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Repro Week 4 > Obstetric Complications > Flashcards

Obstetric Complications Flashcards

1
Q

define preterm labor

A

regular uterine contractions with cervical changes

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2
Q

what must cervical length be to be considred preterm labor?

A

less than 2.5 cm

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3
Q

what is something you can measure to see if someone has preterm labor?

A

cervicovaginal fetal fibronectin

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4
Q

what three things should be given in preterm labor?

A

corticosteroids
abx
magnesium sulfate

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5
Q

what is difference in preterm premature ROM and premature ROM?

A

preterm means its early…premture ROM just means it happened without labor

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6
Q

name three ways to diagnose ROM

A

nitrazine positive
ferning
placental a macroglobulin-1 assay

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7
Q

what do you give with PPROM?

A

corticosteroids and abx

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8
Q

how do abx (penicillin) help PPROM?

A

delay labor actually

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9
Q

what is cervical insufficiency?

A

painless cervical dilation leading to recurrent second trimester pregnancy losses/births with normal pregnancies

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10
Q

what is a way to acquire cervical insufficiency?

A

trauma from delivery or DandC trauma

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11
Q

what are congenital factors that may lead to cervical insufficiency?

A

collagen disorders

DES exposure

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12
Q

when does HTN onset to be considered gestational?

A

after 20 weeks gestation and no proteinuria

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13
Q

define preeclampsia?

A

htn develops with proteinuria after 20 weeks gestation

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14
Q

define eclampsia

A

HTN with proteinuria that leads to tonic clonic seizures

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15
Q

what can be found with preeclampsia but isnt specific finding?

A

edema

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16
Q

when is preeclampsia considered severe?

A

BP 160/110 at minimum

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17
Q

with preeclampsia severe, what is fetus at risk for?

A

growth abnormalities

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18
Q

what are findings in mother with severe preeclampsia?

A

liver function disturbance, renal abnormalities, low platelets

19
Q

what is thought to cause preeclampsia?

A

endothelial disturbances

20
Q

what pre existing coniditions increase risk for preeclampsia?

A

HTN, diabetes, renal disease

21
Q

what are some common presenting signs for severe preeclampsia?

A

RUQ pain, HA< cyanosis, oliguria

22
Q

what do women with preeclampsia hae long term increased risk for?

A

CV disease

23
Q

what is HELLP syndrome?

A

variant of severe preeclampsia….that has hemolysis, elevated liver enzymes and low platelets

24
Q

if woman gets HELLP syndrome, what should you do?

A

deliver rn

25
Q

what do you give for preeclampsia HTN?

A

antihypertensives…

26
Q

what do you give to limit seizure risk in mom with preeclampsia?

A

seizure prophylaxis with magnesium sulfate

27
Q

when does eclampsia occur?

A

can be antepartum, intrapartum or postpartum

28
Q

what happens in eclampsia?

A

seizures and coma

29
Q

when does fatty liver of pregnancy occur?

A

3rd trimester only

30
Q

what are sx of fatty liver of pregnancy?

A

N/V
abdominal pain
JAUNDICE
hypoglycemia

31
Q

what is pathogenesis of fatty liver of pregnancy?

A

micro vesicular fatty infiltration of hepatocytes

32
Q

what do half of moms with fatty liver of pregnancy also have?

A

preeclampsia

33
Q

what is umbilical cord prolapse?

A

cord slips ahead of presenting part of fetus and protrudes into cervical canal

34
Q

what type of fetal presentation is biggest risk for umbilical cord prolapse?

A

breech and shoulder

35
Q

what do you do to treat umbilical cord prolpse?

A

elevate presenting part to prevent cord compression and do C section

36
Q

what is shoulder dystocia?

A

head delivered then anterior shoulder cannot pass

37
Q

what is the sign associated with shoulder dystocia?

A

turtle sign….head retracts into the perineum after expulsion

38
Q

what can happen with shoulder dystocia?

A

erbs palsy

39
Q

how does hemostasis occur after delivery?

A

contractions of myometrium

and local hemostatic factors released

40
Q

what are the four Ts of postpartum hemorrhage?

A

uterine atony (tone)
Tissue (retained placenta)
Trauma
cloTTing issue

41
Q

what is uterine atony?

A

lack of effective uterus contraction after delivery

42
Q

what is management of post partum hemorrhage?

A

fluid and blood replacement
treat cause
uterotonic agents given

43
Q

if hemorrhage is bad enough, what do you do?

A

emergency hysterectomy

Repro Week 4 (8 decks)

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