Week 5- other preganacy conditions Flashcards
What is hyperemisis gravidarium?
what are the causes and things to consider
sevre vomitting
Causes- unknown, endocrine?
often assocaited with multiple births (twins, tripplets)
Starts around 6 weeks
may last longer than first trimester
consider electrolytes and hypovolemia
what is the managment for hyperemisis gravidarum?
History: EPOMS
Examination- vital signs, vomitus, skin, turgor
Managment- transport to primary obsetric service- consult with clanician- ?IVF, ?antiemetic
what is an in compitent cervix?
painless dilation of cervix, the foetus, placenta and membranes completly expelled- painless delivery of foetus usually in second trimester (16-23 weeks)
- If known stich paced untill dilation of the cervix
what are reduced foetal movements?
foetal movements start 16-24/40, recognise normal pattern by 28 weels- expect 10 movements in 2 hours
maternal concern with decreased movments overids any definition of DFM- should be assessed within 2 hours of noticing.
what assesments will the hospital do if there is reduced foetal movements?
Need to consider risk factors for still brith; foetal growth restriction, hypertension, diabetes, advanced maternal age
Examination and investigation depends on gestation and risk factors
What is the definition of a venous thromboembolism?
What id deep vein and PE?
is it more likley in pregnant people?
Thrombus in the venous system which becomes detached- lodges elsewhere. Deep vein- lodged in the veins of the legs or the pelvis
PE
it is 10 times more common in pregnant women than in women the same age that are not pregnant.
what are the risk factors for deep vein thromboembolism?
age >35 obesity parity >4 History of thromboembolism prolonged travel operative delivery instrumental vaginal delivery prolonged labour >12 hours > 4 days bed rest or immobility
What is the ambulance diagnosis and treatment for venous thromboembolism?
DIfficult to diagnose
Manage as per non-pregnant paitent, consut PIPER or clinician, MICA early, Upright poistion, Oxygen and rapid transport with notification
what i amniotic fluid embolism?
Rare condition- unpredictable-without warning, rapidly progressive, patho unknown.
Usually during labour or procdure- amniotic flud entres maternal circulation and there is anapylaxis or activstion of complement cascade
what are the sings and symptoms of amniotic fluid embolsim?
Acute resp distress or collapse after birth or push
Symptoms prior to colapse- breathlessness, chest pain, cold and light headed, restlessness, paniced and distressed, pins and needles, nausea and vomitting.
what is the av managment for amniotic fluid embolsim?
Manage what you see oxygen therapy IV enroute- fluids to maintain CO consult lights and sirens with pre-alert
what are the causes of sepsis likned with pregnancy?
- antenatal and post-partum periods
Often due to genital tract
A- misscarriage, termination of pregnancy, cervical structure, ruptured ectopic
p- retained producys, postoperative infections
could also be unrealted to pregnancy
what are the signs and symptoms of sepsis in pregnancy?
Everything from normal spepsis plus vaginal discharge, abdo pain and D and V
DIC and uterine atony common: can lead to PPH
what is the managment for a pregnant sepsis paitent?
In sevre sepsis the foetus needs to be delivered
- manage as per non-pregnant paitents
Pre-alert and time critical pt transport
when is suicide highest in pregnancy?
in the third trimester
what is tokophobia?
pathological fear of pregnancy can lead to an avoidance of childbirth
what are the risk factors for mental health presentations ?
women in late pregnancy and first three months post partum previous mental health issues social isolation previous puerperal psychosis recent termination unwanted pregnancy
what is the managment for mental health conditions in pregnancy?
new onest- transport and follow up
support and guidance
good communication
check environment if safe for the baby
what are the most common minor conditions of pregnancy?
naesea and vomitting, constipation, reflux, heammorides, vericose veins, pelvic gerdle pain, carple tunnel syndrome
what causes fainting in pregnancy?
vasodilation and poor venus return to heart
supine hypotension in later pregnancy >28 weeks
anemia
what is the managment for fainting in pregency
left lateral position
don’t stand or lay down for prolonged periods of time
what causes anemia in pregnancy?
increased blood volume 30-50%
increased red blood cell mas 18-20%
plasma volume increase 50%
what are the sings and symptoms of anemia in pregnancy?
weakness, fatigue, dizziness, SOB, palpitations
what is the managment for anemia in pregnancy?
increased iron dietry and supplimentary
what causes varicose veins in pregnancy?
progesterone relaxes smooth muscle
increasing weight an dpelvic congestion puts pressure on circulitory system
what is the managment of vericose veins in pregnanacy?
leg exercises, raising legs when able, compression stockins, usually cease after preganancy
what is the cause of morning sickness in pregnancy?
nausea and vommiting usually occurs in the 1st trimester- cause unknown due to HGC? Oestrogen?
what is the managment of morning sickness?
smaller, more frequent meals, ginger, prescription meds
what are some of the complications of morining sickness in pregnancy?
Dehydration and loss of weight
what causes heart burn in pregnancy?
usually late
progestorone relaxes the gastric sphincter
as size of foetus gros, there is increased pressure on the stomach and gastric contests into the oesophegus
what is the managment of reflux?
avoid bending over, small meals, sleep semi-recumbant, if severe antacids
what are the causes of constipation in pregnancy?
Progestorone relaxes the bowel, bowel displaced by growing uterus, iron suppliments
what is the managment for constipation?
high fibre diet, moderate exercise
why xo pregnant people experince frequent urine output and UTIs?
bladder compressed by growing uterus
what are some of the things that cause musculoskeltal back pain in pregnancy?
Progesterone and relaxin later are muscle relaxants
there is a change in the centre of gravity
weak pelvic floor muscles and activation of the core
what causes carpel tunnel in pregnancy?
progesterone causes genralised odeam- in the wrist can put pressure on the median nerve
what are the signs and symptoms of carple tunnel syndrome?
pain
wekaness and pins and tingling
what is the managment for carpal tunnel sydrome?
reassure- resolve after pregnancy
raisinf hand on illow ad night
splinting of the hand at night
