Pregnancy Pathophysiology Flashcards
what is a spontanoues abortion
loss of pregnancy prior to 20weeks gestation
what is a missed abortion
fetal demise without expulsion from uterine cavity
what is threatened abortion
symptoms of abortion (bleeding/cramping) but fetus remains viable and os closed
what can increase the risk of spontaneous abortion
advanced maternal age
infection
poorly controlled DM
ETOH
smoking
elicit drug use
obesity
thyroid dysfunction
medications
what accounts for 70% of loss of pregnancy
genetic alterations
what are maternal abnormalities that can lead to spontaneous abortion
fibroids
intrauterine scarring
trauma
cervical insufficiency
what are causes of second-trimester miscarriage
chromosomal abnormalities
congenital brith defects
cervical insufficiency
placental problems
infections
abdominal trauma
thrombophilia
poorly controlled chronic condition
drug and alcohol use
what is a septic abortion
infectious agent able to enter endometrium and/or myometrium
risk increased with unsafe abortion techniques, prolonged bleedings, surgical intervention
what is the most common pathogens seen with septic abortion
enterobaceriaecaea, strep, staph
associated with procedure or retained products of conception
what is the presentation of septic abortion
vaginal bleeding (POC), PID sxs, purulent vaginal discharge, fever, evidence of septicemia
what is the inner layer of the fetal development
amnion
what is the outer layer of the fetal development
chorion
what is secreted that will cause continued stimulation to corpus luteum to secrete progesterone
chorionic gonadotropin
what develops during the 2nd week of placental development
yolk sac and amnion development
yolk - nutrients initially
develop primordial germ cells
encourages development of vasculature, fetal RBC production
when does the fetal heart begin to contract
day 21
how does the blood get to the fetus
umbilical vein
how does blood get from fetus to mom
via umbilical artery
what does the placenta secrete
estrogens and progestins
takes over for corpus luteum at end of first trimester
once the baby is developed, how much blood is exchanged every minute during the last week
625mL of blood
what is premature separation of placental form to endo uterine lining
abruptio placentae - placental abruption
what causes seperation of placenta from endometrium
break in vasculature
may be arterial or venous
what is placenta previa
placenta develops over the cervix
thought to be associated with poor vascular supply in the typical upper uterine cavity attachment area
what can increase the risk of placental previa
c-section or other trauma
what is implantation of fertilized ovum outside of typical intrauterine site
ectopic pregnancy
where is the most common location of ectopic pregnancy
fallopian tube
may also occur within the cervix, ovary, abdominal cavity, previous scar tissue
What is the presentation of ectopic pregnancy
POOP typically 6-8 weeks after LMP
Pain typically along one of the lower quadrants
vaginal bleeding
may be in shock
syncope
what is the problem with cord prolapse
compression can cause occlusion of key vasculature - decreased O2 to fetus
what are risks for cord prolapse
multiples
premature delivery
malformation of uterus
low attached placenta
prolonged labor
long umbilical cord
abnormal fetal presentation
what can pre-eclampsia result in
maternal hypertension
what occurs during preeclampsia
spiral artery remains narrow - placenta hypo-perfusion
occurs 18-20 weeks gestation
H20/Na retention- increased BP
vascular dysfunction/inflammation - proteinuria
What is HELLP syndrome
Hemolysis
Elevated
LiverEnzymes
Low
Platelets
associated with preeclampsia
what is eclampsia
extreme of preeclampsia
severer HTN and seizures
what is the treatment of eclampsia
magnesium* key
what is normal amounts of amniotic fluid
500-1,000mL
how often is amniotic fluid exchanged
every 3 hours, key electrolytes every 15 hours
what are risk factors of PROM (premature rupture of membranes)
Trauma
genetic predisposition
inflammatory issues
cigarette smoking
what does PROM lead to
oligohydramnios
what is oligohydramnios
loss of amniotic fluid
when is primary postpartum hemorrhage usually seen
within 24 hours of delivery
when is secondary postpartum hemorrhage usually seen
24 hours - 12 weeks after delivery
What is am amniotic embolism
amniotic fluid is able to get into mom’s circulation
m/c occurs during labor or immediate postpartum
when is amniotic embolism at an increased risk
premature delivery
advanced maternal age
abnormal attachment site of placenta
preeclampsia
c-section
polyhydramnios
what is heart failure seen in perimartum period
cardiomyopathy - typically third trimester
what are risks for cardiomyopathy during pregnancy
advanced maternal age
multiple gestation
HTN
african descent
cocaine
what is a compounded risk if mom already has a collagen disorder or cardiac malformation
arterial dissection/rupture
what increases the risk of arterial dissection/rupture during pregnancy
increased abdominal pressure
hormonal changes on vasculature
when is intracerebral hemorrhage the highest risk
3rd trimester - also during postpartum period
typically associated with preeclampsia/eclampsia
