Conditions of Pregnancy Flashcards
What are common symptoms experience during pregnancy?
Constipation
Hemorrhoids
Leg cramps/Restless legs
Nausea and vomiting
Urinary Tract infections
Vaginitis
Varicose veins
What are the common signs and symptoms of gestational trophoblastic disease?
Abnormal uterine growth
Vaginal bleeding in 1st trimester
Severe nausea and vomiting
Signs of preeclampsia in 1st trimester: edema, hypertension
What is the danger of rubella infection during pregnancy?
Can cause severe birth defects in an exposed fetus
How is rubella transmitted?
Respiratory droplets
What normal flora of the vaginal mucosa may cause an infection of the newborn with possible life-threatening diseas?
Group B streptococcal sepsis
What are the risk factors for developing toxoplasmosis in pregnancy?
Exposure to cat feces especially cat litter
Exposure to contaminated water
Raw or undercooked meat
Blood Transfusion
What are the symptoms of toxoplasmosis?
Usually asymptomatic
Head and neck LAO
Systemic symptoms: fatigue, fever, malaise
What is found on serology with toxoplasmosis?
High IgM titers: acute infection
Low IgM, IgG: previous infection
No IgG: never infected
What are some of the risks of developing gestational diabetes?
History of babies > 9 pounds
History of hyperglycemia, history of family history of DM
BMI > 25
What should be part of the prenatal screening that might help pick up the beginning of gestational diabetes?
Urinalysis for glycosuria
Oral glucose tolerance test
What is the lab test done to diagnose gestational diabetes?
Oral glucose test
What is the definition of pregnancy-induced hypertension?
> 140/90 BP or rise of more than 30 systolic or 15 diastolic from the intake baseline
What is the most common pregnancy complication and the cause of maternal death in the US and the world?
Preeclampsia
What clinical findings are present with preeclampsia?
Pregnancy induced HTN
Proteinuria
Edema and excessive weight gain
What is the usual time period for preeclampsia to occur?
Week 20 to the end of 1st week postpartum
What is added to the symptoms of preeclampsia or toxemia situation?
Seizures and/or coma
What are some ominous findings in preeclampsia?
HA, visual changes, retinal changes: nicking , oliguria
What finding on a urine dipstick is consistent with preeclampsia?
High urine protein
How does preeclampsia affect urine calcium?
It will cause a decrease
What are the signs and symptoms of abruptio placentae?
Vaginal bleeding after 20 weeks gestation
Abdominal pain
Uterine tenderness
Fetal Heart Rate changes
What might you expect in a history of someone with ectopic pregnancy?
Infertility treatment
History of PID or abdominal/pelvic surgery
Post tubal ligation
Current IUD use
Hx of endometriosis
What are the signs and symptoms of ectopic pregnancy?
1) Severe lower abdominal pain and tenderness about 5-10 weeks into pregnancy with rebound tenderness and rigidity
2) Amenorrhea
3) Vaginal bleeding or spotting with brownish discharge
4) Referred neck and shoulder pain
How is a diagnosis of ectopic pregnancy made?
1) Positive pregnancy test
2) Transvaginal ultrasound finds non-pregnant uterus
3) Beta hCG levels do not double as they should in a normal pregnancy
What is in the DDx for ectopic pregnancy?
Appendicitis
PID
Ovarian tumor
Spontaneous abortion
Ruptured cyst
Kidney stones
What are the common signs and symptoms of placenta previa?
Painless vaginal bleeding during second half of pregnancy
In what condition do you get erythroblastosis fetalis?
Rh incompatibility between mother and infant
What causes Rh incompatibility?
Mother who is Rh negative and a father who is Rh positive
What does Rh compatibility become a problem?
In a second or later pregnancy: first pregnancy causes sensitization
How is the mother affected by Rh incompatibility?
Asymptomatic
What are the symptoms of erythroblastosis fetalis?
Causes RBC destruction leading to fetal death or high bilirubin levels at birth, followed by poor feeding, flaccidity, seizures, apnea and neonatal death
When do most spontaneous abortions occur?
Between 8-12 weeks
How long might it take after fetal death for the fetus to be expelled?
2-4 weeks
What is usually done to confirm fetal death?
Ultrasound, beta hCG levels
What might indicate the onset of spontaneous abortion?
Cramping and/or bleeding without tissue loss
What can be triggered by retained products of conception?
DIC
What labs are indicated to closely to monitor for DIC?
PT, fibrinogen and platelet levels
What defines recurrent pregnancy loss?
History of 3 or more consecutive spontaneous abortions
What might be some of the causes of recurrent pregnancy loss?
1) Endocrine Factors: PCOS, luteal phase defect, DM, thyroid autoimmunity
2) Chromosomal abnormalities
3) Infection: Toxoplasmosis, cytomegalovirus
4) Uterine anomalies
5) Cervical insufficiency
6) Antiphospholipid syndrome
7) Factor XII deficiency
What are some of the risk factors for developing postpartum depression?
1) Personal history of depression
2) Lack of social/family/ financial support
3) Unplanned pregnancy
4) Miscarriage
What are common causes for lactation disorders?
Inadequate milk supply
Nipple and breast pain
Lip and tongue ties
Poor milk extraction by infant
What are the common presentations of postpartum thyroiditis?
1) Classic: hyperthyroidism, followed by hypothyroidism; followed by return to normal thyroid function 25%
2) Transient hyperthyroidism followed by return to normal thyroid function 32%
3) Transient hypothyroidism followed by return to normal thyroid function 43%
4) 30% remain hypothyroid 1 year after presentation
What are the common signs and symptoms of symphysis pubis dysfunction?
Suprapubic pain
Pain radiates to legs, hip or back
Worse with weight bearing, turning in bed or getting up from a chair
Symphysis separation >10-13 mm on imaging (not usually performed)
