OB Test 2: High Risk Pregnancy Flashcards
What are psychosocial risk factors for high risk pregnancies?
History of mental illness
Depression
Substance use
Family violence
What are the biophysical risk assessment?
Hero-placental perfusion Preeclampsia Diabetes History of preterm labor Diseases
What are socio-demographic risk factors for high risk pregnancies?
Poverty Lack of insurance No prenatal care Level of family support Age Education level
What are environmental factors of high risk pregnancy?
Saftey Home Workplace Exposure Pollution
When do kicks start?
28 weeks
Can be formal or instinct
What can decreased fetal movement indicate?
Chronic hypoxia
Gives mother anxiety
What are the different uses of obstetric ultrasound?
Confirm pregnancy: # and presentation Evaluate placenta: location, size, grade Fetal anomalies Fetal maturity Complications Amniotic fluid: placental abruption, fetal demise BPP testing Fetal procedures Doppler blood flow Fetal well being
When can you do an ultrasound?
16 weeks and mother drink water to raise uterus
External or transduced
What a BPP?
Biophysical profile
Evaluates fetal oxygenation & well being in utero
What is AFP?
Alpha fetoprotein
MsAFP: maternal serum which increases neural tube defects and decreases downs
Screening tool only
When should you do an amniocentesis?
What color should it be?
What should the LS ratio be?
What d the different colors mean?
15-20 weeks Clear color Chromosomal analysis At 30-35 weeks fetal lung maturity 2:1
Yellow: increased bilirubin
Green: meconium
Bloody: placenta
What are the risks of amniocentesis?
Spontaneous abortion Trauma Bleeding PTL: per term labor Infection RH sensitization (mom may be exposed)
What is CVS?
Chorionic villus sampling
Genetic testing
10-12 weeks, can be as early as 8 weeks
Early diagnosed for rH negative mom needs RhoGAM
What are the risks of CVS?
Miss digits & limbs
Spontaneous abortion
Limb reduction
What is PUBS
Percutaneous umbilical blood sampling
Draw baby blood out from umbilical cord
Done in 2 and 3 trimester
What are other genetic tests?
Coombs test: moms blood Fetal fibronectin: protein in fetal membranes, May predict preterm labor Endocervical length L:S ratio PG
What is fetal heart rate testing?
Non stress test used for at risk women such as diabetes, hypertension, decrease fetal movement, multiple gestation
Criteria: 2 accelerations of 15 bpm X 15 sec in 20 min
What is a CST?
Contraction stress test
Determines if fetus will tolerate labor
Contraction:
- 3 moderate contractions in 10 minutes to determine how fetus will respond
- nipple stimulation: pill roll 2 min, stop 2 min then switch nipples
- oxytocin: low levels
What are the different gestational hypertensive disorders?
Preeclampsia
Eclampsia
Prevalence
What is the etiology of gestational hypertensive disorders?
No cause
Some sort of immunological problem
Only cure is delivery
What is preeclampsia?
Hypertension
Proteinuria
After 20 weeks
Eclampsia
Results in seizure
What is the prevalence of gestational hypertensive disorders?
3-7%
Usually in primagravida
What are the signs and symptoms of preeclampsia?
Vasodpasm and organ perfusion
Intra vascular coagulation.
Increased permeability & capillary leakage
