pregnancy pathophys Flashcards
What are some common causes of spontaneous abortion
Genetic alterations**
Maternal abnormalities
placental abruption
premature rupture
What is the most common cause of septic abortion
vaginal bacteria
-strep
-staph
-enterobacteria
What does the endoderm lead to
respiratory tract
GI tract
Visceral organs
When does the yolk sac develop
2nd week
What is the initial type of cells that will become the placenta
Syncytiotrophoblast
*help produce HCG
How much blood is within the placenta by the last week during pregnancy
625mL exchanged every minute
What is the job of the placenta in the second trimester
takes over the job of the corpus luteum and secretes the estrogen and progesterone
Placental abruption
separation of the placenta from the endo uterine lining
What is placenta previa
placenta develops on top of the cervix
What increases the risk of PID and ectopic pregnancy
smoking
What are ectopic pregnancies associated with
inflammatory or scar developing state
*m/c in fallopian tube
What is the leading cause of death for women in the first trimester of their pregnancy
ectopic pregnancy
Why may a woman die from an ectopic pregnancy
the fallopian tube ruptures and the patient exsanguinates
What is the presentation of an ectopic pregnancy
POOP 6-8 weeks after LMP
pain along lower quadrants
vaginal bleeding
maybe in shock
syncope
What are the risks for cord prolapse
Multiples
premature delivery
uterine malformations
low placenta
prolonged labor
long cord
abnormal fetal presentation
When should the spiral arteries in the placenta enlarge and what occurs if they dont
18-20weeks
If they remain narrow = placental hypo perfusion
What causes increased BP with preeclampsia
H2O and Na+ retention
*leads to proteinuria
What is occurring in eclampsia
Diffuse vasospasm as a result of placental ischemia and leading to seizures
Close to delivery, what is responsible for breaking the membranes down in the uterus
matrix metalloproteases
What is a common cause of a premature rupture of membranes
Genital tract infections causing inflammation and weakening
What are the risk factors for prematures membrane rupture
Trauma
genetic predisposition
inflammatory issues
cigarette smoking
What does PROM lead to
oligohydramnios
How much pressure is elicited on the fetus during each contraction
25lbs
When do membranes typically rupture
once the cervix is fully dilated
What can RH incompatibility lead to during pregnancy
Fetal hemolytic anemia
hydrops fetalis
Fetal demise
What is virchows triad
endothelial injury
stasis
hypercoagulability
When do amniotic embolisms typically occur
During labor or immediately post partum
When is cardiomyopathy seen in pregnancy
in the peripartum period
-third trimester
-after delivery
What are the risk factors for peripartum cardiomyopathy
advanced maternal age
multiple gestation
hypertension
African descent
cocaine
What is the vaso vasorum
Vessels that feed the layers of the larger vessels
What are aortic dissections most commonly associated with
HTN
Smoking
advanced age
hyperlipidemia
When are you at the highest risk for intracerebral hemorrhage during pregnancy
third trimester
What is intracerebral hemorrhage typically associated with in pregnancy
preeclampsia / eclampsia
