Obstetric 4

Question 1

What are some common conditions/sx of pregnancy?

Answer 1

• back pain
• breast tenderness
• CTS
• constipation
• edema
• fainting
• insomnia
• mm cramps
• urinary frequency
• varicosities
• fatigue
• HA

Question 2

pregnancy sx: back pain

Answer 2

• 50-90%

- cause related to muscle, joints, or ligaments

Question 3

pregnancy sx: CTS

Answer 3

due to increased fluid volume

Question 4

pregnancy sx: edema

Answer 4

progesterone causes venous engorgement

Question 5

pregnancy sx: fainting

Answer 5

vasodilation in early pregnancy

Question 6

pregnancy sx: insomnia related to

Answer 6

physical discomfort

Question 7

pregnancy sx: muscle cramps

Answer 7

pressure from expanding uterus on LE nerves

Question 8

pregnancy sx: urinary frequency

Answer 8

pressure of uterus on the bladder

Question 9

pregnancy sx: varicosities of:

Answer 9

• LE
• vulva
• rectum

Question 10

pregnancy sx: varicosities caused by

Answer 10

• increased blood volume

- increased pressure of uterus on pelvic veins

Question 11

pregnancy sx: HA

Answer 11

• typical in early pregnancy

- related to hypertensive disorders later

Question 12

GDM =

Answer 12

gestational diabetes mellitus

Question 13

GDM is defined as

Answer 13

carbohydrate intolerance diagnosed during prengancy

Question 14

GDM may be caused by

Answer 14

• exaggerated physiological changes in carbohydrate metabolism OR
• may be maturity onset DM II uncovered during pregnancy

Question 15

What are the hormones released by the placenta that contribute to GDM?

Answer 15

• human placental lactogen

- human placental growth hormone

Question 16

GDM: placental hormones can cause

Answer 16

• increased blood glucose

- insulin resistance

Question 17

GDM: usual screening when?

Answer 17

24-28 weeks

Question 18

typical protocol for GDM screening

Answer 18

• 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

Question 19

Screen for GDM usually determines if this is needed

Answer 19

full GTT

Question 20

GDM sx

Answer 20

• may or may not show sx
• can increase BP during pregnancy
• increase risk of DM II later on

Question 21

risks for fetus with GDM

Answer 21

• 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

Question 22

What is an increased fetal size, extra fat?

Answer 22

macrosomia

Question 23

How is infant hypoglycemia corrected?

Answer 23

• feeding

- glucose supplement

Question 24

Exercise for pregnant women with DM: GDM

Answer 24

Program that includes cardio component improves glycemic control better than diet

Question 25

Exercise for pregnant women with DM: Type I

Answer 25

• monitor BG closely

- vulnerable to exercise-induced hypoglycemia

Question 26

Exercise for pregnant women with DM: general recommendations on intensity

Answer 26

can be safely increased w/o fear of fetal distress if lower body is kept from an excessive WB load