HLTH 2501: potential complications of pregnancy and embryonic development Flashcards
ectopic pregnancy
occurs when the zygote is implanted outside the uterus
why is the prevalence of ectopic pregnancies increasing?
due to an increase in pelvic inflammatory disease that may scar the tube and restrict movement of the zygote to the uterus
possible complications of an ectopic pregnancy
spontaneous abortion, rupture of the tube (causing hemorrhage or peritonitis)
pregnancy induced hypertension
refers to a state of high BP (> 140/90 mm Hg) that develops after 20 weeks of gestation and returns to normal after delivery
potential complications of pregnancy-induced hypertension
damaged blood vessels in the kidneys and retina, stroke, or heart failure
what are serious conditions of hypertension in pregnancy (2)?
preeclampsia and eclampsia
signs of preeclampsia and eclampsia
kidney dysfunction, weight gain, and edema in the face, hands, feets, and legs
complication for preeclampsia
HELLP (hemolysis, elevated liver enzymes, and low platelets)
what help HELLP progress to?
coagulation disorders such as disseminated intravascular coagulation
relationship between preeclampsia and eclampsia
preeclampsia may progress to eclampsia
eclampsia
when the BP is extremely high and generalized (grand mal) seizures or coma develops
gestational diabetes mellitus
is diabetes mellitus that can develop in women during pregnancy due to increased glucose intolerance
risks to the fetus of gestational diabetes mellitus
if blood glucose is higher during the first trimester, the newborn can be larger in size and experience problems regulating their own blood glucose
treatment for women with gestational diabetes mellitus
dietary management and sometimes insulin
placenta previa
occurs when the placenta is implanted in the lower uterus or over the cervical os (passageway between uterus and cervix)
complications of placenta previa
the uterus expands and contracts near the end of pregnancy, causing the placenta to tear and for bleeding to occur (bright red and painless)
abruptio placentae
refers to premature separation of the placenta from the uterine wall, resulting in bleeding that may or may not be evident vagianlly
signs of abruptio placentae
dark red bleeding and abdominal pain
thromboembolisms
aka blood clots; these are common after childbirth and usually develop in the veins of the legs or pelvis
how to prevent thromboembolism after birth?
walking and being up
phlebothrombosis
thrombus forming spontaneously usually due to stasis of blood or increased coagulability
thrombophlebitis
occurs when the clot forms over an inflamed area in the vein wall
pulmonary embolus
occurs when a piece of the thrombus breaks away and will flow will venous blood to the right side of the heart, then lungs and obstruct blood flow in the lungs
treatment for thromboembolism
do not massage and antiembolic stockings or bed rest
disseminated intravascular coagulation
is a secondary complication of events such as abruptio placentae and preeclampsia and occurs when an increased activation of the clotting mechanism occurs
what can disseminated intravascular coagulation lead to?
hemorrhage during early stages or formation of multiple thrombi, leading to tissue or organ damage in later stages
where does bleeding occur during disseminated intravascular coagulation?
from the uterus, injection sites, from the nose or mouth, or from under the skin
what is hemolytic disease of the newborn called?
erythroblastosis fetalis
possible complications of hemolytic disease in second pregnancy
severe anemia, high serum bilirubin (resulting in jaundice), neurological damage, and heart failure
treatment for the fetus in hemolytic disease
early birth of intrauterine transfusion
treatment for hemolytic disease after birth
transfusion and phototherapy for jaundice (exposure to fluorescent or blue light)
indirect coombs test
is routine screening of maternal blood for Rh antibodies
puerperal infection
is childbed fever in mothers and is an infection of the reproductive tract at any time during the 6 weeks after birth; can be endogenous or exogenous
common organisms causing puerperal infection
group B hemolytic streptococcus, E coli, S aureus, mycoplasma, and chlamydia trachomatis
endometritis
is inflammation of the uterine lining and is common is mothers due to the separation of the placenta which leaves raw tissue vulnerable
signs of endometritis
fever, vomiting, lower abdominal pain, and foul-smelling discharge
endometritis spread
can spread to cause pelvic cellulitis or peritonitis
peritonitis signs
severe pain, high fever, tachycardia, and abdominal distention
potential complications of endometritis
infertility due to scar tissue resulting from infection in the tubes or ovaries
risks of adolescent pregnancy
small pelvis causing labor problems, anemia, smoking, drugs, alcohol, and lack of prenatal care
babies born to adolescent mothers
are often smaller
what does the inner mass of the zygote become?
the fetus
what does the outer mass of the zygote become?
the placenta and amnion
period of fetus development from 3-8 weeks
is the embryonic stage
organogenesis
occurs during the embryonic stage and includes cells divides, moeing, and differentiating to form the basic elements of the organs and external structures
when are all organs formed in fetus development?
by the end of 8 weeks
when does the fetal heart start beating?
