Toni - Week 5 - Exam 3 Flashcards
what is Group B Streptococcus?
a bacteria that can become colonized in women - no problem for women, but can be deadly for a newborn
what percentage of woman are colonized with GBS?
25% of pregnant women
for newborns, GBS is the leading cause of ____ and _____.
sepsis and deathj
how and when is Group B Streptococcus screened?
GBS is screened via swab/culture of a woman’s rectum and vagina at 35 to 37 weeks gestation
what is done if a woman tests GBS+??
She is given IV antibiotics during labor
If a woman is GBS+ and planned for a C-S, is antibiotics given to treat the GBS??
depends, are the membranes intact or not? if intact, it’s okay; prophylactic antibiotics given during C-S
what two antibiotics are given for GBS?
- penicillin G: 5 million units initial dose, then 2.5 million units q4hr until delivery
- ampicillin: 2 g initial dose, then 1 g q4hr until delivery
what occurs if a mother is GBS+, in labor, not yet screened, and not yet given antibiotics?
there is rapid GBS screen; we will try go wait labor until baby has had an adequate dose of 4 hrs
what occurs when a baby has not been given an adequate dose for GBS antibiotics?
If baby born within 1/2/3hr - not given adequate tx - tell MD - further watching
what is cervical insufficiency?
premature dilation of cervix WITHOUT contractions - (efface/change of the cervix)
what are the risk factors of cervical insufficiency?
short cervix, cervical trauma, and possibly an abortion that manipulated the cervix (the integrity of cervix is lacking in order to stay closed)
what are the 4 ways that cervical insufficiency be managed?
bedrest, fluids, possible tocolysis (meds to stop contraction), and cerclage
cerclage: what is it?
circle stitch around cervix to reinforce CLOSED cervix **can’t tighten up, needs to be closed
cerclage: when is it placed?
surgically placed 12 - 14 weeks gestation
cerclage: what are activity restrictions?
pelvic rest (no tampons, no sex, minimal vaginal exam) possible bedrest
what is hyperemesis gravidarum?
pernicious (dangerous) vomiting first 20 weeks - beyond morning sickness
what is hyperemesis gravidarum associated with?
significant dehydration and weight loss **hard on mother and developing fetus
what are the 7 interventions for hyperemesis gravidarum?
- IV fluids with glucose, electrolytes, vitamins (NS, D5W, Banana Bag)
- Antiemetics
- Sea-bands (accupressure), ginger, herbal tea
- TPN, small frequent meals (crackers)
- Avoid laying down 2 hrs after eating
- Home: carbonated drinks, high protein drinks
- Monitor fetal growth via serial ultrasounds
what is placenta previa?
placenta implanted near or over cervix
what are the signs and symptoms of placenta previa?
painless bleeding after 20th week without uterine contractions
what are the risk factors of placenta previa?
history of C/S, ↑ maternal age/parity, smoking
what are the three different types of placenta previa?
marginal, complete, low lying
what are the management steps for placenta previa?
- ultrasound, type/Rh/cross, CBC (H+H)
- IV, external fetal monitoring, bedrest, pelvic rest, no straining for BM (stool softener, nutritiono)
- no vaginal exams, assess blood loss (dislodged placenta)
placenta previa: what types are possible for a vaginal birth?
low lying or marginal previa