Guest- Common Preg Problems Flashcards
when is the 1st, 2nd and 3rd trimesters?
1st- conception to 13 weeks
2nd- 13-26 weeks
3rd- 26 weeks to delivery
5 first trimester probs
1) . Morning sickness and hyperemesis gravidum
2) . Gestational trophoblastic neoplasia
3) . 1st trimester bleeding
4) . Drugs in pregnancy
5) . Multiple gestations
how common is morning sickness? cause? when is it usually gone by? what is it associated with?
more than half of pregnancies; unclear etiology; gone by 2nd trimester; high hCG levels
weeks __-___ are usually when women feel the worst (in terms of N/V). at 10 weeks, hCG levels are about __________
7-10; 100,000
a full pregnancy is considered ___ weeks but a woman is usually only pregnant for ___ weeks
40; 38
tx for morning sickness: diet and drugs
diet- high in simple carbs, avoid animal protein/dairy
(small frequent meals)
drugs- doxylamine and vitamin B6 (maybe promethazine)
what is hyperemesis gravidarum (HEG)?
intractable vomiting severe enough to cause fluid and electrolyte disturbance
how common is HEG? how does the pt present? what does the UA show?
less than 1% of all pregnancies; tachycardia and orthostatic BPs; UA shows ketouria and Na/K/HCO3 disturbances
Tx for HEG?
IV fluids, electrolyte replacement, vitamin B6 and doxylamine
benign and malignant forms of gestational trophoblastic dz are called…
benign- hydatidiform mole
malignant- choriocarcinoma
hydatidiform mole: has increased lab values of? absence of? what test is this confirmed by? how to tx?
increased hCG; absence of fetal heart tones; confirmed by US; refer to OB for D and C
choriocarcinoma is common or rare? elevated levels of what still persist after molar evacuation?
RARE; hCG still elevated
___________ ________ is any bleeding before 20 weeks
threatened abortion
presence of what doesn’t rule out threatened abortion?
fetal heart tones
definition of miscarriage?
passage of product of conception
1st trimester bleeding is how common? 4 possible causes of it?
very common, may be greater than half of all pregnancies
causes- ectopic preg, molar preg, cervicitis, placenta previa
what is a molar pregnancy?
rare complication when tissue inside the uterus becomes a mass or tumor
what is the 1st step in 1st trimester bleeding work up? Second step?
confirm IUP- intrauterine preg; second- speculum exam (evaluate vagina vault, rule out cervicitis, check hCG and Rh status)
teratogenic effects of drugs are ______ in 1st trimester
worse
describe use of Zofran in 1st trimester and lactation
Zofran- consider avoiding in 1st trimester and safety unknown in lactation
describe use of ibuprofen in 1st trimester and lactation
1st trimester- caution advised, don’t use after 30 weeks (may delay ovulation when trying to get pregnant)
Lactation- NSAID of choice for pain while breastfeeding
incidence of multiple births? describe how monozygotic and dizygotic twins form
1.5% of all births; monozygotic us single fertilized ovum divides;
dizygotic is 2 ova fertilized by 2 sperm
two fetal complications of twins?
premature birth and twin to twin transfusion (TTTS)
what is TTTS?
disease of the placenta that affects identical twin pregnancies; twins share a common placenta and one twin has a decreased blood volume
5 problems that can occur in the 2nd trimester
1) . Rh Incompatibility
2) . GERD
3) . Incompetent Cervix
4) . Round ligament Pain
5) . Pre-term Contractions or Pre-term Labor
Rh+ people have antigens on _____; ___-___% of people are Rh negative
RBCs; 10-15%
describe what the Rh incompatibility is
problem when Rh+ fetus blood gets in Rh- maternal blood stream
