High Risk Pregnancy (AI made these) Flashcards
What is Preterm Labor?
Labor (cervical change) between 20 and 36 6/7 weeks gestation.
Leading cause of fetal/infant mortality and morbidity in the US.
List three signs and symptoms of Preterm Labor.
- More than 6 uterine contractions in an hour
- Cramping
- Leaking of fluid
What are the risk factors for Preterm Labor?
- Prior history of incompetent cervix or preterm delivery
- Infections: BV, STI, HPV
- Multiple pregnancy
Fill in the blank: To prevent Preterm Labor, obtain good _______.
[prenatal care]
What is Preterm Premature Rupture of Membranes (PPROM)?
Rupture of the amniotic sac prior to 37 weeks gestation.
Signs include leaking of fluid from the vagina.
What is the management approach for PPROM?
- Active vs. expectant management
- Prevention of infection
- Bedrest
What are the types of Hypertensive Disorders in Pregnancy?
- Chronic Hypertension
- Gestational Hypertension
- Preeclampsia
What is a significant risk factor for Preeclampsia?
Pre-gestational hypertension or diabetes.
Other factors include obesity and extremes of age.
True or False: Preeclampsia can present with severe features.
True
What is the recommended treatment for severe Preeclampsia?
- Monitor for worsening symptoms
- Administer Magnesium Sulfate
- Fetal monitoring
Fill in the blank: Normal levels of magnesium are _______.
[1.5-2.5]
What are the risks associated with Diabetes in Pregnancy?
- Preterm Labor
- Increased risk for preeclampsia/eclampsia
- Macrosomia
What is the management strategy for Gestational Diabetes?
- Diet control
- Insulin therapy
- Glucose monitoring
What is Placenta Previa?
Placenta partially or completely covers the os, or opening of the cervix.
Can present with painless, bright red bleeding.
What is the primary management for a patient with Placenta Previa?
- No vaginal exams
- Maintain large-bore IV access
- Frequent monitoring of vital signs
List the causes of Placental Abruption.
- Abdominal trauma
- Vasospasm
- Preeclampsia or HTN
What is the hallmark sign of Placental Abruption?
Painful, dark red bleeding in smaller amounts than previa.
Can lead to maternal shock and fetal distress.
What is Rh factor incompatibility?
Rh negative mothers with Rh positive babies, leading to maternal antibody formation.
Subsequent pregnancies can be affected.
What is the purpose of administering Rhogam?
To prevent Rh factor incompatibility complications.
Administered at 24-28 weeks gestation and within 72 hours of delivery.
What infections are included in the TORCH complex?
- Toxoplasmosis
- Other infections
- Rubella
- Cytomegalovirus (CMV)
- Herpes Simplex Virus
What is the consequence of contracting Toxoplasmosis during pregnancy?
Causes intellectual disability in the baby if contracted prenatally.
True or False: The MMR vaccine is contraindicated during pregnancy.
True
What is the management for a woman with Herpes Simplex Virus during pregnancy?
- Valcyclovir for suppression
- Cesarean for active outbreak
What is the goal of HIV management in pregnancy?
Healthy mom, no vertical transmission to fetus/newborn.
What is a common side effect of Magnesium Sulfate?
Pt. feels hot, ‘flu-ish.’
What is the antidote for Magnesium Sulfate toxicity?
Calcium Gluconate.
What is the primary goal of pregnancy management in HIV-positive women?
Healthy mom, no vertical transmission to fetus/newborn
What should HIV positive women adhere to during pregnancy?
ART (Antiretroviral Therapy)
What is the mode of delivery for mothers with a viral load over 1,000 copies?
Cesarean
What is the mode of delivery for mothers with a viral load under 1,000 copies?
Vaginal birth; avoid invasive procedures
What prophylaxis is recommended in labor for HIV positive mothers?
Zidovudine (AZT)
What is the normal flora percentage for Group Beta Strep in women?
20%
What is the recommended prophylaxis for Group Beta Strep during labor?
Penicillin every 4 hours
What should be monitored in newborns exposed to Group Beta Strep?
Decreased temp, poor feeding, lethargy, CBC shift to the left, elevated CRP
What is Hyperemesis Gravidarum?
Excessive vomiting during pregnancy that interferes with nutrition
What is the management strategy for Hyperemesis Gravidarum?
- Replace fluids and electrolytes, especially K+ * NPO until vomiting stops * Anti-emetics (Zofran, Reglan, Phenergan, Diclegis) * TPN via central line may be necessary * Measure I&O * Provide emotional support
What percentage of pregnant women reportedly use one or more illicit addictive substances?
5%
What is SBIRT in the context of substance abuse in pregnancy?
Screening, brief intervention, referral to treatment
What is the key statistic regarding maternal drinking during pregnancy?
20 to 30 percent of women reported drinking at some point during pregnancy
What are some craniofacial features associated with Fetal Alcohol Syndrome (FAS)?
- Skin folds at the corner of the eye * Low nasal bridge * Short nose * Indistinct philtrum * Small head circumference * Small eye opening * Small midface * Thin upper lip
True or False: There is a safe amount of alcohol during pregnancy.
False
What is the incidence of Fetal Alcohol Spectrum Disorder (FASD) estimated to be?
One in 20 school-aged children
What are some adverse outcomes associated with Opioid Use Disorder (OUD) during pregnancy?
- Neonatal Abstinence Syndrome (NAS) * Pregnancy loss * Sepsis * Exposure to hepatitis, HIV * Fetal growth restriction * Preeclampsia * Postpartum hemorrhage * Fetal seizures
What has been the increase percentage of opioid abuse in pregnancy from 2010 to 2017?
131%
What is the recommendation for women who use medicinal marijuana during pregnancy?
Discontinue and be offered safer treatments
What are some effects of marijuana use during pregnancy?
- Low birth weight * Neurological issues (impaired social interaction, cognitive and attention deficits, abnormal response to sensory stimuli)
What are some potential problems associated with MDMA use during pregnancy?
May cause problems with learning, memory, and motor development
What complications can cocaine and methamphetamine use during pregnancy cause?
- Intrauterine growth restriction * Low birth weight * Pregnancy loss (stillbirth or miscarriage) * Placental abruption * Hypertensive disorders * Preterm delivery * Neonatal death
