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Women's Health > Quiz 7 > Flashcards

Quiz 7 Flashcards

1
Q

Gestational diabetes

A

develops during pregnancy and screened at 24-28 weeks by a FBS and 1-hr glucose challenge test—if abnormal, then 3-hr glucose tolerance test (GTT); affects about 18% of pregnant women

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2
Q

Pregestational diabetes

A

detected during the first prenatal visit by a FBS or random BS

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3
Q

Prevalence order for gestational diabetes

A

African American
Hispanic
Native American
Asian cultures/ethnic groups

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4
Q

Insulin in normal pregnancy

A

As the placenta grows, the hPL and somototropin (placental) hormones increase in production causing insulin resistance, causing increases in insulin secretion to overcome the action of these hormones. Normally the pancreas can respond and control glucose levels

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5
Q

Insulin in diabetes pregnancy

A

insufficient insulin to meet the metabolic needs and changes

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6
Q

Spontaneous Abortion

A

Bleeding disorder
Loss of a pregnancy before 20 weeks gestation
Cause unknown/highly variable
1st trimester commonly due to fetal genetic abnormalities (80%)
2nd trimester more likely related to maternal conditions (20%)
This is usually managed as an outpatient

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7
Q

Spontaneous Abortion symptoms

A 
Vaginal bleeding (starts as spotting, can increase)
Cramping or contractions
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8
Q

Spontaneous Abortion: threatened

A

Slight bleeding, no cervical changes

reduce activity, ensure adequate hydration

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9
Q

Spontaneous Abortion: Inevitable

A

Increased vaginal bleeding, ROM, cervical dilation, strong cramping, possible passage of “POC”

U/S & hCG levels to confirm pregnancy loss, vacuum curettage if POC are not passed to prevent infection & reduce risk of excessive bleeding

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10
Q

Spontaneous Abortion: Incomplete

A

heavy bleeding, intense cramping, cervical dilation

U/S to confirm, stabilize patient, u/s confirms that “POC” are still in uterus, D&C or Misopostol (prostaglandin analog)

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11
Q

Spontaneous Abortion: Complete

A

ID & treat underlying cause, genetic/chromosomal abnormalities, reproductive tract abnormalities, incompetent cervix; possible cervical cerclage in 2nd trimester of future pregnancies

U/S to confirm, no med/surg intervention necessary, f/u appt for family planning discussion

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12
Q

Spontaneous Abortion: Missed

A

irregular spotting, absent contractions, U/S to confirm presence of “POC”

U/S to confirm presence of “POC”, vac.curettage-1st Tri, D&C-2nd Tri, (Induction of Labor-post 20 weeks gestation= stillbirth).

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13
Q

Spontaneous Abortion: Habitual

A

hx of 3 or more consecutive spontaneous abortions

ID & treat underlying cause, genetic/chromosomal abnormalities, reproductive tract abnormalities, incompetent cervix; possible cervical cerclage in 2nd trimester of future pregnancies

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14
Q

Cervical insufficiency

A

Premature spontaneous dilatation of cervix

Spontaneous dilation occurs without contractions in the second trimester. It is typically rapid, relatively painless, and accompanied by minimal bleeding, and it results in the loss of the pregnancy

Cervical cerclage can be put in to prevent this- snip at 36 weeks

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15
Q

Ectopic Pregnancy

A

Emergency***
Fertilized ovum implants outside the uterine cavity
Most common place is Fallopian tube
Pain on side and bleeding- common symptoms

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16
Q

Ectopic Pregnancy symptoms

A

Abdominal pain
Spotting
6-8 weeks after a missed period

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17
Q

Ectopic preg rupture symtpoms

A

severe sharp, sudden pain, hypotension, abdominal tenderness with distention, hypovolemic shock

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18
Q

Gestational Trophoblastic Disease (GTD)

A

Fertilized egg by sperm but doesn’t have mothers DNA so it’s not viable
Hydatidiform Mole
Choriocarcinoma

19
Q

Complete Hydatidiform Mole

A

empty egg fertilized by one normal sperm

20
Q

Partial Hydatidiform Mole

A

normal egg fertilized by two normal sperm

21
Q

Choriocarcinoma

A

Aggressive, virulent cancer that rises from the trophoblastic tissue and
often metastasizes to lungs, lower GI tract, brain, liver, kidneys

