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N934 Adv Principles Fa 21 > Complications of the Obstetric Patient > Flashcards

Complications of the Obstetric Patient Flashcards

1
Q

PPH definition

A

EBL >500 for vaginal delivery or >1000mL for c section

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2
Q

PPH is the result of (6)

A 
uterine atony (80%)
uterine abnormalities
placental retention
lacterations
uterine inversion
coagulation abnormalities
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3
Q

uterine atony is associated with (4)

A

multiparty
prolonged oxytocin infusion
polyhydraminos
multiple gestation

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4
Q

PPH treatment includes

A

uterotonics
surgical intervention
intrauterine balloon

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5
Q

PPH uterotonics used to stimulate uterine contractions include (4)

A

oxytocin
methylergonovine
prostaglandins (carboprost, hemabate)
misoprostal

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6
Q

MOA and dosage of methergine

A

ergot alkaloid with strong vascular effects, administered SQ (.2mg)

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7
Q

MOA and dosage of prostaglandins (carboprost, hemabate)

A

initiate strong intramuscular contractions

250mcg IM or directly into uterine muscle

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8
Q

route of admin and dosage of misoprostal

A

administered rectally, vaginally, orally

800-1000mcg

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9
Q

what other meds can be considered for PPH especially during surgical intervention

A

can give antifibrinolytics, transfuse, can give nitroglycerin during surgical intervention to relax muscles and get retained placenta out if thats the problem. hysterectomy may happen

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10
Q

preeclampsia is characterized by 4 things you usually always see and 4 more things in worst case scenarios

A 
SBP >140mmHg after 20w gestation
DBP >90mmHg after 20w gestation
proteinuria
plt count <100,000
impaired liver fx and/or RUQ pain
renal insufficiency
pedema
cerebral or visual disturbances
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11
Q

preeclampsia results in/can result in (4)

A

increased vascular tone and sensitivity to catecholamines
pronounces upper aw edema during labor
thrombocytopenia
hepatocellular necrosis

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12
Q

preeclampsia CNS effects

A

HA, hyperexcitability, hyperreflexia

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13
Q

management of preeclampsia: pharmacological

A

magnesium sulfate

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14
Q

management of preeclampsia directed at

A

avoiding ureteroplacental hypo perfusion

HTN managment, delivery is only way to end disease process

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15
Q

what kind of anesthetic is preferred for the pre eclamptic patient

A

regional preferred over GA

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16
Q

HELLP is a complication of preeclampsia that results in (3)

A

hemolysis
elevated liver enxymes
low platelet count

17
Q

signs of HELLP include

A

HTN, proteinuria, n/v

18
Q

obese parturients are at increased risk for

A

HTN, DM, complicated labor

19
Q

placenta previa

A

placenta implants on lower uterine segment and covers opening to cervix

20
Q

sx of placenta previa

A

painless vaginal bleeding. hemodynamically significant blood loss, increases risk in postpartum bleeding

21
Q

placenta previa: vaginal delivery or c section?

A

c section indicated

22
Q

placenta accreta

A

placenta normally implants into endometrium. this describes implantation into myometrium and growth through myometrium into surrounding organs

23
Q

placenta accreta is associated with

A

massive hemorrhage, uterine artery embolization

24
Q

placenta accreta: vaginal delivery or c section

A

cesarean hysterectomy

25
Q

placenta abruption and at risk patients

A

separation of placenta from uterus during delivery. higher in women with HTN and preeclampsia

26
Q

placenta abruption signs include

A

hemorrhage
uterine irritability
abdominal pain** aka painful bleeding
fetal hypoperfusion and distress

27
Q

placenta abruption: open venous sinuses allows

A

amniotic fluid to enter circulation. increased incidence of DIC

28
Q

AFE is a rare event that can occur during

A

labor, vaginal delivery, or c section. occasionally associated with placental abruption

29
Q

signs of AFE include

A

anxiety, dyspnea, hypoxia, HoTN, CV collapse, coagulopathy

30
Q

tx of AFE

A

supportive

31
Q

how many weeks gestation accounts for 70% of all premature births

A

34-36w

32
Q

birth weight below _____ is associated with these long term complications

A

1500g

resp distress syndrome, intracranial hemorrhage, hyperbilirubinemia

33
Q

delaying preterm labor with these drugs allows lungs time to develop

A

mag sulfate
CCB
beta sympathomimetics

34
Q

what usually results in spontaneous respiration for neonatal resuscitation

A

tactile stimulation

N934 Adv Principles Fa 21 (23 decks)

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