Week 9 Obstetric complications

Question 1

Bleeding between chorion and myometrium OR placenta =

Answer 1

Subchorionic hemorrhage

Question 2

What is subchorionic hemorrhage a risk factor for?

Answer 2

1st trimester, risk factor for spontaneous abortion

Usually resolves spontaneously

Question 3

Discharge instructions for spontaneous abortion/when to call HCP

Answer 3

• Fever >100.4, chills
• Saturate >1 pad/hour
• Large clots >50c piece
  *

Question 4

What describes a natural termination of pregnancy prior to 20 weeks caused by the expulsion of products of conception?

Answer 4

spontaneous abortion

Question 5

Hydatidiform mole pregnancy

What

complications

risk factors

symptoms

Answer 5

What:

• Abnormal growth trophoblastic cells (abnormal sperm/egg union)

Complications

• Benign but can become cancerous *malignant choriocarcinoma*

Risk Factor

• Young or old
• Hx of molar pregnancy

S/S

• Severe/persistent N/V
• Uterine bleeding
• enlarged/tender ovaries
• Develop preeclampsia
• Elevated HCG

Question 6

Management of hyperemesis gravidarum

Answer 6

• Replace fluids
• avoid IV fluids with dextrose
• NPO to rest gut

Pharm

• Promethazine (Phenergan)
• Prochlorperazine (Compazine)

Question 7

When the blastocyst implants in the fallopian tubes, this leads to

Answer 7

Ectopic pregnancy

Question 8

In a hydatidiform pregnancy, the trophoblast contains no fetal tissue.

True or false?

Answer 8

True

Question 9

what is preterm labor?

Answer 9

birth before 37 weeks

Question 10

What is the leading cause of neonatal mortality, longer morbidity and neurologic disability?

Answer 10

Preterm labor

Question 11

What are the signs of preterm labor?

Diagnostic criteria?

Answer 11

• Pelvic Pressure
• lower back pain
• Abdominal tightness, cramps
• >6 contractions/hour
• Fetus low before 36 weeks
• Increased vag discharge/bleeding
• diarrhea

Diagnostic criteria

• Uterine contractions between 20 to 36 weeks
• Cervical effacement 80% or greater
• Cervical dilatation >1cm

Question 12

When does insulin resistance in pregnancy peak?

Answer 12

24 - 28 weeks

Question 13

What are the complications of fetal macrosomia?

Answer 13

• Protracted labor
• Shoulder dystocia
• Brachial plexus injury
• Cephalohematomoa
• Facial palsy
• Clavicle fracture
• C section

Question 14

What is the criteria for gestation diabetes?

What about for a glucose tolerance test?

Answer 14

• Fasting blood sugar >92 but <126

Glucose tolerance test

• Fasting >92
• 1 hour >180
• 2 hours >153

Question 15

What glucose tolerance test results would cause you to refer to the obstetric team?

Answer 15

• Fasting sugar 105
• 1 hour 190
• 2 hour 165
• 3 hour 145

THIS IS A HIGH RISK PATIENT

Question 16

Vasa Previa

Answer 16

Fetal blood vessels cross cervical opening = hemorrhage

Question 17

signs of abruptio placenta

Answer 17

Mimic labor

back pain/pelvic pain

tender abdomen

Bloody discharge

Question 18

Which condition is created when velamentous vessels precede the fetus?

Answer 18

vasa previa

Question 19

Which of these options describes marginal previa?

Answer 19

The edge of the placenta is near but not actually covering the internal cervical os.

Question 20

When are conditions such as thrombophlebitis, thyrotoxicosis, uterine subinvolution, and endometritis likely to occur?

Answer 20

post partum period

Question 21

What will the labs look like for a patient with acute hep B infection?