Lecture 7 Flashcards
some signs of pregnancy
- Amenorrhea
- Nausea/vomitting (morning sickness, will go away by 12 w)
- hyperemesis gravidarum (more extreme persistent vomitting
- urinary frequency and noctunia
- Breast changes (tingly, more dark areola)
how accurate are home preg devices and what do they test
measure human chorionic gondadotropin
90% accurate
when is the 1st, 2nd, 3rd trimensters
1st- week 1-12
2nd- week 13-26
3rd- 27- preg (usually 37)
(don’t let go past 42)
Risks w preg over 35
down syndrome gestational diabetes preg induced hypertension miscarriage premature labour
under 17 years old risks
preterm labour
blood pressure probs
amenia
Birth provider exam on baby (what should be covered
- height
- weight
- HR
- RR
- BP
Fundal height at 12,16,20 weeks
12- level of symphysis pubis
16- halfway between symphysis pubis and umbilicus
20- Level of umbilicus
What are some routine tests during preg
CBC Blood type (rh factor) Syphulis serology antibody titer (hemolytic disease, rubella, hep B) Urinalysis
At what weeks should dating US, anatomy scan and glu tollerence test be done
dating US- 11-14 weeks
Anatomy scan- 18-22 weeks
Glucose tolerance test- 23-28weeks
What are the first trimester tests
- US for nuchal translucency (increased transparency increases chances for chromosomal abnormalities)
- Maternal blood test (preg associated plasma protein screen, hCG)
What is the main test during second trimester and what is it testing for
Quad test @ 15-20 weeks
-ised to evaulate if preg can be affected by down syndrome or neural tube defects
AFP
hCG
Estriol
Inhibin
How accurate is the quad test
Correctly identifies about 80% of women carrying a baby who has down syndrome
5% false pos
What is an amniocentesis
procedure used to obtain a small sample of amniotic fluid surroundsing the fetus to dx chromosomal disorders and neural tube defects
performed at 15-20 weeks
risky for baby
what is a villus sampling and when is it done
sample taken of the placenta either via cervix or abdomen
preformed between 10-12 week of preg
mc adverse outcome of preg
miscarriage (30%)
-as weeks go on the changes decrease
what is chemical preg
happens after women misses her period but miscarriage occurs before first ultrasound
what is blighted ovum
an embryonic preg
=egg is fertilized and attaches but the embryonic itnself does not develop
topic preg facts
preg outside uterus mc in fallopian times
1-2% of pregs
risk factors of ectopic preg
- pelvic inflammatory disease
- endometriosis
- scar tissue from past preg
- inf of fallopian time
- > 35
- too many sexual partners
- invitro fertlization
symptoms of ectopic preg
- severe sharp stab like pains in lower abdomen
- ireegular vaginal bleeding
- nasuea/dizziness
- breat tenderness
- amenorrheea
Etopic preg tx (2)
Methotrexate (stops growth)
Laparoscopic surgery
overal complications that can occur in second trimester
-overall uneventful usually but;
- late miscarrage
- chlecyctitis
- pyelonephritis
when does a late miscarriage usually happen
btw the end of 1st trip and 20th week
pot causes
- maternal health
- condition fo cervix/uterus
- drugs and toxic exposure
- placental probs
What is incompetent cervix and how common
Weak cervical tissues causes or contributes to premature birth or preg loss following dilation
-1 - 20% of all pregs
cholystitis during preg causes/results
cholesterol levels go up in preg and can cause duct obstruction
- right upper quad pain associated w eating meals
- may also get nausea/vomitting
Why does pyelonpherphitis happen during second trimester and symptins
Ureters become dilated and compressed due to influence of uncreased progesterone and the uterus
- glucosuria leads to bac growth
- bladder loses tone and leads to UTIs
complications of the third trimester (5)
- gestational diabetes
- preg rinduced hypertension
- preclampsia
- placenta previa
- abruption placenta
Gestational diabetes- %, how is it screened and symptoms
4-7% of preg
-screened with glu tolerance test at 23-25w
will have thirst and copious urine
-baby will not be able to go thru full term
symptoms of hypertension during preg
mild- face/ankles/hands edema and sudden weight gain
severe- headache, visual disturbance, fever, rapid heart, severe heartburn
what is gestational hypertension and when is it usually dx
Hypertension dx after 20 weeks of gestation without concurrent proteinuria
what is preclampsia
new onset hypertension with new onset proteinuria
risk factors for preclampsia
- > 35y
- first preg
- hx of diabetes, high BP, kidney disease
- hx of preclampsia
best tx for gestational diabetes, gestational hypertension and preclampsia
exercise during preg have a 40% reduction
what is placenta previa
when placenta is partially or fully covering the cervix
dx thru ultrasound
risk factors of placenta previa
increased parity increased maternal age prior placenta previa multiple fetuses smoking
symptoms of placenta abruption
vaginal bleeding abdominal pain backpaine uterine tenderness rapidd contraction s
if you see bleeding during preg what should you do
contract OBGYN, midwife etc or Emergency room immediately