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PAR3031 - MATERNITY > Week 5 > Flashcards

Week 5 Flashcards

1
Q

what are the 2 categories of maternal death?

A

direct and indirect

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2
Q

What is direct maternal death?

A

deaths are those resulting from obstetric complications of pregnancy or its management

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3
Q

What is indirect maternal death?

A

Indirect maternal deaths are those resulting from diseases or conditions that were not due to a direct obstetric cause, but were aggravated by the physiologic effects of pregnancy

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4
Q

define parity

A

Parity refers to a woman’s number of previous pregnancies, excluding the current pregnancy, carried to a viable gestational age (usually 20 weeks).

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5
Q

how much more common is VTE in pregnant woman than women in general?

A

10x

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6
Q

What is VTE?

A

Venous Thromboembolism

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7
Q

What are some risk factors for VTE?

A 
Age >35
Obesity
Parity >4
History of thromboembolism
Prolonged travel
Operative delivery
Instrumental vaginal delivery
Prolonged labour >12 hours
>4 days bed rest (immobility)
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8
Q

How would you manage a patient with PE or VTE?

A 
Consult PIPER/clinician
MICA early
Upright position
Oxygen
Rapid transport with notification
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9
Q

what happens in amniotic fluid embolism?

A

Usually during labour or procedure: amniotic fluid/debris enters maternal circulation
Anaphylaxis or activation of the complement cascade (or both!)

Progression is in 2 phases

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10
Q

what are the s&s for amniotic fluid embolism?

A

Normal scenario is: women has acute resp distress then collapses often after doing a big push during labour or after delivery.

Common “premonitory” symptoms:

  • breathlessness
  • chest pain
  • cold and light headed
  • restless-panicked and distressed
  • pins and needles in fingers
  • nausea and vomiting
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11
Q

what should always be a differential in a pregnant patient with ATYPICAL chest pain?

  • especially if pain is interscapular with hypertension
A

Aortic dissection

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12
Q

What should be suspected if there is sever headache during pregnancy or post natal period?

A

Intercranial haemoorhage

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13
Q

What is associated with hypertensive diseases in pregnancy?

A

intercranial haemorrhage

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14
Q

What are risk factors for genital tract sepsis?

A
  • obesity
  • vaginal discharge
  • vaginal trauma during birth
  • anaemiaq
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15
Q

what are some causes of sepsis prior to birth?

A
  • miscarriage
  • termination of pregnancy
  • cervical suture
  • ruptured ectopics
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16
Q

what are some causes of sepsis post to birth?

A
  • retained products

- postoperative infections

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17
Q

what is the mortality rate of sepsis in pregnant patients?

A

20-40%

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18
Q

What is a differential for placental abruption

A

Sepsis

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19
Q

What are S&S for sepsis in pregnancy?

A
  • everything you’d expect in a non
  • pregnant patient +
  • vaginal discharge
  • Abdo pain
  • D & V
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20
Q

what are some minor disorders of the digestive system seen in pregnancy?

A 
Morning sickness
Heart burn
Constipation
Ptyalism (excessive salvation)
Pica (cravings)
21
Q

How do you treat morning sickness?

A

dry biscuits and fluid

22
Q

What complications can arise from morning sickness?

A

–Hyperemesis
•leading to Weight loss;
–Dehydration;
–Electrolyte imbalances

23
Q

Whats the cause of heartburn in prego patients?

A

progesterone relaxes cardiac sphincter

  • usually occurs in late pregnancy
24
Q

how do you manage heartburn in pregnant patients?

A

Avoid bending over
Small meals
Sleep semi-recumbent or right side
If severe → antacids

25
Q

What causes constipation in pregos?

A

Progesterone relaxes bowel
Bowel displaced by growing uterus
Iron supplements
Occurs throughout the pregnancy

26
Q

How do you treat constipation?

A

Hi fibre diet & water +++
Moderate exercise
Aperients last resort

27
Q

How do you treat Ptyalism & Pica?

A

Effective reassurance if uncomfortable
Craving may be potentially dangerous
–Requires further investigation

28
Q

what are some minor disorders of the circulatory system seen in pregnancy?

A

Anaemia
Fainting
Varicosities
Supine Hypotension

29
Q

WHat causes Anaemia in oregnancy?

A

Circulating blood/plasma volume ↑’s 50%
Red blood cells ↑18%
Considered normal
–unless physiologically compromised

30
Q

What causes fainting in pregnancy?

A

1.Vasodilatation & poor return to heart
•May occur throughout pregnancy

2.Supine Hypotension
•Later in pregnancy: middle of 2nd trimester to birth

31
Q

How do you treat fainting in pregnancy?

A
  1. Avoid long periods of standing if vasodilation

2. Avoid lying on back later in pregnancy

32
Q

What causes varicosities - varacose veins

A

Progesterone relaxes sooth muscle

↑’ing weight & pelvic congestion

33
Q

How do you manage varacose veins?

A

Leg exercises
Raising legs when able
Support stockings
Reassure will cease a few months after delivery

34
Q

what are some minor musculosketal disorders seen in pregnancy?

A 
Back aches
Sciatica
Sublaxations & dislocations
Cramps
Pelvic floor damage
35
Q

What causes back aches/sciatica/sublaxations?

A

Progesterone (& relaxin later) muscle relaxant
Change in centre of gravity of growing uterus
–occurs any time but usually in 3rdtrimester

36
Q

How do you manage cramps in pregnancy?

A

Elevate feet slightly
Moderate exercise & leg movements
Warm bath prior to sleep

37
Q

What causes pelvic floor damage?

A
  • Cause
  • Progesterone
  • ↑’ing weight on pelvis
38
Q

what are some minor disorders seen in genitourinary system during pregnancy?

A
  • frequency of urine

- leucorrhoea

39
Q

What causes an increase in frquency of urination in pregnancy?

A

Bladder competes for space in pelvis with growing uterus & later with foetal head
UTI’s more common in pregnancy

40
Q

What is Leucorrhea?

A

Increased benign white vaginal discharge

41
Q

what causes carpal tunnel syndrome in pregnancy?

A

Oedema and pressure on the median nerve

Occurs most commonly in the morning

42
Q

what is Linea Nigra?

A

line from belly button to pelvis

43
Q

what IS CHLOASMA?

A

butterfly shaped pigmentation on face

44
Q

how much blood can a pregnant patient lose without showing symptoms?

A

30-50%

45
Q

What are some potential complications with trauma in a pregnant patient?

A
  • Placental abruption
  • Cardiorespiratory arrest
  • Labourand birth
  • Preterm labour
  • Spontaneous abortion
  • Uterine rupture
  • Pelvic fractures
  • Haemorrhageand shock
  • Prematurity and low birth weight
46
Q

what is the acronym for possible causes of maternal cardiac arrest?

A

BEAUCHOPS

47
Q

What does BEAUCHOPS stand for?

A

B- Bleeding/DIC
E - Embolism cardiac/pulmonary/amniotic fluid
A - Anaesthetic complications
U - Uterine atony
C - Cardiac disease: MI/ischemia/aortic dissection/cardiomyopathy
H - Hypertension/preeclampsia/eclampsia
O - Other -Review standard ACLS guidelines (Hs and Ts)
P - Placental abruptio, previa
S - Sepsis

48
Q

WHat are the 4 H’s & T’s for causes of cardiac arrest?

A
  • hypoxia
  • hypothermia
  • hyperkalaemia
  • hypovolaemia
  • tamponade
  • TPT
  • thrombosis
  • toxins

PAR3031 - MATERNITY (11 decks)

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