Late Pregnancy Complications Flashcards
Labor (20-37 weeks) with cervical effacement & dilatation
Pre-term
Contractions without cervical changes
Pre-term uterine contraction
1 cause of neonatal morbidity/mortality.
Pre-term birth
Risk factors for pre-term labor
Poor <18 or > 40 Low pre-pg weight Short interval between pgs (< 3months) Poor weight gain during pg Hx of abortion Hx of previous complications of pgs Smoking, Alcohol, infections...etc
Pre-term labor treatment.
Bed rest (meh).
Corticosteroids (betamethasone 12 mg IM q 24 hrs x 2) to help fetal lung maturity up to 7 days.
Tocolytics (drugs to halt preterm labor..Nifedipine).
When to use tocolytics
<5 cm dilation. 5 or more is therapy failure.
When to give prophylaxis GBS abt?
Preterm birth where GBS status is positive or unknown.
Penicillin, clindamycin, cefazolin
PROM?
Membrane ruptured before active labor
Diagnosing PROM.
Nitrazine test (turns blue..alkaline pH)
Ferning
Pooling
Signs of chorioamnionitis
Fever
Leuko
Tachy (mother or baby)
Uterine tenderness
Causes of chorioamnionitis
E coli
GBS
(ascend from vagina)
PROM + chorioamnionitis?
Deliver immediately regardless of GA
Pg 40-42 weeks?
Postterm pg or Prolonged pg
Most common cause of postterm pg?
Incorrect dating
Dysmaturity
Complication of possterm pg.
Complications of dysmaturity
From large fetal size
birth injury, labor problems, placenta insufficiency, oligohydramnios
Treatment of postterm pg?
Induction (at 41)
CS
RH Alloimmunization
Mother RH -
Baby RH +
Fetal RBCs move to mothers circulation (mostly during delivery or termination), cause mother to develop antibodies AGAINST baby.
How to prevent mother RH sensitization?
Give RhIgG at 28. Can be given postpartum (72 hrs)
Erythroblastosis fetalis
hemolytic anemia of baby (mothers antibodies cross placenta and attack baby RBCs)
Measure what if mother is rH +.
Antibodies titers (<1:32 is ok) Fetal cerebral artery with US (high blood flow indicates severe anemia)
Intrauterine fetal death at or >20
Still Birth
Dx of stillbirth
No cardiac activity on US or at birth
Risk for recurrent stillbirth w/o known causes
1-2%
