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NCM-109 > High Risk Pregnancy w/ Sudden Complication (2) > Flashcards

High Risk Pregnancy w/ Sudden Complication (2) Flashcards

1
Q
  • A condition that refers to the inability of the cervix to hold the fetus any longer until term because it has dilated prematurely

Termed “incompetent cervix”

A

PREMATURE CERVICAL DILATATION

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2
Q

Pink-tinged vaginal discharge

A

SHOW

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3
Q

This is ordered when incompetent cervix is suspected

A

ULTRASOUND

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4
Q

Surgical managements for Premature cervical dilatation

A
  1. McDonald’s Cervical Cerclage
  2. Shirodkar Cervical Cerclage
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5
Q

nylon sutures are placed horizontally and vertically across the cervix. They are pulled back together until the cervical canal is only a few mm in diameter.

A
  • McDonald’s Cervical Cerclage
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6
Q

sterile tape is used for this technique. It is threaded in a purse-string manner under the submucous layer of cervix. Then it is sutured in place so it would close the cervix

A
  • Shirodkar Cervical Cerclage
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7
Q
  • A condition in which the placenta is implanted abnormally in the uterus
A

PLACENTA PREVIA

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8
Q
  • It accounts for the most incidents of bleeding in the 3rd trimester
A

PLACENTA PREVIA

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8
Q
  • Premature separation of placenta that occurs late in pregnancy
A

PLACENTAL ABRUPTION

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9
Q

Types of Placenta Previa

A
  1. Low-lying placenta
  2. Marginal implantation
  3. Partial placenta previa
  4. Total placenta previa
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10
Q

hard, board-like uterus w/ none or minimally apparent bleeding present occurs

A

COUVELAIRE UTERUS

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11
Q

Grade ___ : No indication of placental separation and diagnosis of slight separation is made after birth.

A

GRADE 0

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11
Q

infection of the fetal membranes and fluid

A

CHORIOAMNIONITIS

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11
Q

This bleeding occurs if placenta separates first from the edges.

A

EXTERNAL BLEEDING

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12
Q

GRADE __: Minimal separation w/c causes vaginal bleeding, but no changes in fetal VS occur

A

GRADE 1

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13
Q

GRADE ___ : Moderate separation occurs and fetal distress is already evident. Uterus is hard & painful upon palpation

A

GRADE 2

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13
Q

GRADE __ : Extreme separation; maternal shock and fetal death is imminent if no interventions are done

A

GRADE 3

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14
Q

This bleeding occurs if placenta separates from the center because blood would pool under it.

A

INTERNAL BLEEDING

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15
Q

During placental abruption a woman may experience sharp, stabbing pain on the ________ as initial separation occurs

A

UPPER UTERINE FUNDUS

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15
Q

Uterus that is tense & rigid

A

COUVELAIRE UTERUS

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15
Q

this test would be taken several times before birth to detect DIC

A

FIBRINOGEN DETERMINATION

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16
Q
  • An acquired disorder of blood clotting in which the fibrinogen level falls to below effective limits
A

DISSEMINATED INTRAVASCULAR COAGULATION (DIC)

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17
Q

This occurs when there is such extreme bleeding and so many platelets and fibrin from the general circulation rush to the site that not enough are left in the rest of the body

A

DISEEMINATED INTRAVASCULAR COAGULATION (DIC)

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17
Q

must be give cautiously close to birth or postpartum hemorrhage could occur from poor clotting after delivery of placenta

A

HEPARIN

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17
Q
  • Labor that occurs before end of 37th week of gestation
A

PRETERM LABOR

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18
Q

This strengthens uterine contractions

A

OXYTOCIN

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18
Q

Management / Interventions for Preterm Labor

A
  1. Bed rest
  2. Hydration (IV fluid therapy)
  3. Tocolytics
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19
Q

This drug is administered to accelerate formation of fetal lung surfactant

A

CORTICOSTEROIDS

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19
Q

reduces risk of cerebral palsy for babies born before 32 weeks gestation

A

MAGNESIUM SULFATE

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20
Q

These are given to temporarily stop contractions

A

TOCOLYTICS

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21
Q

Typical fetus moves ______ times in an hour

A

10 TIMES IN 1 HR

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21
Q

It is done if fetus very immature and labor can’t be halted to reduce pressure on fetal head and possibility of subdural / intraventricular hemorrhage from vaginal birth

A

C-SECTION

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22
Q

Rupture of fetal membranes w/ loss of amniotic fluid before 37 wks

A

PRETERMPREMATURE RUPTURE OF MEMBRANES (PPROM)

