L&D: 1 Gestational Disorders and Disease Consideration in Labor Flashcards
1) Meconium stained amniotic fluid2) Meconium Aspiration Syndrome (MAS)3) Tx via antibiotics, amnioinfusion, fetal nasal suction immediately after birth
Chorioamnionitis is more likely to occur when meconium-stained amniotic fluid (MSAF) is present. Meconium may enhance the growth of bacteria in amniotic fluid by serving as a growth factor, inhibiting bacteriostatic properties of amniotic fluid. Many adverse neonatal outcomes related to MSAF result from Meconium Aspiration Syndrome (MAS). MSAF is associated with both maternal and newborn infections. Antibiotics may be an effective option to reduce such morbidity.
HELLP Syndrome
HELLP syndrome is a group of symptoms that occur in pregnant women who have:H – hemolysis (the breakdown of red blood cells)EL – elevated liver enzymesLP – low platelet count
HELLP Syndrome: Risks
Many women have high blood pressure and are diagnosed with preeclampsia before they develop HELLP syndrome. In some cases, HELLP symptoms are the first warning of preeclampsia and the condition can be misdiagnosed
HELLP Syndrome: When can it occur?
Most often HELLP develops before the pregnancy is 37 weeks along. Sometimes it develops in the week after the baby is born.
HELLP Syndrome: 1) Tx? (2)2)
1a) The main treatment is to deliver the baby as soon as possible, even if the baby is premature. Problems with the liver and other complications of HELLP syndrome can quickly get worse and be harmful to both the mother and child.1b) Your doctor may induce labor by giving you drugs to start labor, or may perform a C-section.You may also receive:A blood transfusion if bleeding problems become severeCorticosteroid medications to help the baby’s lungs develop fasterMedications to treat high blood pressure
Disseminated Intravascular Cougulation (DIC)What is it?
Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become over active.
Disseminated Intravascular Cougulation (DIC)1) As the disease progresses what happens?2) Risk factors
1) Over time, the clotting proteins in your blood are consumed or “used up.” When this happens, you have a high risk of serious bleeding, even from a minor injury or without injury. You may also have bleeding that starts spontaneously (on its own). The disease can also cause healthy red blood cells to break up when they travel through the small vessels that are filled with clots.2) Pregnancy complications (such as placenta that is left behind after delivery)
Idiopathic thrombocytopenic purpura (ITP)1) What is it?2) Risk factors
1) Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clotting. Persons with the disease have too few platelets in the blood.ITP is sometimes called immune thrombocytopenic purpura or simply, immune thrombocytopenia.2) pregnancy (plus more)
What is umbilical cord prolapse?
Umbilical cord prolapse is a complication that occurs prior to or during delivery of the baby. In a prolapse, the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby. The cord can then become trapped against the baby’s body during delivery. Umbilical cord prolapse occurs in approximately one in every 300 births.(ClevelandClinic.org)
What causes an umbilical cord prolapse?
The most common cause of an umbilical cord prolapse is a premature rupture of the membranes that contain the amniotic fluid. Other causes include:Premature delivery of the babyDelivering more than one baby per pregnancy (twins, triplets, etc.)Excessive amniotic fluidBreech delivery (the baby comes through the birth canal feet first)An umbilical cord that is longer than usual
What are the consequences of umbilical cord prolapse?
An umbilical cord prolapse presents a great danger to the fetus. During the delivery, the fetus can put stress on the cord. This can result in a loss of oxygen to the fetus, and may even result in a stillbirth.
How is an umbilical cord prolapse detected?
The doctor can diagnose a prolapsed umbilical cord in several ways. During delivery, the doctor will use a fetal heart monitor to measure the baby’s heart rate. If the umbilical cord has prolapsed, the baby may have bradycardia (a heart rate of less than 120 beats per minute). The doctor can also conduct a pelvic examination and may see the prolapsed cord, or palpate (feel) the cord with his or her fingers.
How is an umbilical cord prolapse managed?
How is an umbilical cord prolapse managed?Because of the risk of lack of oxygen to the fetus, an umbilical cord prolapse must be dealt with immediately. If the doctor finds a prolapsed cord, he or she can move the fetus away from the cord in order to reduce the risk of oxygen loss.In some cases, the baby will have to be delivered immediately by cesarean section. If the problem with the prolapsed cord can be solved immediately, there may be no permanent injury. However, the longer the delay, the greater the chance of problems (such as brain damage or death) for the baby.
Dystocia or Dysfunctional laborWhat is it?(ATI)
Dystocia, or dysfunctional labor, is a difficult or abnormal labor related to the five powers of labor (powers, passenger, passageway, psyche, and position).Atypical uterine contraction patterns prevent the normal process of labor. These contractions can be hypotonic (weak, inefficient, or completely absent) or hypertonic (excessively frequent, uncoordinated, and of strong intensity with inadequate uterine relaxation) with failure to efface and dilate the cervix for the progression of labor.
Dystocia or Dysfunctional laborRisk Factors(ATI)
Risk factors for dysfunctional laborShort stature, overweight statusAge greater than 40 yearsUterine abnormalitiesPelvic soft tissue obstructions or pelvic contractureCephalopelvic disproportion (fetal head is larger than maternal pelvis) Fetal macrosomia Fetal malpresentation, malpositionMultifetal pregnancyHypertonic or hypotonic uterusMaternal fatigue, fear, or dehydrationInappropriate timing of anesthesia or analgesics