Maternal fetal health 1 Flashcards
thyroid storm clinical (5)
assoc
fever, tachycardia
altered mental state
diarrhea
vomitng
arrhythmia
assoc - infection, labor, hypoglycemia, DKA inciting event
impact of DM vs gestational diabetes
in DM, fetus experiences high glucose levels earlier
at 7wks - glucose toxic in organogenesis
contributing factors antepartum hemorrhage (after 20 weeks gestaion)
palcental abruption
vasa previa
uterine ruprture
placenta previa
getational HTN cutoff
140/90
catalyzes iodiantion of tyrosine residues of Tg in the formation of T3/T4
thyroid peroxidase
fetal mortality ratio =
fetal deaths >20wks or 500g divinded bytotal births (still and live)
prolactin trends after pregenancy
return to baseline 3 months post
remain high longer in lactating women)
live birth =
expulsion or extraction of fetus at any stage in which fetus breathes or has beatin heart, pulsation of ubiical cord, or definite movemnet of voluntary mucles
side effects Mg Sulfate
warmth, flushing
Nausea/vomiting
Rare - loss of patellar reflex
respiratory depression
maternal death =
maternal mortality =
maternal mortality ratio =
death while pregnant or within 42 days termination of prenancy
Rate = # of deaths per 100,000 women of reproductive age 15-49yr
Ratio = maternal deats per 100,000 live births (deaths/live briths)x100,000
Rx for preeclamspia
seizure phrphylaxis
for fetal lung maturation
Mg sulfate for seizure proph
Betamethasone for fetal lungs dev
pathophys TSH drop in first try mester
hcG beta subunit has wek ability to activate TSH receptor, increased hCG leads to decreased TSH
fetal outcomes in gestational diabetes
macrosomia = growth beyon 4500g
polyhydramnios
neomnatal hypoglycemia
risk of brith trauma
risk of long term metabolic disorders
Graves in pregnancy pathophys and associations
antibodies cross placenta
risk of abortion, preterm, low birth weight, still birth, preeclampsia
neonatal mortality rate =
neonatal deats per 1,000 live births
contributing factors to postpartum hemorrhage (4)
uterine atony
coagulaition defects
trauma
placenta accreta
pathophys sheehan syndrome
ischemic injury to hypothal-pituitary axis
(due to pregnancy assoc increase in pituitary size and low flow, low pressure nature of portal circullation)
leading cause of maernal mortality in US
CV disease
infection / sepsis
mother uses ____ for fuel after mels, leaving ___ for fetal growth
mother uses TAG, glyccerol, FFa
glucose adnd maino acids for fetal growth
gestational hyperthyroidism assoc
treatment
first half of pregnacy
associated with increased hCG or increaed thyroid stimualting activity of hCG
hyperemesis gravidarum - nausea, vomiting ,weight loss
supportive treatment - IV fluids, antiemetics
maternal increase in thyroid binding globulin due to
increase production and decreased clearance of TBG mediated by increse in estrogen
presence of Tg or TPO autoantibodies in mother associated with
pregnacy loss
recurrent miscarraiges
preterm
(thyroid destruction no suffeicient in most to casue hypothyroidism)
HELLP syndrome
severe HTN plus
Hemolysis
Elevated Liver enzymes
low platelets
stillbirh =
death of>20wk fetus
impact of greater fetal glucose supply in gestational diabetees
macrsomia
extra glucose sotred as fat
increased insulin production
hyperthyroidism and thyrotoxicosis associated with increase risk of (6)
spontaneous abortion
permature labor
low birth weight
still birth
preeclmapsia
heart failure
PREECLAMPSIA =
SEVERE htn 160/110 PLUS
proteinuria
visual disturbances, headaches
epigastric pain
thrmobocytopenia
abnl liver fxn
betamethasone mechanism
side effects
accelrate devo of type 1 and 2 pneomocytes > improve lung mehcnacis andsurfactant production
fluid retention in mother and transient increasse in fetal heart raet possible
risk factors preeclmapsia
primiparity
Hx or Fhx
Diabetes, high BMI, kidney disease, antiphospholipid ABs
multiple gestations
Maternal age below 20 or above 35
hypothyroidism in pregnancy most often due to (in area of adequate iodine)
presence of TPO or thryoglobulin antibodies (hashimotos)
indirect obstetric death
deat due to preexisting disease or new diseae aggravated by effects of pregnancy
heyodynamic and renal hallmarks of pregnancy
increased capactiy and reduced resistance
amino acid concentration fetus vs mother
hgiher in feuts
gestational diabetees attributed to (pathophys)
insuf compensatory capcity to increase beta cell mass and insulin secretion
pre-existing insulin resistance if obese
crculating islet cell antiboies (“latent” type 1)
sheehan syndrome characterized by
failure of lactation
failure of hair growth over areas shaved for delivery
poor wound healing after C-section
weakness
fetal sequalae of pregnacy HTN disorders
growth restriction
oligohydramnios
indicated preterm delivery
metabolic or CV disorders
