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
2
Q
Pink-tinged vaginal discharge
A
SHOW
3
Q
This is ordered when incompetent cervix is suspected
A
ULTRASOUND
4
Q
Surgical managements for Premature cervical dilatation
A
- McDonald’s Cervical Cerclage
- Shirodkar Cervical Cerclage
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
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
7
Q
- A condition in which the placenta is implanted abnormally in the uterus
A
PLACENTA PREVIA
8
Q
- It accounts for the most incidents of bleeding in the 3rd trimester
A
PLACENTA PREVIA
8
Q
- Premature separation of placenta that occurs late in pregnancy
A
PLACENTAL ABRUPTION
9
Q
Types of Placenta Previa
A
- Low-lying placenta
- Marginal implantation
- Partial placenta previa
- Total placenta previa
10
Q
hard, board-like uterus w/ none or minimally apparent bleeding present occurs
A
COUVELAIRE UTERUS
11
Q
Grade ___ : No indication of placental separation and diagnosis of slight separation is made after birth.
A
GRADE 0
11
Q
infection of the fetal membranes and fluid
A
CHORIOAMNIONITIS
11
Q
This bleeding occurs if placenta separates first from the edges.
A
EXTERNAL BLEEDING
12
Q
GRADE __: Minimal separation w/c causes vaginal bleeding, but no changes in fetal VS occur
A
GRADE 1
13
Q
GRADE ___ : Moderate separation occurs and fetal distress is already evident. Uterus is hard & painful upon palpation
A
GRADE 2
13
Q
GRADE __ : Extreme separation; maternal shock and fetal death is imminent if no interventions are done
A
GRADE 3
14
Q
This bleeding occurs if placenta separates from the center because blood would pool under it.
A
INTERNAL BLEEDING
15
Q
During placental abruption a woman may experience sharp, stabbing pain on the ________ as initial separation occurs
A
UPPER UTERINE FUNDUS
15
Q
Uterus that is tense & rigid
A
COUVELAIRE UTERUS
15
Q
this test would be taken several times before birth to detect DIC
A
FIBRINOGEN DETERMINATION
16
Q
- An acquired disorder of blood clotting in which the fibrinogen level falls to below effective limits
A
DISSEMINATED INTRAVASCULAR COAGULATION (DIC)
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)
17
Q
must be give cautiously close to birth or postpartum hemorrhage could occur from poor clotting after delivery of placenta
A
HEPARIN
17
* Labor that occurs before end of 37th week of gestation
PRETERM LABOR
18
This strengthens uterine contractions
OXYTOCIN
18
Management / Interventions for Preterm Labor
1. Bed rest
2. Hydration (IV fluid therapy)
3. Tocolytics
19
This drug is administered to accelerate formation of fetal lung surfactant
CORTICOSTEROIDS
19
reduces risk of cerebral palsy for babies born before 32 weeks gestation
MAGNESIUM SULFATE
20
These are given to temporarily stop contractions
TOCOLYTICS
21
Typical fetus moves ______ times in an hour
10 TIMES IN 1 HR
21
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
C-SECTION
22
Rupture of fetal membranes w/ loss of amniotic fluid before 37 wks
PRETERMPREMATURE RUPTURE OF MEMBRANES (PPROM)
22
Risk factors of PROM
- Chorioamnionitis
- Vaginal infections
- Cervical abnormalities
- Smoking
23
Amniotic membrane rupture before or after 37 completed weeks and not in labor yet
PREMATURE RUPTURE OF MEMBRANES (PROM)
24
Risk Factors for PROM
- Chorioamnionitis
- Vaginal infections
- Cervical abnormalities
- Smoking
24
– extension of the cord out of the uterine cavity into the vagina
CORD PROLAPSE
25
distorted facial features and pulmonary hypoplasia from pressure
POTTER-LIKE SYNDROME
25
Complications of PROM
* Cord prolapse
* Cord compression
* Placental abruption
26
Special tests for PROM
1. Fern test
2. Litmus test
3. Nitrazine test
27
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.
FERN TEST
27
amniotic fluid has an alkaline pH (7.1-7.3), and the paper will turn blue
LITMUS TEST
28
involves putting a drop of liquid obtained from vagina to paper strips containing nitrazine dye.
NITRAZINE TEST
28
This color of the strip means that membranes have ruptured
BLUE
29
In management of PPROM, this type of antibiotic should be avoided
CO-AMOXICLAV
29
This antibiotic is given if woman CANNOT tolerate erythromycin
PENICILLIN
30
Antibotics for the management of PPROM
ERYTHROMYCIN
AMPICILLIN
PENICILLIN
30
This is done for lower genital tract infections beneficial in preventing preterm birth
SCREENING
30
* A condition in which vasospasm occurs during pregnancy in both small and large arteries
PIH or GESTATIONAL HYPERTENSION
31
* Most common medical problem encountered during pregnancy
PREGNANCY INDUCED HYPERTENSION (PIH)
31
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.
