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CABS3: Womens Health > Pregnancy Pathophysiology > Flashcards

Pregnancy Pathophysiology Flashcards

1
Q

what is a spontanoues abortion

A

loss of pregnancy prior to 20weeks gestation

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2
Q

what is a missed abortion

A

fetal demise without expulsion from uterine cavity

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3
Q

what is threatened abortion

A

symptoms of abortion (bleeding/cramping) but fetus remains viable and os closed

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4
Q

what can increase the risk of spontaneous abortion

A

advanced maternal age
infection
poorly controlled DM
ETOH
smoking
elicit drug use
obesity
thyroid dysfunction
medications

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5
Q

what accounts for 70% of loss of pregnancy

A

genetic alterations

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6
Q

what are maternal abnormalities that can lead to spontaneous abortion

A

fibroids
intrauterine scarring
trauma
cervical insufficiency

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7
Q

what are causes of second-trimester miscarriage

A

chromosomal abnormalities
congenital brith defects
cervical insufficiency
placental problems
infections
abdominal trauma
thrombophilia
poorly controlled chronic condition
drug and alcohol use

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8
Q

what is a septic abortion

A

infectious agent able to enter endometrium and/or myometrium
risk increased with unsafe abortion techniques, prolonged bleedings, surgical intervention

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9
Q

what is the most common pathogens seen with septic abortion

A

enterobaceriaecaea, strep, staph
associated with procedure or retained products of conception

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10
Q

what is the presentation of septic abortion

A

vaginal bleeding (POC), PID sxs, purulent vaginal discharge, fever, evidence of septicemia

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11
Q

what is the inner layer of the fetal development

A

amnion

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12
Q

what is the outer layer of the fetal development

A

chorion

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13
Q

what is secreted that will cause continued stimulation to corpus luteum to secrete progesterone

A

chorionic gonadotropin

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14
Q

what develops during the 2nd week of placental development

A

yolk sac and amnion development
yolk - nutrients initially
develop primordial germ cells
encourages development of vasculature, fetal RBC production

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15
Q

when does the fetal heart begin to contract

A

day 21

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16
Q

how does the blood get to the fetus

A

umbilical vein

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17
Q

how does blood get from fetus to mom

A

via umbilical artery

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18
Q

what does the placenta secrete

A

estrogens and progestins
takes over for corpus luteum at end of first trimester

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19
Q

once the baby is developed, how much blood is exchanged every minute during the last week

A

625mL of blood

20
Q

what is premature separation of placental form to endo uterine lining

A

abruptio placentae - placental abruption

21
Q

what causes seperation of placenta from endometrium

A

break in vasculature
may be arterial or venous

22
Q

what is placenta previa

A

placenta develops over the cervix
thought to be associated with poor vascular supply in the typical upper uterine cavity attachment area

23
Q

what can increase the risk of placental previa

A

c-section or other trauma

24
Q

what is implantation of fertilized ovum outside of typical intrauterine site

A

ectopic pregnancy

25
Q

where is the most common location of ectopic pregnancy

A

fallopian tube
may also occur within the cervix, ovary, abdominal cavity, previous scar tissue

26
Q

What is the presentation of ectopic pregnancy

A

POOP typically 6-8 weeks after LMP
Pain typically along one of the lower quadrants
vaginal bleeding
may be in shock
syncope

27
Q

what is the problem with cord prolapse

A

compression can cause occlusion of key vasculature - decreased O2 to fetus

28
Q

what are risks for cord prolapse

A

multiples
premature delivery
malformation of uterus
low attached placenta
prolonged labor
long umbilical cord
abnormal fetal presentation

29
Q

what can pre-eclampsia result in

A

maternal hypertension

30
Q

what occurs during preeclampsia

A

spiral artery remains narrow - placenta hypo-perfusion
occurs 18-20 weeks gestation
H20/Na retention- increased BP
vascular dysfunction/inflammation - proteinuria

31
Q

What is HELLP syndrome

A

Hemolysis
Elevated
LiverEnzymes
Low
Platelets

associated with preeclampsia

32
Q

what is eclampsia

A

extreme of preeclampsia
severer HTN and seizures

33
Q

what is the treatment of eclampsia

A

magnesium* key

34
Q

what is normal amounts of amniotic fluid

A

500-1,000mL

35
Q

how often is amniotic fluid exchanged

A

every 3 hours, key electrolytes every 15 hours

36
Q

what are risk factors of PROM (premature rupture of membranes)

A

Trauma
genetic predisposition
inflammatory issues
cigarette smoking

37
Q

what does PROM lead to

A

oligohydramnios

38
Q

what is oligohydramnios

A

loss of amniotic fluid

39
Q

when is primary postpartum hemorrhage usually seen

A

within 24 hours of delivery

40
Q

when is secondary postpartum hemorrhage usually seen

A

24 hours - 12 weeks after delivery

41
Q

What is am amniotic embolism

A

amniotic fluid is able to get into mom’s circulation
m/c occurs during labor or immediate postpartum

42
Q

when is amniotic embolism at an increased risk

A

premature delivery
advanced maternal age
abnormal attachment site of placenta
preeclampsia
c-section
polyhydramnios

43
Q

what is heart failure seen in perimartum period

A

cardiomyopathy - typically third trimester

44
Q

what are risks for cardiomyopathy during pregnancy

A

advanced maternal age
multiple gestation
HTN
african descent
cocaine

45
Q

what is a compounded risk if mom already has a collagen disorder or cardiac malformation

A

arterial dissection/rupture

46
Q

what increases the risk of arterial dissection/rupture during pregnancy

A

increased abdominal pressure
hormonal changes on vasculature

47
Q

when is intracerebral hemorrhage the highest risk

A

3rd trimester - also during postpartum period
typically associated with preeclampsia/eclampsia

CABS3: Womens Health (6 decks)

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