LO 7-8 Obstetrical Disorders Flashcards
Para
how many live deliveries
Gravida
how many times shes been pregnant
Ectopic pregnancy
- Egg fertilized in distal 3rd of fallopian tube
- Happens usually 8-9 weeks
- Unilateral pain
- Bleeding
- Pain
Pre-eclampsia/eclampsia
- 3rd trimester complication
- Women younger than 18 who are experiencing their first pregnancy and women with advanced maternal age 35 years or older and women with risk of chronic hypertension or all at increased risk
- Something happens to the placenta
- 3 main signs
o extreme edema to face
o Any blood pressure over 140/90 is flagged pre-eclampsia
o Proteins in urine
- Eclampsia vs pre-eclampsia= seizures
o Only thing that can help is delivering the baby
- Airway management
- Load and go
Abruptio placenta
- 3rd trimester condition
- Placenta separates from uterine wall baby is no longer supplied
- Excruciating tearing pain
- Partial separation: concealed bleeding or apparent bleeding
- Rapid transport
Placenta previa
- Low placenta
- Placenta comes out first
- Painless bleeding
Uterine rupture
- 3rd trimester complications
- Usually a result of multiple c-sections
- Compromise in the wall of uterus or is weak and it ruptures
- Excruciating pain
- Tons of blood
- Weakness, dizziness, thirst
- Strong painful contractions that weaken
Spontaneous Abortion (Miscarriage)
- 1st trimester before 20th week
- Most of the time happens because of a x-some defect
Fetal membrane disorder PROM and Amniotic Fluid Embolism
- 3rd trimester
- Water breaks but shes not in labour
o Clear
o Smell
o Color
Management of Third Trimester Bleeding
- Initial assessment (LOC, ABC’s, Skin, etc.)
- Obtain V/S
- Nature of the bleeding? OPQRST?
- Quantity of blood loss?
- Orthostatic changes?
- Oxygen
- ECG and V/S
- Establish 1x (consider 2x) IV lines to maintain appropriate BP 18 GAUGE
- 250ml blous and continue up to 20ml/kg
- Left lateral recumbent
- Loose trauma pads (no packing) to vaginal area.
- Transport to appropriate facility
- CONSTANTRE‐EVALUATION
Breech Presentation
- Elevate the hips
- Spread legs very far apart
- Push knees back
- May have to put hand in to secure airway
Limb Presentation
- Limbs come out first
- Position on all fours
- Not common
- Don’t push
Prolapsed Cord
- Position hips up on pillows and knees back
- Oxygen
- Instruct pt to pant with each contraction to prevent bearing down
- With 2 gloved fingers push presenting part back into vagina until its no longer pressing on the cord
- While u maintain pressure get partner to put moist dressing on umbiloical cord
- Hold until hospital
Cephalopelvic Disproportion
- Head and pelvis disproportioned
- Head is too big for pelvis
Uterine Inversion
- Placenta fails to detach properly and stays attached to uterine wall
- You have 1 attempt to push it back in
Maternal Hemorrhage
- Blood loss exceeds 500ml in 24hrs
- Uterine massage and encourage woman to breast feed
- Diabetes
o Increased chance of miscarriage, pregnancy‐ induced hypertension, and birth defect
o Gestational diabetes: inability to process carbohydrates during pregnancy
o Oral hypoglycaemic agents can cross the placenta barrier in affect the fetus
o Prehospital management includes high flow oxygen, intravenous, fluids and DW
General Management
- In absence of distress / injury, transport patient in position of comfort (usually left lateral recumbent)
- ECG monitoring, high-flow O2 and IV fluid therapy may be indicated
- Embryo:
the egg third week after conception
Hyperemesis gravidum
- Continuous morning sickness
- Prehospital treatment:
o NRB oxygen
o BGL
o IV 250ml boluses
o Gravol
o Vital signs
o Transport
- Rh factor
: is a protein found on the red blood cells of most people when this factors absent the person is said to be Rh negative
Rh Sensitization
- When a woman who is Rh negative becomes pregnant by a man who is Rh positive the fetus inherits this factor in the fetal blood can pass through the mothers circulation and produce maternal antibodies to the factor
o This can result in death for the fetus or cause haemolytic disease in a newborn
Molar pregnancy
- Malfunction of the egg or sperm resulting in an abnormal placenta
- Normal progression of pregnancy but there is no fetus
