Pregnancy, Preterm Labor & Women's Reproductive Health

Vocabulary flashcards covering key concepts from lecture notes on pregnancy, preterm labor, and women's reproductive health.

Iron supplementation for pregnancy

Administered beginning with the first prenatal visit and continued to 6 weeks postpartum.

Common adverse effects of iron supplements

Nausea, constipation, black stools, GI irritation, epigastric pain, vomiting, urine discoloration, and diarrhea.

Administering iron supplements

Take with water/juice initially; if GI upset, take with food.

Folic acid deficiency early in pregnancy

Can result in spontaneous abortion and congenital disorders such as brain malformation or spina bifida.

Folic acid supplementation timing

400-800 mcg 1 month before pregnancy, continued 2-3 months into pregnancy.

Safe antacids during pregnancy for heartburn

Antacids without sodium (combo antacids Ca/Al).

First-line pharmacologic treatments for constipation during pregnancy

Metamucil and docusate sodium.

Analgesic for use throughout pregnancy (short-term, therapeutic doses)

Acetaminophen (Tylenol).

Risks of aspirin in pregnancy

May inhibit initiation of labor and prolong labor, and greater blood loss.

Ibuprofen contraindication during the third trimester of pregnancy and during labor and delivery

Premature closure of ductus arteriosus and bleeding risk.

Tocolytic therapy

To decrease uterine muscle contractions.

Adverse effects of sympathomimetic drugs in pregnant women

Arrhythmias, increased heart rate, hyperglycemia, hypokalemia, MI, and pulmonary edema.

Parenteral magnesium sulfate action

Relaxes smooth muscle, including the uterus, through calcium displacement.

Combined hormonal contraceptives (CHCs)

Contain estrogen and progestin.

Estrogen component in CHCs

Prevents pregnancy by inhibiting ovulation, preventing the formation of a dominant follicle.

7-day pill-free period in CHCs (withdrawal bleeding)

Allows estrogen and progestin levels to decrease, leading to the breakdown of the endometrial lining.

Health risks from eliminating withdrawal bleeding with CHCs

No risks involved.

Withdrawal bleeding with 84 days of active pills and 7 days of inert pills (extended-use CHCs)

Occurs four times per year.

Menstrual disorders benefiting from continuous-cycle CHCs

Menorrhagia, metrorrhagia (irregular), endometriosis, dysmenorrhea, PMS, and physiologic ovarian cyst formation (PCOS).

Breakthrough bleeding

An episode of bleeding that occurs during the active pill cycle of COC products.

Impact of breakthrough bleeding on COC effectiveness

No decrease in effectiveness.

Absolute contraindications for combined hormonal contraceptives (CHCs)

Pregnancy, venous thrombosis, vascular disease, liver disease, undiagnosed vaginal bleeding, breast cancer, tobacco use, and migraines with aura.

Adverse effects of excess estrogen on fluid balance

Fluid retention.

Adverse effects of excess estrogen on breasts

Enlargement and tenderness.

Cardiovascular risks of estrogen

Hypertension (HTN), myocardial infarction (MI), pulmonary embolism (PE), and cerebrovascular accident (CVA).

ACHES acronym (dangerous cardiovascular side effects of estrogen)

Abdominal pain, chest pain, headache, eye problems, swelling/aching in legs.

Adverse effect of estrogen avoided by progestin-only contraceptives

Higher incidence of irregular bleeding and spotting, with the possibility of mood changes, fatigue, weight gain, and decreased libido.

Candidates for progestin-only contraception

Women who cannot take estrogen, patients with a family history of VTE or heart disease, breastfeeding women, smokers older than 35, and women with hypertension.

Minipill (progestin-only pills) administration

Taken daily within a 3-hour window.

Depot medroxyprogesterone acetate (DMPA) administration schedule

Every 11-13 weeks.

Managing late DMPA injection

Rule out pregnancy.

Calcium and vitamin D supplementation with DMPA

Recommended due to potential low estrogen levels that may lower bone density.

Menopause

Permanent cessation of spontaneous menses for 1 year, caused by cessation of ovarian function; typical age of onset is 51 years.

Common menopausal symptoms treated with hormone therapy (HT)

Hot flashes, vaginal dryness, and associated sleep disorders.

Boxed warning for hormone therapy (HT) in postmenopause

Lowest dose possible for the shortest duration possible (less than 5 years), and only for treatment of menopausal symptoms.

Alendronate administration

Taken with water, on an empty stomach 30 minutes prior to food, and remain upright for 30 minutes.

Common side effects of alendronate

Abdominal pain and acid reflux.

Side effects of raloxifene

Hot flashes and risk of DVT.