22
Q

GTD symtpoms

A

Early is normal signs of pregnancy
Late: similar to spontaneous abortion at 12 weeks
severe, morning sickness
brownish vaginal spotting/bleeding,
uterine size larger than expected for dates,
extremely high hCG levels
U/S shows no fetal activity/heart rate at 6-10 weeks,
U/S shows typical transparent vesicular molar pattern in uterus

23
Q

GTD management

A

Emphasize the importance of serial hCG monitoring & birth control for 1 year
Avoid pregnancy for 1 year

24
Q

Placenta Previa

A

Usually happens last 2 trimesters
Occurs when embryo implants in the lower uterine segment
Placenta covers some to all of the cervical os

25
Q

Placenta previa symptoms

A

Bright red bleeding
Usually painless
Start and stop bleeding
Baby’s HR is normal

26
Q

Placenta previa

Accreta, Increta, or Perceta

A

Accerta- sticks to wall of uterus
Increta- penetrates wall
Perceta- whole way through

27
Q

Abruptio Placentae

A

Emergengy***
Separation of a normally located placenta leading to hemorrhage & compromised fetal blood supply
Pregnant woman can lose up to 40% of her blood volume before showing signs
Immediate C-section

28
Q

Abruptio Placentae symptoms

A 
Bleeding (dark red clot)
Decrease fetal movement/HR
Fundal height changes could indicated a concealed hemorrhage
Painful (knife-like)
uterine tenderness
29
Q

Disseminated Vascular Coagulation (DIC)

A

Patient starts to bleed (due to increase of circulating plasmin) yet has too much thrombin therefore develops small clots throughout the body

30
Q

DIC symptoms

A

bleeding from other places such as gums and IV site, petechiae, tachycardia

31
Q

Hyperemesis Gravidarum

A

Severe form of persistent, uncontrollable n/v

32
Q

Chronic HTN

A

HTN that exists prior to pregnancy or that develops before 20 weeks’ gestation. Classified as mild or severe based on systolic & diastolic values.

33
Q

Gestational HTN

A

BP elevation (140/90) identified after 20 weeks’ gestation without proteinuria. BP returns to normal by 12 weeks postpartum

Diagnosis = BP >140/90 mm Hg, 2x, at least 6h apart, after 20 weeks of gestation

34
Q

Preeclampsia

A

st common HTN disorder of pregnancy, which develops with proteinurea after 20 weeks’ gestation. It is a multisystem disease process, classified as mild or severe, depending on the severity of the organ dysfunction

35
Q

Eclampsia

A

Onset of seizure activity in a woman with preeclampsia

36
Q

Chronic HTN & Superimposed Preeclampsia

A

Occurs in ~20% of pregnant women, with increased maternal & fetal morbidity rates

37
Q

Preeclampsia symptoms

A

Vasospasm & hypoperfusion are the underlying mechanisms
epigastric pain and increased liver enzymes
headaches, visual disturbances, blurred vision and hyperactive DTR’s
Edema (pulmonary and generalized)
IUGR, abruptio placentae, persistent fetal hypoxia, acidosis

38
Q

Eclampsia management

A

seizures prevention- bedrest, position on side, low stimulation
Diuresis is a positive sign that, along with a decrease in proteinuria, signals resolution of the disease.

39
Q

Severe preeclampsia symptoms

A

BP >160/110 & symptomatic

40
Q

HELLP syndrome

A

complication of severe preeclampsia

hemolysis, elevated liver enzymes, low platelets

41
Q

Hydramnios

A

Too much amniotic fluid in third trimester

42
Q

Oligohydramnios

A

Decreased amount of amniotic fluid

43
Q

Multiple gestation

A

More than one fetus being born to a pregnant woman

44
Q

Premature rupture of membranes

A

Water breaks after 37 weeks but before onset of labor
Risk for infection if rupture is greater than 24 hours

PPROM rupture before 37 weeks

Amniotic fluid looks like a fern leaf under microscope
Nitrazine paper –> blue=amniotic fluid

Women's Health (10 decks)

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