Maternal Risk Factors and Birth History Flashcards
What effects does chronic HTN have on mother?
⬆️vasospasm, ⬆️ CNS irritability, ⬆️risk convulsions, ⬆️ renal damage
How does CMV affect the fetus during pregnancy?
Retinochoroidotis, seizures, coma, microcephaly, IUGR, Encephalopathy
What effects does chronic HTN have on the fetus?
⬇️placental perfusion, low birth weight, preterm birth
What effects does renal disease have on the mother and fetus?
Maternal- ⬆️renal failure
Fetal- ⬆️risk IUGR/SGA
⬆️risk preterm birth
What effects does HSV have on the fetus?
Neonatal HSV, Hepatitis with jaundice, neurologic abnormalities
What effects does Syphilis have on the fetus?
⬆️fetal demise
Congenital Syphilis
IUGR
Non immune Hydrops
What is the leading cause of maternal-fetal morbidity and death in pregnancy?
Hypertensive disorders
What is HELLP?
Hemolysis
Elevated Liver enzymes
Low platelets
What effects does HIV have on the fetus?
30% chance of transmission from infected mother
What effects does Chlamydia have on the pregnancy and fetus?
PROM, preterm labor, IUGR, chorioamnioitus, infertility
Conjunctivitis, pneumonia
What effects does gonorroeae have on the pregnancy and fetus?
Pelvic peritonitis, PROM
Sepsis, meningitis, conjunctivitis
What effect does Hepatitis B have on the fetus?
Eta abnormalities, intellectual disabilities, neonatal disease
What effects does toxoplasmosis have on the fetus?
(Cat feces)
Earlier transmission more catastrophic
Neurologic, IUGR, microcephaly
What causes thrombocytopenia in newborns?
⬇️platelets
Platelet destruction: Maternal autoantibodies, igG cfosses placebta and destroys fetal platelets
Neonatal conditions: infection, Rh incompatibility, thrombotic disorders, birth asphyxia, impaired platelet production
How is amniotic band syndrome associated with amniotic fluids?
If amniotic fluid has been leaking (oligydramnios) deformation can occur
What is olihydramnios?
Low amniotic fluid
What conditions should be watched for with olihydramnios?
Fetal genitourinary or lung anomalies
What is associated with polyhydramnios?
Chromosomal disorders, Gastrointestinal anomalies (fetus not swallowing fluid)
What is polyhydramnios?
Too much amniotic fluid
What is chorioamnionitis?
Infection of chorion, amnion and amniotic fluid. Usually associated with premature rupture of membranes
What is biophysical profile?
NST, fetal breathing, gross body/limb movements, fetal tone and amniotic fluid
Lower number indicates asphyxia
What is the significance of the biophysical profile?
8-10 normal
4-6 suspect chronic asphyxia and assess for delivery
0-2 strongly suspect chronic asphyxia and delivery indicated
What does the alpha fetoprotein/triple quad screen indicate?
Performed at 15-20 weeks
Helps evaluate risk of the fetus to have abnormalities including trisomy 21 and neural tube defects
They involve all three tests with consideration of maternal age, weight, race and diabetes status
What can an ultrasound diagnose?
Abnormalities of the fetus, placenta, amniotic fluid and uterus.
Monitors changes in anatomy and growth
What is a normal baseline FHR?
10 min with 110-160 bpm
What is variability in the FHR?
Absent variability- no range in HR detected
Minimal variability- amplitude greater than undetectable but less that 5bpm
Moderate variability- 6-25 bpm
Marked variability- greater than 25 bpm
What are decels?
Decrease in FHR in relationship to contractions
Early- category 1, normal decrease over at least 30 sec then return to baseline (head compression)
Late- category 3, fall in FHH during contraction and returns after contraction (uteroplacental insufficiency)
Variable- a quick drop in FHR less than 15 bpm and lasts 15 seconds (cord compression)
What is fetal tachycardia during labor?
Category 2
Greater than 160 bpm for 10 min or greater
What is bradycardia during labor?
Category 2 or 3
Less than 110 bpm for 10 min or greater
What impact on the neonate does abruptio placenta?
The placenta separated from the uterine wall causing bleeding
Can cause loss of fetal heart tones, tachycardia, late or variable decels, decreased FHR variability
Anemia, hypoxia, hypovolemia
What impact does umbilical cord prolapse have on the neonate?
Life threatening to the fetus! Cord falls below the presenting part is compressed
What impact on the neonate does Breech position have?
Fetal anomalies, preterm fetus, fetal asphyxia or death and multiple pregnancy
What are some complications of a breech delivery?
Prolapsed/compressed cord, asphyxia, genital damage if make, CND injuries
Shoulder Dystocia and impact on neonate
Birth injuries, hypoxic injury, permanent brain or spinal cord injury and intrapartum or neonatal death
How do analgesics affect the fetus?
Decreased variability of the FHR, neonatal respiratory depression
How does anesthesia affect the fetus?
Neonatal respiratory depression, reaches fetus approx 2 min after induction
How do tocolytics affect the fetus?
They slow labor to help get magnesium or steroids to a preterm mom in labor. In turn helping the fetus to develop further along
How does maternal hemorrhage affect the neonate?
Causes mother to be anemic, fatigued and hypotension making it harder to care for newborn. Also affects milk supply
How does meconium affect the neonate?
Can be inhaled into lungs causing respiratory issues and infection
How does placenta previa affect the neonate?
Implantation if the placebta in the lower part of the uterus near or over the cervical os. Common cause of bleeding in the 2nd trimester
Perinatal mortality, fetal anemia, malpresentation, fetal growth restriction, prematurity, congenital malformations
What impact do forceps and vacuum have on the neonate during delivery?
Clavicle fracture, facial palsy, scalp abrasions
What impact does a c-section have in neonates?
Fetal compromise from anesthesia, preterm birth, TTN, PPHN, lacerations, bruising
If a laboring mother, self reports repeated her when abuse and pregnancy, the nurse should suspect to see signs of neonatal abstinence syndrome within
? 24-72 hours
