MATERNAL LESSON 4 Flashcards
MATERNAL BLOOD
begins to collect IN THE INTERVILLOUS SPACE of
the UTERINE ENDOMETRIUM
12th day OF PREGNANCY
O2 and other nutrients (glucose,
amino acids, fatty acids, minerals, vitamins, and
water OSMOSES from maternal blood through
CHORIONIC VILLI into the VILLI capillaries. From
there, nutrients are transported to embryo
3RD WEEK
uteroplacental blood
flow (amount)
50ml/min in 10 week
braxton hicks-maintains
pressure in the intervillous spaces
12week
placenta measurements
-15-20 CM IN DIAMETER
* 2-3 CM IN DEPTH
* COVERS HALF OF THE UTERUS AT TERM
* 400 to 600g at TERM
NORMAL AMNIOTIC FLUID:
800-1200ml
-Reduced placental circulation
● -Leads to _______
and ______
very low maternal BP |low uterine circulation
Polyhydramnios
> 2000ml
oligohydramnios
<500ml
a loose
loop of cord around the
neck
nuchal cord
gelatinous
monopolysaccharides cord’s body and prevents
pressure
wharton’s jelly
Hypocoiling-associated
with _____
maternal HPN
Hypercoiling-associated
with ______
FETAL RESP.
DISTRESS
6 weeks initial diagnose
UTZ
UTZ use
confirms the presence, size, and location.
establishes fetus’ health, sex, presentation, position
checks complications
A combination of UTZ and non-stress test done during 26-28 weeks of
gestation.
antepartum: biophysical profile
Stress test – to be done at
32 weeks
HGH RISK (BIOPHYSICAL PROFILE)
multiple pregnancy, HPN, DM,CVD,Previous pregnancy
complication, Rh incompatability, Obesity, Pregnancy >35 years ol
FHR NORMAL & ABNORMAL
- 20min: > 2 Acceleration (2 points)
- 40min: No acceleration (0 points)
Fetal breathing NORMAL & ABNORMAL
30 secs: + rhythm ( 2points)
: - rhythm (0 points)
Fetal Body
Movement NORMAL & ABNORMAL
➢ 3 movements (2 points)
➢ No movements (0points)
Fetal Leg Movement NORMAL & ABNORMAL
- (+) extension from flexed position (2points)
- No extension (0points)
Amniotic fluid NORMAL & ABNORMAL
- index >5= (2 points)
- pocket fluid (0points)
color of amniontic fluid
clear, pale yellow
98% predictive of fetal lung maturity
lecithin/sphingomyelin ratio 2:1
predictors of fetal lung maturity
phosphatidyl glycerol and desaturated phosphatidylcholine
determines abnormal RBC breakdown or may have only a very mild anemia
bilirubin determination
helps predict the likelihood of premature delivery within 7-14 days
fetal fibronectin
INBORN ERRORS
down syndrome, cystic fibrosis, tay sach’s disease
tests baby’s risk for having certain genetic problems and birth defects
alpha-fetoprotein
complications of amniocentesis
cramping
bleeding/leaking amniotic fluid
infection
Miscarriage
preterm labor
aka cordocentesis or funicentesis
to detect and treat blood conditions, such as fetal anemia/ fetal infections
percutaneous umbilical blood sampling
checks for fetal heart’s acceleration
non-stress test
non stress test results
reactive=normal (2 acc in 20 mins)
non-reactive= abnormal (0 acc in 20 mins)
checks for fetal heart deceleration
stress test
stress test results
negative for decelerations= 3 contractions for 20 mins (normal)
positive for decelerations= abnormal
mother receives oxytocin to see how the FHR response during uterine contractions
stress test
leads to serious fetal defects or death
radiation
causes abnormalities in organs
syphilis and toxoplasmosis
causes nerve damage
lead and mercury
MMR, POLIO, HPV
live vaccines
hearing impairment, cognitive and motor difficulty, cataracts, cardiac problem, IUGR, thrombocytopenia purpura, facial defects (clef lip/palate)
rubella
causes severe vasocontriction, compromised placental flow
drugs
vitamin b deficiency, neurological damage, still birth, low birth weights
alcohol and tobacco
adequate and well controlled studies in pregnant women have failed to demonstrate a risk for the fetus in the first trimester of pregnancy
category A (doxylamine, folic acid, levothyroxine)
animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well controlled studies in pregnant women, or animal reproduction studies have shown adverse effects but well controlled studies in pregnant women have shown no adverse effects to the fetus
category b (amoxicillin, loratadine, ondansetron)
psotive evidence of fetal risk, risks clearly outweight any possible benefit
category X (methotrexate, simvastatin, warfarin)
positive evidence of fetal risk, but benefits may outweigh risks
category D (lisinopril, lithium, phenytoin)
animal reproduction studies have shown an adverse effect on the fetus, or there are no minimal reproduction studies and no well controlled studies in humans
category c (fluconazole, metoprolol, sertraline)
in dental care what is recommended?
eat healthy snacks to reduce amount of sugar
in bathing what is recommended?
shower is recommended than tub baths
in breast care what is recommended?
wear firm supportive bra with wide straps
16 weeks, colostrum secretion begins- use breast pads
clean with tap water, no soap
In perineal care what is recommended
Wipe from front to back
douching alters the pH of the vagina (no douching)
in clothing what is recommended?
shoe modeerate low heel to minimize pelvic tilt
avoid tight jeans
in sleeping what is recommended?
modified sims position or left-sided sims position
in exercise what is recommended?
walking is the best exercise
for sexual avtivity
coitus does not initiate labor
orgasm does not initate preterm labor
coitus does not cause PROM