TOXAEMIA
32
* Third leading cause of maternal mortality after thromboembolism and non-obstetric injuries
PIH
32
4 Categories of PIH
* Chronic Hypertension
* Pregnancy Induced Hypertension
* Preeclampsia-Eclampsia
* Preeclampsia superimposed on chronic HTN
33
if BP elevation >140/90 BEFORE 20 weeks and persists >12 weeks postpartum
CHRONIC HTN
34
* Most severe classification of PIH
* W/ Seizure or coma (+)
ECLAMPSIA
35
if BP return to normal by 12 weeks postpartum
GESTATIONAL HTN
35
* if BP elevation >140/90 BEFORE 20 weeks and persists >12 weeks postpartum
CHRONIC HTN
35
* No edema, no proteinuria, and blood pressure returns to normal AFTER birth
GESTATIONAL HTN
36
Given for women in active labor with uncontrolled severe chronic HTN
IV Labetalol or hydralazine
36
Common agents as treatment for chronic hypertension
- METHYLDOPA
- LABETALOL
- NIFEDIPINE
37
* 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
MILD PREECLAMPSIA
38
Manifestations of Chronic hypertension
1. BP elevation >140/90 BEFORE 20 WEEKS
38
This position is to avoid uterine pressure on vena cava and prevent supine hypotension
LATERAL RECUMBENT POSITION
39
* 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
SEVERE PREECLAMPSIA
40
best method in aiding evacuation of sodium and encouraging diuresis
BED REST
40
Manifestations of Gestational HTN
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
Manifestations of mild preeclampsia
BP >140/90
1+ or 2+ proteinuria
Weight gain
less than 20 weeks gestation
40
Manifestation of eclampsia
Hypertension
Edema
Proteinuria
Seizures
40
Manifestations of severe preeclampsia
BP >160/110
3+ or 4+ proteinuria
Extreme edema
Oliguria
Visual disturbances
41
Normal blood serum for MgSo4
5-8mg/100 mL
41
Main medicine for treating eclampsia
MAGNESIUM SULFATE
41
Medications to prevent eclampsia
-Hydralazine
-Labetalol
-Nifedipine
-Cathartic
-Magnesium sulfate
42
Stages of Tonic-Clonic seizures in eclampsia
1. Preliminary or aura
2. Clonic stage
3. Postictal stage
42
Signs of MgSo4 toxicity
Decreased urine output
Depressed respirations
Reduced consciousness
Decreased deep tendon reflex
42
reduces edema by causing shift in fluid from extracellular spaces into intestine, has CNS depressant action
CATHARTIC
42
Antidote for MgSo4 toxicity
CALCIUM GLUCONATE
42
New or increased proteinuria, development of increasing blood pressure, or HELLP syndrome
PREECLAMPSIA SUPERIMPOSED ON CHRONIC HTN
43
is tearing of the fetal
membranes with loss of amniotic fluid before the pregnancy is at term.
PRETERM RUPTURE OF MEMBRANES
44
is a unique disorder that
occurs with pregnancy with three classic symptoms: hypertension, edema, and proteinuria
PREGNANCY INDUCED HYPERTENSION
44
a unique form of pregnancyinduced hypertension marked by hemolysis of red blood cells, elevated liver enzymes, and a low platelet count.
HELLP SYNDROME
45
Division takes place between 4th and 8th day after formation of inner cell mass when chorion has already developed
Diamniotic-monochorionic
45
* Occurs when more than one fetus simultaneously develops in the uterus
MULTIPLE PREGNANCY
45
Meaning of HELLP
- Hemolysis
-Elevated liver enzymes
- Low platelet
45
fertilization of two ova leading to fraternal twin
DIZYGOTIC TWINS
45
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.
DIZYGOTIC TWINS
45
fertilization of one ova leading to identical twin
MONOZYGOTIC TWINS
45
is overproduction of amniotic fluid (above 2000 mL), a condition that can lead to ruptured membranes and premature birth because of increased intrauterine pressure
HYDRAMNIOS
45
simultaneous development of two fetuses
- Most common variety of multiple pregnancy
TWIN PREGNANCY
45
the lessened amount of
fluid and suggests a renal disorder exists in the fetus.
OLIGOHYDRAMNIOS
46
Single ovum twins
One placenta
One chorion
Two amnions
Two umbilical cords
ALWAYS of the same sex
MONOZYGOTIC TWINS
46
-Division occurs after 8th day of fertilization when amniotic cavity has already formed
Monoamniotic-monochorionic
46
Twinning may occur at different periods after fertilization: (4)
1. Diamniotic-dichorionic
2. Diamniotic-monochorionic
3. Monoamniotic-monochorionic
4. Conjoined twin
46
Division after 2 weeks
Conjoined twins
46
-Division takes place within 72 hrs after fertilization
Diamniotic-dichorionic
47
Excess amniotic fluid more than 2000 mL
HYDRAMNIOS
47
* Normal amniotic fluid volume
500-1000 mL
48
Pregnancy with less than average amount of amniotic fluid
OLIGOHYDRAMNIOS
49
to remove extra amniotic fluid (polyhydramnios)
AMNIOCENTESIS
50
instillation of fluid to uterus
AMNIOTRANSFUSION
