworsening symptoms
Severe pre-eclampsia signs
Headache
Confusion
History of convulsion
Respiratory symptoms
Visual disturbances
Nausea/ vomiting
Right upper quadrant pain
Decreased urine output
Which medications may be used to manage HTN in pregnancy?
Labetalol
Magnesium sulphate
Nifedipine
Hydralazine
What are the risks to the mother? (HTN)
Stroke
Renal artery stenosis
Enlarged heaart
What are the risk to the fetus? (HTN)
Premature birth
Infant death
Intrauterine growth restriction (UUGR) - also called small for gestational age
Define (3)
indications for
urgent delivery of
the fetus.
Persistent severe head or visual changes
Eclampsia
Severe uncontrolled hypertension
Placenta previa
Also referred to as low-lying placenta
This is when the placenta attaches to the lower end of the uterus, near or covering the cervical opening.
Marginal, total or partial
Abruptio placentae
Premature detachment of the placenta
Hydatidiform mole (gestational trophoblastic disease)
Also called molar pregnancy
When the chorionic villa increases abnormally and develop vesicles that resemble tiny grapes
