HIGH RISK PREGNANCY Flashcards
a woman who develops a complication of pregnancy
high risk pregnancy
signs of hypovolemic shock
rapid and weak pulse. low bp, clammy skin
causes of bleeding in 1st trimester
abortion and ectopic pregnancy
causes of bleeding 2nd trimester
hydatidiform mole and premature cervical dilatation of cervix
causes of bleeding 3rd trimester
placenta previa, abruptio placenta, preterm labor
any interruption of pregnancy before fetus is viable
abortion
fetus is viable (weeks or weight)
20 weeks 500 grams
types of abortion
spontaneous, threatened, imminent, complete, incomplete, missed, recurrent
threatened : under __ weeks; late __ to __ weeks
16, 16 to 24
complications of abortion (HISIP)
hemorrhage, infection, septic abortion, isoimmunization, powerlessness or anxiety
implantation outside uterine cavity (in ampulla)
ectopic pregnancy
bluish tinge discoloration
cullen’s sign
signs of ectopic pregnancy
stabbing pain in lower abd quadrants, rapid rr, weakness, boggy and tender uterus
management for ectopic pregnancy
methotrexate and mifepristone
management if ruptured ectopic pregnancy
cbc, hgb, IV and laparoscopy
ligate bleeders and repair damaged fallopian tube
laparoscopy
abnormal proliferation and degeneration of trophoblastic villi
Hydatidiform mole
hydatidiform mole assessment
abnormally large uterus, high hcg, no fetal heart sounds, hyperemesis gravidarum
incompetent cervix - cervix dilates prematurely
premature cervix dilatation
causes of incompetent cervix
congenital development factors, endocrine factors, trauma to cervix
signs and symptoms of incompetent cervix
presence of show and uterine contractions, rupture of membranes and painless cervical dilatation.
management for incompetent cervix
cervical cerclage (mcdonald or shirodkar procedure)
low implantation of placenta
placenta previa
types of placenta previa
low-lying, marginal partial, complete
placenta previa bleeding
abrupt, painless and bright red
management for placenta previa
bedrest or side-lying position, do not attempt internal examinations, monitor intake and output, obtain vital signs, weigh perineal pads, external fetal monitor, blood works, O2 therapy
drug lung surfactant for placenta previa
methamethasone or dexamethasone
predisposing factors of placenta previa
increasing parity, advanced maternal age and rapid succession if pregnancies
premature separation of placenta
abruptio placenta
signs and symptoms of abruptio placenta
sharp stabbing pain high in fundus, dark red painful bleeding
predisposing factors of abruptio placenta
high parity, advanced maternal age, short umbilical cord, chronic hypertensive disease, PIH, direct trauma, cigarette use and autoimmunity
assessment for abruptio placenta
couvelaire uterus, signs of shock, uterus is tense and firm, DIC syndrome
management for abruptio placenta
blood works, IV, O2 by mask, side-lying position, no vaginal examination, monitor intake and output, monitor bleeding, monitor vs and fht, IV administration of fibrinogen and cryoprecipitate
acquired disorder of blood clotting - easy bruising
disseminated intravascular coagulation
management for DIC
dilatation and curettage, dilatation and evacuation, IV administration of heparin, blood or platelet transfusion
preterm labor is associated with..
dehydration, uti and chorioamnionitis
common symptoms of preterm labor
persistent dull low backache, vaginal spotting, pelvic pressure, uterine contractions, increased vaginal discharge, intestinal cramping
how to rule out infection in preterm labor
cervical and vaginal cultures and clean catch urine sample
oral tocolytic
duvadilan and duphaston
drug administration for preterm labor
antibiotic for group b streptococcus prophylaxis, administration of corticosteroid to fetus (dexamethasone), magnesium sulfate