4 weeks
tetraogen
any substance or situation that causes a developmental abnormality
common teratogens
drugs, viruses, smoking, alcohol, and radiation
viruses that cause damage to fetuses
rubella or erythema infectiosum
what can erythema infectiosum cause?
severe anemia in the fetus and possibly death
smoking damage to fetus
can result in a child that is low in birthweight and irritable, and a risk of placenta previa
fetal alcohol syndrome
impairs a child’s neurological and intellectual development, as well as causing unique physical characteristics
folic acid beneifts
can reduce the chances of neural tube defects like spina bifida and anencephaly
when is the term fetus used?
at 8 weeks
when do teratogens have the greatest damage?
before 8 weeks because organs aren’t formed yet
functional impairment
refers to fetus damage of the CNS due to teratogens and can occur at any time
last trimester
the fetus gains weight and organs such as the lungs mature
name for identical twins
monozygotic; this occurs when the developing embryo divides to form two separate, genetically identical embryos
name for fraternal twins
dizygotic; this occurs when two ova and fertilized by two different sperm
what is the diagnosis of pregnancy based on?
the presence of human chorionic gonadotropin (hCG) in the plasma or urine
what is hCG secreted by?
the chorionic villi which is part of the outermost extraembryonic membrane
positive signs of pregnancy
includes a fetal heartbeat, ultrasound visualization, and fetal movement
how is the fetal heartbeat detected?
auscultation via a stethoscope
gestation
refers to the length of time since the first day of the last menstrual period and equals 40 weeks; this is 2 weeks longer that the age of the child
gravidity
refers to the number of pregnancies; ex. primigravida is a woman who is pregnant for the first time
parity
refers to the number of pregnancies in which the fetus has reached viability (apprx. 22 weeks)
amniocentesis
is the withdrawal of a small amount of amniotic fluid including some sloughed cells after 14 weeks
villus sampling
can be useful in chromosomal examination
what hormones does the placenta create?
estrogen and progesterone, causing these levels to rise during pregnancy as they are important for development of the uterus, maintenance of pregnancy, and preparation of the breasts for lactation
thyroid during pregnancy
the thyroid gland goes through hyperplasia as the production of thyroxine increases to support the mothers metabolism
how does the uterus change during pregnancy?
it increases in size due to estrogen, increases in fibrous tissue, and the number of vessels increases
what does the uterus put pressure on?
the bladder, the rectum, and the diaphragm (leads to shortness of breath)
goodell sign
refers to the changes in the cervix and vagina and that the tissues soften
chadwick signs
refers to the changes in the cervix and vagina in which the mucosal lining becomes a deeper purple colour
changes in the reproductive structures during pregnancy
uterus grows and becomes more vascular and fibrous, cervix and vagina soften and become purple, cervical mucus thickens, vaginal secretions increase, breasts grow, and bluish veins on the breast become more prominent
where does extra weight come from during pregnancy
the baby, the placenta, the amniotic fluid, breast tissue, blood supply, stored fat for delivery, and a larger uterus; total gain is about 25-30 pounds
digestive system changes during pregnancy
nausea and vomiting increase (this can lead to dehydration and electrolyte imbalances), heartburn may develop, bloating, abdominal discomfort, constipation, and hemorrhoids
hyperemesis gravidarum
is severe, uncontrollable vomiting
role of progesterone in digestion for pregnant women
it relaxes the smooth muscle in the GI tract, but decreases mobility
hemorrhoids
are dilated veins in the anal canal; can be painful, bleed, or become infected
musculoskeletal changes in pregnant women
the pelvic joint relaxes (widens the hips) and weight can cause lordosis leading to backache
cardiovascular changes during pregnancy
BV increases to supply to fetus (leads to edema), vascular resistance decreases as smooth muscle relaxes, HR increases slightly during the last trimester, and varicose veins develop
iron and pregnancy
is important as the fetus requires iron from hte mother
why do varicose veins develop in pregnant women?
because the restriction of blood flow in the veins to the heart is decreased due to the pressure of the uterus; common in women who stand a lot
