GENETICS SG Flashcards
study guide questions
what are high-risk HR pregnancies?
- Corrected & non-corrected heart dx
- Cystic fibrosis
- Severe DM
- Severe asthmatics
who can become HR pregnancy?
- PTL/PROM * trauma related injuries, DIC
- pneumonia * placenta abnormalities
- PE/E, HELLP * multiple gestation
Cardiac Disease in pregnancy
- Rheumatic fever: (@50%, but now requiring 2* antibiotics
- mitral valve prolapse (very common)
- congenital heart defects - corrected & non-corrected T of F
- cardiomyopathies - many are pregnancy-induced
- dysrhythmias
how pregnancy influences cardiac system?
increase CO (40-50%) with peak @ 32-34 wks - then further increase during labor (may be as high as 10L during labor)
45% increase in bld vol - also helps at time of delivery as protective mechanism
hormonal influence –> vasodilation, increased peripheral resisitance
what are the classification in cardiac disease?
Class I: asymptomatic
Class II: symptomatic with increased activity
Class III: symptomatic with ordinary activity
Class IV: symptomatic at rest
chronic cardiac disease maternal effects?
increases oxygenation loss of function pulmonary edema dissecting aneurism pulmonary hypertension cardiac failure
what is the biggest cardiac risk during labor? for MOB with cardiac disease
pulmonary edema
chronic cardiac disease and fetal effects?
Fetal hypoxia FGR Fetal distress Mental retardation increase risk of cardiac anomaly (50%)
diabetes in pregnancy causes what maternal effects?
increased insulin production
increased peripheral resistance to insulin
increased antagonistic effect from hormones
“Diabetogenic State”
how GDM develops?
pancreatic B-cell fnc is impaired in response to increased stimulation & induced insulin resistance in pregnancy; 24-28 weeks
DM and maternal effects?
SAB/spontaneous abortion? PE/Eclampsia PTL Polyhydraminos Infection
maternal hyperglycemia effect on fetus?
- congenital anomalies
- macrosomia
- delayed lung maturity: increased BS interferes with PG (phosphyatidylglycerol) production, therefore mature fetal lung surfactant may not be present until 38-39 wks
GDM effect on fetus?
Anomalies & related sequalae Birth trauma Prematurity Hypoglycemia Hyperbilirubinemia Learning Disabilities Childhood obesity & Type II Diabetes
maternal thyroid disease
Thyroid hormones (T3 & T4) does not cross the placental barrier
Fetal thyroid synthesizes its own hormones (10 weeks)
Disease and drug therapy often have an adverse effect on pregnancy outcome
maternal hyperthyroid effect on neonate
Observe neonates for s/s of thyroid dx. S/s may not appear for 5-10 days after birth.
Hyperthyroidism in neonates may resolve in 1-3 months.
if MOB has graves, baby might have graves
Neonatal grave’s: increased HR, FGR, goiter, CHF
UTI in pregnancy, effects of fetus
FGR Chronic hypoxia Sepsis CNS Damage Fetal death
connective tissue disorder in pregnancy?
Rheumatoid arthritis
Multiple sclerosis
Scleroderma
Lupus
prenatal infections?
HIV, AIDS Hepatitis Pyelonephritis Chorioamnionitis STD’s CMV
preeclampsia vs eclampsia?
PE: development of HTN & proteinuria or edema during pregnancy after the 20th week gestation in a previously normotensive, non-proteinuric woman
Eclampsia: PE with seizure activity
Incidence
5-7% of pregnant women
closer to 10-20% in our population 2* to risk factors
risk factors for preeclampsia?
Primigravidas or 1st pregnancy with current partner
Teens or older gravida
Low socioeconomic & poor nutritional status
Previous history of PE
Familial history
Multiple gestation
Medical conditions: DM, CHTN, renal, lupus
RH incompatibility
preeclampsia maternal effects?
2nd leading cause of maternal mortality Vasospasms uteroplacental insufficiency kidney damage cerebral & visual changes Pulmonary & hemodynamic changes Fluid & electrolyte shifts/imbalances Seizures HELLP (10-24% mortality) DIC
