High Risk Pregnancy Conditions Flashcards
Skin Changes and Rashes of Pregnancy
● Melasma ● Dark spots/Darkening of freckles and moles ● Pregnancy glow ● Acne ● Linea Nigra ● Stretch marks ● PUPPP ● Skin Tags
Effects of Increased Vascularization in Pregnancy
● Bloody noses
● Swollen/tender gums
● Spider veins/Spider Nevi–Small, reddish vessels that branch outward. Usually seen on the face, neck, upper chest and arms.
● Varicose veins–Bulky, bluish veins that typically appear
on the legs during pregnancy.
● Edema
While there is no known cause, women who have PreE or eclampsia have a much higher risk of this condition.
It is a medical emergency that needs VERY QUICK treatment, as it is life threatening!
HELLP Syndrome
HELLP Stands for hemolysis, elevated liver enzymes, and low platelet count.
What is the treatment for HELLP Syndrome
Treat with: Corticosteroids, antihypertensives, administration of blood products/components and DELIVERY!!!
Signs and symptoms of preeclampsia
Increased BP
Weight gain
Proteinuria
Facial puffiness
Pedal edema
Pancreas unable to deal with the increased insulin requirements of
pregnancy
○ Increased insulin resistance secondary to hormones released during pregnancy ○ Change in carbohydrate metabolism
Gestational Diabetes
Risk factors of Gestational Diabetes
● Being overweight/obese ● Sedentary lifestyle ● Hx of prediabetes ● Prior GDM in previous pregnancy ● PCOS ● FH of DM ● Prior hx of of a baby weighing greater than 9 lbs (4.1 kg) ● Black, hispanic, american indian and asian american ethnicities
When to screen for gestational diabetes
24-28 weeks, screen glucose in urine
What are complications of gestational diabetes
Macrosomia
Preeclampsia
Hypoglycemia
● A maternal liver condition that typically occurs in later pregnancy, causing bile acids to enter the bloodstream. As bile acids rise, fetal safety is significantly compromised!
● When bile acids enter the bloodstream, it causes intense, “maddening”
itching that is mostly on the soles of the feet and palms of the hands..
● The exact cause is unknown, but pregnancy hormones may be involved.
● Pregnancy hormones rise throughout pregnancy and this may be what
causes a slow down in the normal flow/excretion of bile through the bile
duct.
Cholestasis of Pregnancy
Risk factors of Cholestasis of pregnancy
● A personal or FH of cholestasis of pregnancy
● History of liver damage or disease
● Being a parent of multiples
Complications of Cholestasis of Pregnancy
For the mother:
- SEVERE itching —often there can be scarring resulting from maternal scratching
- rarely causes a temporary disruption in the way the mother’s body absorbs fat
- this results in lower vit-K-dependent factors-can impact the ability to clot!
For the fetus
- preterm birth
- lung problems—from aspiration of meconium
- death!
Treatment of Cholestasis of Prefnancy
● There is no known prevention, so the focus is always early
recognition and intervention!
● If still in the early third trimester (before 36 weeks), the focus is
on giving Ursodiol, which helps to lower bile acids in the blood. It
also may help to relieve some of the symptoms of itching.
● If before 36 weeks, the fetus is also closely monitored with NSTs
at least twice weekly.
● If after 36-37 weeks, plan to deliver no matter what.
An egg is fertilized, but impants outside of the uterine cavity
○ Fallopian tube
○ Cervix
○ Abdomen
Ectopic pregnancy
What is the therapeutic management of Ectopic Pregnancy?
● PREVENT rupture!!
○ Detect with US
○ Surgically removed
● Methotrexate
○ Stops the embryo from being able to grow
○ Aborts the fetus
● Rh immune globulin
○ Given to mom if they is Rh negative
○ Prevent erythroblastosis fetalis — Don’t know Rh type of fetus, Better safe than sorry!
