Obstetric 2 Flashcards
What is a high risk pregnancy?
any fetal or maternal condition that can adversely affect the pregnancy, usually with a premature delivery
What types of maternal pre-existing conditions may cause a high risk pregnancy?
- heart/lung disease
- DM
- chronic illness
- disability
- substance abuse
- lack of prenatal care
What are some complications that may make a pregnancy high risk?
- preeclampsia
- preterm labor
- multiple gestation
- premature rupture of membranes
- hyperemesis gravidarum
- pulmonary edema
- cardiomyopathy
Who does preeclampsia affect?
- both mother and fetus
- can be fatal!
preeclampsia is characterized by:
- HTN
- presence of protein in urine
may also include:
- swelling/sudden weight gain
- HA
- vision changes
When does preeclampsia typically occur?
20 weeks gestation to 6 weeks postpartum
outdated terms you might hear for preeclampsia
- pregnancy-induced HTN
- toxemia
variants of preeclampsia (2)
- HELLP syndrome
- eclampsia
HELLP syndrome =
H: hemolysis
EL: elevated liver enzymes
LP: Low Platelet count (thrombocytopenia)
eclampsia =
seizures
progression of preeclampsia or inability to manage usually results in
- delivery of the baby, regardless of gestational age
- increased risk for whole host of issues for the baby
PROM =
- premature rupture of membranes
- rupture of membranes prior to onset of labor
When does membrane rupture usually occur?
- typically occurs at term
- apoptosis appropriately initiates rupture
PROM: pathology
inflammation or infection of the membranes
PROM: risk factors
- low socioeconomic status
- low BMI
- tobacco use
- preterm labor hx
- UTI
- vaginal bleeding
- cerclage
- amniocentesis
What is hyperemesis gravidarum?
nausea so severe, excessive vomiting occurs
hyperemesis gravidarum: can quickly lead to
- dehydration
- electrolyte imbalances
- WL
hyperemesis gravidarum: cause?
- unknown
- may be linked to hormonal changes
hyperemesis gravidarum: tx
requires hospitalization
When do sx of typical morning sickness or hyperemesis gravidarum usually subside?
13 weeks (end of 1st trimester, first part of 2nd)
bedrest prescription: high risk pregnancies
~ 18% of the time (think about how decreased WB produces changes in every body system)
extremely relevant to PT practice
procedure used to address incompetent cervix
cerclage
What are other common conditions that warrant communication with the PCP during pregnancy?
- ectopic pregnancy
- placental abruption
- placenta previa
ectopic pregnancy =
egg implanted in fallopian tube instead of uterus