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22
Q

Risk factors of PROM

A
  • Chorioamnionitis
  • Vaginal infections
  • Cervical abnormalities
  • Smoking
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23
Q

Amniotic membrane rupture before or after 37 completed weeks and not in labor yet

A

PREMATURE RUPTURE OF MEMBRANES (PROM)

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24
Q

Risk Factors for PROM

A
  • Chorioamnionitis
  • Vaginal infections
  • Cervical abnormalities
  • Smoking
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24
Q

– extension of the cord out of the uterine cavity into the vagina

A

CORD PROLAPSE

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25
Q

distorted facial features and pulmonary hypoplasia from pressure

A

POTTER-LIKE SYNDROME

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25
Q

Complications of PROM

A
  • Cord prolapse
  • Cord compression
  • Placental abruption
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26
Q

Special tests for PROM

A
  1. Fern test
  2. Litmus test
  3. Nitrazine test
27
Q

visualization of a “fern-like” pattern on a slide, viewed under microscope; if water is broken, the fluid mixed together with estrogen and create a fern-like pattern due to salt crystallization.

A

FERN TEST

27
Q

amniotic fluid has an alkaline pH (7.1-7.3), and the paper will turn blue

A

LITMUS TEST

28
Q

involves putting a drop of liquid obtained from vagina to paper strips containing nitrazine dye.

A

NITRAZINE TEST

28
Q

This color of the strip means that membranes have ruptured

A

BLUE

29
Q

In management of PPROM, this type of antibiotic should be avoided

A

CO-AMOXICLAV

29
Q

This antibiotic is given if woman CANNOT tolerate erythromycin

A

PENICILLIN

30
Q

Antibotics for the management of PPROM

A

ERYTHROMYCIN
AMPICILLIN
PENICILLIN

30
Q

This is done for lower genital tract infections beneficial in preventing preterm birth

A

SCREENING

30
Q
  • A condition in which vasospasm occurs during pregnancy in both small and large arteries
A

PIH or GESTATIONAL HYPERTENSION

31
Q
  • Most common medical problem encountered during pregnancy
A

PREGNANCY INDUCED HYPERTENSION (PIH)

31
Q

original term for PIH because researchers pictured a toxin of some kind being produced by the woman in response to the foreign protein of the growing fetus, the toxin leading to the typical symptoms. No such toxin identified.

A

TOXAEMIA

32
Q
  • Third leading cause of maternal mortality after thromboembolism and non-obstetric injuries
A

PIH

32
Q

4 Categories of PIH

A
  • Chronic Hypertension
  • Pregnancy Induced Hypertension
  • Preeclampsia-Eclampsia
  • Preeclampsia superimposed on chronic HTN
33
Q

if BP elevation >140/90 BEFORE 20 weeks and persists >12 weeks postpartum

A

CHRONIC HTN

34
Q
  • Most severe classification of PIH
  • W/ Seizure or coma (+)
A

ECLAMPSIA

35
Q

if BP return to normal by 12 weeks postpartum

A

GESTATIONAL HTN

35
Q
  • if BP elevation >140/90 BEFORE 20 weeks and persists >12 weeks postpartum
A

CHRONIC HTN

35
Q
  • No edema, no proteinuria, and blood pressure returns to normal AFTER birth
A

GESTATIONAL HTN

36
Q

Given for women in active labor with uncontrolled severe chronic HTN

A

IV Labetalol or hydralazine

36
Q

Common agents as treatment for chronic hypertension

A
  • METHYLDOPA
  • LABETALOL
  • NIFEDIPINE
37
Q
  • BP >140/90 mmHg taken on two occasions at least 6 hours apart
  • Sys >30 mmHg; Dys >15 mmHg (above pregnancy values)
  • 1+ or 2+ Proteinuria
  • Usually happens < 20 weeks gestation
A

MILD PREECLAMPSIA

38
Q

Manifestations of Chronic hypertension

A
  1. BP elevation >140/90 BEFORE 20 WEEKS
38
Q

This position is to avoid uterine pressure on vena cava and prevent supine hypotension

A

LATERAL RECUMBENT POSITION

39
Q
  • BP risen to 160/110 mmHg or greater on at least two occasions 6 hrs apart at bed rest
  • Marked 3+ or 4+ proteinuria
  • Cerebral or visual disturbances
A

SEVERE PREECLAMPSIA

40
Q

best method in aiding evacuation of sodium and encouraging diuresis

A

BED REST

40
Q

Manifestations of Gestational HTN

A

o BP ≥ 140/90 mmHg when ≥ 160/≥ 110 mmHg
o Previously normotensive
o ≥ 20 weeks gestation

