Module 13 risk assessment in preg Flashcards
fetal assessments
fundal height
HFT: patterns
kick counts: 10 in 2 hours
high risk preg
condition that inc. risk for uteroplacental insufficiency - GDM, HTN Hx of previous stillbirth advanced maternal age spontaneous abortion risk genetic abnml nutritional deficiencies psychosocial concerns - substance abuse - domestic violence - STI multifetal post-term dec. fetal movement intrauterine growth retardation oligohydramnios hx congenital abnml chronic disease in mother
screenings
US doppler NIPT quad screen NST (non-stress test) US biophysical profile (BPP) - FHT, fetal breathing, fetal movements, fetal muscle tone, amniotic fluid CST (contraction stress test)
diagnostic tests
CVS
Amnio
- L/S ratio
vaginitis causes and s/s
Causes: - yeast - bacteria - protozoa s/s - itching - burning - malodorous discharge Tx: - 7 day topical vaginal azole cream
BV
associated with adverse preg. outcomes if left untreated.
- bacteria -> uterus -> preterm labor/ preterm rupture of membranes, intrauterine infection, postpartum endometritis
Help prevent vaginal infections
refrain from douching freq. wash hands wear cotton underwear and loose clothes keep underwear dry avoid scented liners; dont wear every day DO eat yogurt or use probiotics
N/V dietary changes
small, freq. meals eat first thing before rising high-protein avoid triggers of strong smelling foods carbonated drinks can help try ginger, acupressure, Vit B6
GERD prevention
raising HOB
eating small, bland meals
avoiding lying flat
constipation and hemorrhoids management
inc. water and fiber inc foods with laxative properties - prunes - decaf moderate physical activity avoid straining to pass BM
bleeding in the first trimester
25% of women will have this - only 50% of these will result in live infant Causes - cervical, uterine, or chromosomal abnormalities - ectopic pregnancy - hormonal or nutritional imbalance - trauma - poorly controlled DM - maternal infection - substance abuse
expectant management (non-viable fetus)
the expulsion of the uterine contents proceed spontaneously
- bleeding can last 7-10 days, significant
- if uterine contents have not passed in 7 days RTC
- inc. bleeding accompanied by pain, adnexal pain, or fever, or heavy bleeding with pain lasting longer than 1 hr -> RTC
medical management (non-viable fetus)
use of misoprostol
less than 13wks
- less pain, but more bleeding than surgical intervention
- if no expulsion by day 3 dose repeated
- > no expulsion by day 8 -> surgical management
surgical intervention
dilation and curettage
- may be needed if expulsion of uterine contents not completely evacuated or if woman develops sepsis
ectopic pregnancy
implantation outside uterus
- slowly rising or continued + b-hCG levels with no intrauterine preg seen with US
- poss. severe lower abd. pain, spotting, diaphragmatic irritation, especially w/ rupture
- need surgical intervention
