Maternity complications Flashcards
what are the 2 main signs of miscarriage
spotting AND cramping (2 together)
what is the treatment for miscarrage (2)
measure hCG lvls (worry when they drop)
bedrest and pelvic rest (no sex)
if miscarrage is imminent whtat do we do? (3)
IV
blood
dilation and cuttage
What is hydatidiform mole also called
molar pregnancy
what is hydatidiform mole
benign neoplasaslm; can turn malignant
is there a fetus involved in hydatidiform mole
no
how does molar pregnany start
uterus enlarges too fast
what are the two signs of molar pregnancy
absent fetal heart sounds
bleeding
how is molar pregnancy confirmed
U/S
should someone with molar pregnancy attempt to get pregnant again in the follow up time? how is follow up time determined
no
hCG measured weekly until normal
rechecked every 2-4 weeks; then every 1-2 months for 6 montsh to a year
what will be done to ensure no metastisis in a molar pregnancy
CXR
how is ectopic pregnancy determined
U/S
if a client has one ectopic pregnancy are they at risk for another
yes
what is the main goal of treatment for ectopic pregnancy
save the tube
what is given to a mom with an ectopic pregnancy? what does it do
methotrexate –> stops growth of embryo to save tube
what is done if methotrexate does not work in ectopic pregnancy
laparoscopic incsion will be made into the tube and the embryo will be removed
- potentially whole tube is removed
when is a laparotomy done in ectopic prengnacy
if the tube has ruptured or the ectopic pregnancy is advnaced
what are you worried about if the fallopian tube ruptures in an ectopic pregnancy
hemorrhage - need blood transfusion
what is the most common pregnancy complication associated with bleeding in later months of pregnancy
placenta previa
what is placenta previa
placenta has implanted wrong
what is done to confirm placental location
U/S
how does placenta previa occur
placenta begins to prematrurely separate when the cervix begins to dilate and efface –> baby doesnt get O2
what is low lying placenta
placenta is on side of uterus
what is partial previa
halfway covering the cervix
what is complete previa
placenta compltely covering cervix
what is the problem with placenta previa
placenta is coming out first
does placneta previa require hospitilization? why?
yes, to prevent blood loss and fetal hypoxia if pt. goes into labor
what is the delivery method of choice for placenta previa
c-section
what should not be done on pregger ladies with placenta previa
no vaginal exams –? can puncture placenta
what are 4 fetal complications for placenta previa
preterm delivery
intrauterin growth retardation
fetal distress
anemia
what are two maternal complications for placenta previa
hemorrhage
potential DIC risk (blood clot formation)
what is abruptio placenta
when the placenta seperates prematurely and bleeds
can be partial or complete
when does abruptio placenta occur
during the last part of pregnancy
what is done to confirm abrupto placenta
U/S
how is severity of abruptio placenta measured
scale of 1-3; 3 is the worst
wht can cause abruptio placenta
previous c section
rapid deompression of utures (membranes rupture)
associated with cocaine, PIH and smoking
what are 3 signs and symptoms of abruptio placenta
rigid board like abdomen with or w/o vag. bleed
abdominal pain and increased uterine tone
difficult to palpate fetus
what are the two priorites for abuptio placenta
manage fetal status
manage maternal shock
what is incompetent cervix
heavy baby on cervix causes it to dilate prematurely
when does incompetent cervix occur
4th month of pregnancy
what health hx will a pt. with incompetent cervix usually report
hxx of painless second trimester miscarrages
what is the treatment for incompetent cervix
purse string suture to reinforced cervix
may have c section to preserve the suture
can a woman with incompetent cervix deliver vaginally
yes, doctors can clip the suture
what is the percentage of carrying a baby to term after purse string sutures are done on an incompetent cervix
80-90%
what is hyperemis gravidarum
excessive vomiting that starts out like regular morning sickness but can lead to dehydration starvation and death
what is hyperemeis gravidarum related to
high levles of estrogen and hCG
what happens to the HCT in hyperemesis gravidarum
increases
what happens to UO in hyperemesis greavidarum
decrases
what happens withpotassium in hyperemesis gravidarum
decreases (lots of potassium in stomach)
what will be seen int he urine of people with hyperememsis gravidarum
ketones -> body breaking down fat
how long should a patient with hyperemeiss gravidium be npo
48 hours
how much IVFs should be given to someone with hyperememisis gravidarum for the first 24 hours
3L
what is preeclampsia
increased BP, proteinurai, edema after 20th weeks
what is sudden weight gain and face and swollen hands a sign of
preeclampsia
are preeclampsia patients prone to clonus or seizures
yes
what temp should foods be for patients with hyperemeis gravidarum
icy cold or steaming hot
when you see a pregnant client thag gains 2 or more pounds in a week what are you worried about
pregnancy induced htn
what is considered mild preeclampsia
BP 30/15 off their baseline, documented 6 hours apart
what is the treatment for mild preeclampsia
bed rest as much as possible
what needs to be increased in pateints with preeclampsia diet
protein –> they have glomerular damage with proteinuria
what is severe preeclampsia defined as
160/110 documented 6 hours apart
what are we worried about with severe preeeclampsia? how do we prevent this
sedate to delay seizures
whta drug is used for severe preeclampsia
magnesium sulfate; sedative, anticonvulsant, vasodilate
what are the actions of magneisum sulfate
anticonvulsant
sedative
vasoidlator
what needs to be done when magnesium sulftae is given
client check every 1-2 hours for toxicity
will magnesium sulfate is used what will happen with labor
it will stop, need to use oxytocin
what is used for preterm labor
magnesium sulfate
what is the only cure for preeclampsia
delivery
how long is a postpartum client at risk for seizures if they have preeclampsia
48 hours
why are steroids used for preeclampsia patients
stimulate surfactant prduction in teh alveolar spaces and causes less tension when infant breaths
how long is betamethasone used for preeclampsia babies during pregnancy
24-34 weeks to reduce infant mortality
what is the turning poing from preeclampsia to eclampsia
having a seizure
what is premature labor defined as
20-37 weeks
what is the treatment for preterm labor
tocolytics
magnesium sulfate
betamethaosn
what is the side effect of terbutaline
pulse hyerpactivity
how is betamehtasone given to mom and what is its purpose in preterm labor
given IM to mom
stimulates maturation of the babsy lungs in preterm birth
what are two non pharmacological ways preterm albor can be stopped by
hydrating and treating vaignal and UTIs
what is the definition of a prolapsed cord?
when the umbilical cord falls down through the cervix
what is imporant to check when membranes ruptuer? what are you worried about
fetal heart tones , worried about prolapsed cord
what does it mean if the cord cesases to pulsate
fetal death
can shoulder dysocia lead to erbs or bells palsy
yes
whos at risk for should dysocia
giant babies
gestational diabest
previous hx of should dystocia
post date delviery –> large fetus
what is a mcroberts maneuver
hyperflexing maternal legs to fix shoulder sytocia
what is mazzanti techniqes
applying suprapubic pressure when shoulder dystocia occurs, must be done by primary health care physician
what is the leading cause of neonatal morbidity
group b strep
how is group b strep passed to baby
from birhth canal of infected mom
when is the only time a baby is at risk for contracting group b strep form mo
after membranes have ruptuerd
what is the treatment for group b strep in moms
prophylactic penicillin