  • No edema, no proteinuria, and blood pressure returns to normal AFTER birth
40
Q

Manifestations of mild preeclampsia

A

BP >140/90
1+ or 2+ proteinuria
Weight gain
less than 20 weeks gestation

40
Q

Manifestation of eclampsia

A

Hypertension
Edema
Proteinuria
Seizures

40
Q

Manifestations of severe preeclampsia

A

BP >160/110
3+ or 4+ proteinuria
Extreme edema
Oliguria
Visual disturbances

41
Q

Normal blood serum for MgSo4

A

5-8mg/100 mL

41
Q

Main medicine for treating eclampsia

A

MAGNESIUM SULFATE

41
Q

Medications to prevent eclampsia

A

-Hydralazine
-Labetalol
-Nifedipine
-Cathartic
-Magnesium sulfate

42
Q

Stages of Tonic-Clonic seizures in eclampsia

A
  1. Preliminary or aura
  2. Clonic stage
  3. Postictal stage
42
Q

Signs of MgSo4 toxicity

A

 Decreased urine output
 Depressed respirations
 Reduced consciousness
 Decreased deep tendon reflex

42
Q

reduces edema by causing shift in fluid from extracellular spaces into intestine, has CNS depressant action

A

CATHARTIC

42
Q

Antidote for MgSo4 toxicity

A

CALCIUM GLUCONATE

42
Q

New or increased proteinuria, development of increasing blood pressure, or HELLP syndrome

A

PREECLAMPSIA SUPERIMPOSED ON CHRONIC HTN

43
Q

is tearing of the fetal
membranes with loss of amniotic fluid before the pregnancy is at term.

A

PRETERM RUPTURE OF MEMBRANES

44
Q

is a unique disorder that
occurs with pregnancy with three classic symptoms: hypertension, edema, and proteinuria

A

PREGNANCY INDUCED HYPERTENSION

44
Q

a unique form of pregnancyinduced hypertension marked by hemolysis of red blood cells, elevated liver enzymes, and a low platelet count.

A

HELLP SYNDROME

45
Q

Division takes place between 4th and 8th day after formation of inner cell mass when chorion has already developed

A

Diamniotic-monochorionic

45
Q
  • Occurs when more than one fetus simultaneously develops in the uterus
A

MULTIPLE PREGNANCY

45
Q

Meaning of HELLP

A
  • Hemolysis
    -Elevated liver enzymes
  • Low platelet
45
Q

fertilization of two ova leading to fraternal twin

A

DIZYGOTIC TWINS

45
Q

Results from fertilization of TWO OVA, most likely rupture from two distinct graafian follicles usually of the same or one from each ovary, by TWO SPERMS during single ovarian cycle.

A

DIZYGOTIC TWINS

45
Q

fertilization of one ova leading to identical twin

A

MONOZYGOTIC TWINS

45
Q

is overproduction of amniotic fluid (above 2000 mL), a condition that can lead to ruptured membranes and premature birth because of increased intrauterine pressure

A

HYDRAMNIOS

45
Q

simultaneous development of two fetuses

  • Most common variety of multiple pregnancy
A

TWIN PREGNANCY

45
Q

the lessened amount of
fluid and suggests a renal disorder exists in the fetus.

A

OLIGOHYDRAMNIOS

46
Q

 Single ovum twins
 One placenta
 One chorion
 Two amnions
 Two umbilical cords
 ALWAYS of the same sex

A

MONOZYGOTIC TWINS

46
Q

-Division occurs after 8th day of fertilization when amniotic cavity has already formed

A

Monoamniotic-monochorionic

46
Q

Twinning may occur at different periods after fertilization: (4)

A
  1. Diamniotic-dichorionic
  2. Diamniotic-monochorionic
  3. Monoamniotic-monochorionic
  4. Conjoined twin
46
Q

Division after 2 weeks

A

Conjoined twins

46
Q

-Division takes place within 72 hrs after fertilization

A

Diamniotic-dichorionic

47
Q

Excess amniotic fluid more than 2000 mL

A

HYDRAMNIOS

47
Q
  • Normal amniotic fluid volume
A

500-1000 mL

48
Q

 Pregnancy with less than average amount of amniotic fluid

A

OLIGOHYDRAMNIOS

49
Q

to remove extra amniotic fluid (polyhydramnios)

A

AMNIOCENTESIS

50
Q

instillation of fluid to uterus

A

AMNIOTRANSFUSION

NCM-109 (9 decks)

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