Obstetric 4 Flashcards
What are some common conditions/sx of pregnancy?
- back pain
- breast tenderness
- CTS
- constipation
- edema
- fainting
- insomnia
- mm cramps
- urinary frequency
- varicosities
- fatigue
- HA
pregnancy sx: back pain
- 50-90%
- cause related to muscle, joints, or ligaments
pregnancy sx: CTS
due to increased fluid volume
pregnancy sx: edema
progesterone causes venous engorgement
pregnancy sx: fainting
vasodilation in early pregnancy
pregnancy sx: insomnia related to
physical discomfort
pregnancy sx: muscle cramps
pressure from expanding uterus on LE nerves
pregnancy sx: urinary frequency
pressure of uterus on the bladder
pregnancy sx: varicosities of:
- LE
- vulva
- rectum
pregnancy sx: varicosities caused by
- increased blood volume
- increased pressure of uterus on pelvic veins
pregnancy sx: HA
- typical in early pregnancy
- related to hypertensive disorders later
GDM =
gestational diabetes mellitus
GDM is defined as
carbohydrate intolerance diagnosed during prengancy
GDM may be caused by
- exaggerated physiological changes in carbohydrate metabolism OR
- may be maturity onset DM II uncovered during pregnancy
What are the hormones released by the placenta that contribute to GDM?
- human placental lactogen
- human placental growth hormone
GDM: placental hormones can cause
- increased blood glucose
- insulin resistance
GDM: usual screening when?
24-28 weeks
typical protocol for GDM screening
- all women screened at 24-26 weeks with a 50g glucose load
- if BG over 14-, full 3-hr GTT follows
- retested 6 weeks postpartum
Screen for GDM usually determines if this is needed
full GTT
GDM sx
- may or may not show sx
- can increase BP during pregnancy
- increase risk of DM II later on
risks for fetus with GDM
- congenital malformations
- fetal size increased with extra fat
- obstetric brachial plexus injury
- hypoglycemia upon birth
- respiratory distress at birth
- developmental disabilities
- long-term obesity and DM II
What is an increased fetal size, extra fat?
macrosomia
How is infant hypoglycemia corrected?
- feeding
- glucose supplement
Exercise for pregnant women with DM: GDM
Program that includes cardio component improves glycemic control better than diet
Exercise for pregnant women with DM: Type I
- monitor BG closely
- vulnerable to exercise-induced hypoglycemia
Exercise for pregnant women with DM: general recommendations on intensity
can be safely increased w/o fear of fetal distress if lower body is kept from an excessive WB load
