Pregnancy Problems Flashcards
Anaemia
Presentation: feel tired/weak, pale, feel faint, shortness of breath
Management: take iron and folic acid supplements
Hyperemesis gravidarum
Presentation: persistent nausea, vomiting several times a day, weight loss, reduced appetite, dehydration, feeling faint
Management: dry bland foods, fluids, antiemetics, hospitalisation so can be fed intravenously
Ectopic pregnancy
Presentation: abdominal pain, shoulder pain, vaginal bleeding, feeling dizzy or faint
Investigation: transvaginal ultrasound, hCG test to confirm pregnancy
Management: prescribe methotrexate if no fetal heartbeat, salpingectomy if heartbeat present/significant pain
Miscarriage
Presentation: vaginal spotting/bleeding, cramping or abdominal pain, fluid or tissue passing from the vagina
Management: treatment to remove pregnancy tissue in the uterus, counselling
Placenta praevia
Placenta covers part or all of cervical opening
Presentation: painless vaginal bleeding during 2nd/3rd trimester
Management: palpation to move, usually migrates, but if present at birth then delivery by Caesarean section
Placental abruption
Placenta separates from uterine wall before delivery so fetus doesn’t receive enough oxygen
Presentation: vaginal bleeding, cramping, abdominal pain and uterine tenderness
Management: bed rest, if more than half separates requires early delivery
Pre-eclampsia
Causes HBP and problems with kidneys, after 20 weeks
Presentation: HBP, swelling of hands and face, protein in urine, stomach pain, blurred vision, dizziness, headaches
Management: hydroalazine to lower BP and MgSO4 to prevent seizures, only cure is delivery
Preterm labour
Labour before 37 weeks
Presentation: increased vaginal discharge, pelvic pressure and cramping, back pain radiating to abdomen, contractions
Management: tocolytics such as ritodrine hydrochloride, bed rest, early delivery
Bacterial vaginosis
Caused by overgrowth of bacteria normally found in vagina, smells fishy, is grey, treat with metronidazole
Infectious diseases screened for during pregnancy
HIV, rubella, syphilis, hep B
Rubella can cause CHD, cataracts and deafness
Gestational diabetes mellitus
Glucose tolerance test over 7 then 2 hours later over 11.1
Can lead to macrosomia, shoulder dystocia, still birth, respiratory distress syndrome, polyhydraminos
Mother: inc risk of pre eclampsia, t2dm, gdm, dramatic delivery, c section
Induction of labour
Cervix ripening with prostaglandins
Assess with bishops score
Amniotomy
Syntocinon (oxytocin) to cause uterine contractions
Indications: GDM, pre-eclampsia, post dates, pre labour rupture of membranes
Primary post partum haemorrhage
Over 500ml of blood loss in the first 24 hours
Causes: trauma, tone, thrombin, tissue
Management: emergency, ABC, 15l/min of oxygen, iv access, cross match FBC clotting U&Es, 0.9% saline, treat underlying cause
if cervical os is still open - retained product
