Maternal-Fetal Nursing – High-Risk Pregnancy Vocabulary

A comprehensive set of key maternal-fetal vocabulary terms drawn from the lecture covering cardiovascular disorders, endocrine & metabolic issues, infectious disease, hematology, obstetric emergencies, and substance use in pregnancy. Use these flashcards to master definitions and clinical significance for exam preparation.

Blood Volume Peak (Pregnancy)

Maximum circulating volume reached around 24–28 weeks’ gestation, ↑ maternal preload.

Cardiac Output (Pregnancy)

Rises ~50 %, forcing the heart to beat harder and faster to meet metabolic needs.

Most Dangerous Cardiac Period

Gestational weeks 28–32, just after blood-volume peak when workload is greatest.

NYHA Class I

Uncompromised heart disease; no symptoms during ordinary activity.

NYHA Class II

Slight limitation; fatigue, palpitations or dyspnea with ordinary activity.

NYHA Class III

Marked limitation; symptoms with less-than-ordinary activity.

NYHA Class IV

Symptoms present even at rest; any activity increases discomfort.

Aortic Dilatation

Pathologic widening of the aorta; pregnancy increases risk of rupture or dissection.

Marfan Syndrome

Inherited connective-tissue disorder predisposing to aortic rupture in pregnancy.

Kawasaki- or Rheumatic-Valve Damage

Previous inflammatory disease causing valvular lesions that may decompensate in gestation.

Digitalis (Digoxin)

Positive inotrope given for maternal heart failure; withhold if pulse

Furosemide (Lasix)

Loop diuretic used for pulmonary edema; watch for hypokalemia & digitalis toxicity.

Nitroglycerin

Rapid-acting vasodilator for angina; 1 tab/5 min ×3, seek ER if pain persists.

Heparin / Enoxaparin

Anticoagulants of choice in pregnancy to prevent DVT or PE; do not cross placenta.

Antiphospholipid Antibody (aPLA) Syndrome

Autoimmune state causing thrombosis, miscarriages; corticosteroids may lower antibody load.

Pulmonary Embolism

Obstruction of pulmonary artery by clot; presents with sudden dyspnea, chest pain, hemoptysis.

Echocardiogram

Ultrasound of the heart used to assess structure & function during pregnancy.

Gestational Diabetes Mellitus (GDM)

Glucose intolerance first recognized in pregnancy, usually 24–28 weeks.

Human Placental Lactogen (HPL)

Placental hormone causing insulin resistance—key to the “diabetogenic state.”

50-g Oral Glucose Challenge Test

Screening test at 26–28 weeks; value >140 mg/dL prompts 3-h GTT.

100-g 3-Hour GTT

Diagnostic glucose tolerance test; two or more abnormal values confirm GDM.

HbA1c Goal (Pregnancy)

≤ 6 %; indicates tight glycemic control over preceding 2–3 months.

Macrosomia

Birth weight >4 kg; common fetal outcome of poorly controlled GDM.

Neonatal Hypoglycemia

Blood glucose <40 mg/dL within first hour after birth due to fetal hyperinsulinism.

Respiratory Distress Syndrome (RDS)

Neonatal lung immaturity linked to delayed surfactant in infants of diabetics.

L/S Ratio

Lecithin-sphingomyelin ratio; ≥ 2.5–3 : 1 signals adequate fetal lung maturity.

Regular & NPH Insulin

Only insulins routinely used in pregnancy; no oral hypoglycemics recommended.

Hypoglycemia (Maternal)

Sweating, tremors, confusion; treat with 15–20 g rapid carbohydrate, recheck in 15 min.

Ketoacidosis

Metabolic emergency in diabetes marked by ketonemia, acidosis, dehydration.

Fetal Kick Counts

Maternal report of ≥10 movements/hour starting at 28 weeks to screen fetal well-being.

Cocaine (Pregnancy)

Potent vasoconstrictor linked to placental abruption, preterm labor, neonatal irritability.

Methamphetamine

CNS stimulant similar to cocaine; causes jittery, growth-restricted neonates.

Marijuana

Cannabis; associated with tachycardia, memory loss, reduced milk production, respiratory risk.

Phencyclidine (PCP)

“Angel dust” hallucinogen causing euphoria, hypertension, fetal neurotoxicity.

Opiate / Heroin Use

Leads to neonatal abstinence syndrome; methadone maintenance advised in pregnancy.

Inhalants

Volatile chemicals (glue, spray) causing maternal arrhythmias & fetal hypoxia.

Fetal Alcohol Syndrome (FAS)

Triad of growth restriction, facial anomalies, CNS damage due to prenatal alcohol.

Neonatal Abstinence Syndrome

Withdrawal symptoms in newborn exposed to opioids: tremors, high-pitched cry, seizures.

Rh Incompatibility

Rh-negative mother forms antibodies against Rh-positive fetal blood cells.

ABO Incompatibility

Maternal type O antibodies attack fetal type A / B RBCs, often post-delivery jaundice.

Erythroblastosis Fetalis

Hemolytic anemia from maternal antibodies causing fetal marrow release of immature RBCs.

Hydrops Fetalis

Severe fetal edema secondary to profound anemia in isoimmunization.

Rho(D) Immune Globulin (RhoGAM)

Passive antibodies given at 28 weeks & within 72 h PP to unsensitized Rh-negative mothers.

Direct Coombs Test

Detects antibody-coated fetal RBCs; positive in hemolytic disease of the newborn.

Exchange Transfusion

Neonatal procedure replacing antibody-coated blood; risks hypocalcemia, hypoglycemia, hypothermia.

Zidovudine (AZT)

Nucleoside reverse transcriptase inhibitor used antenatally, intrapartum & to neonate to ↓ HIV transmission.

CD4 Count

Key immune marker; <200 cells/mm³ defines AIDS and ↑ risk for opportunistic infections.

Seroconversion

Period (≈6 weeks–1 year) when HIV antibodies first become detectable.

Pneumocystis carinii Pneumonia (PCP)

Most common life-threatening opportunistic infection in HIV-infected mothers.

Kaposi’s Sarcoma

AIDS-related vascular tumor presenting as purple skin lesions.

Iron Deficiency Anemia (IDA)

Microcytic, hypochromic anemia; Hgb <10 g/dL, serum ferritin <100 µg/L.

Serum Ferritin

Best indicator of total iron stores; low in IDA.

Megaloblastic Anemia

Macrocytic anemia from folate or vitamin B12 deficiency.

Pernicious Anemia

Autoimmune B12 deficiency requiring lifelong IM cyanocobalamin.

Hyperemesis Gravidarum

Severe vomiting >12 weeks causing weight loss, dehydration, ketonuria.

Total Parenteral Nutrition (TPN)

IV nutrient therapy used when persistent vomiting precludes oral intake.

Ectopic Pregnancy

Implantation outside uterus, usually fallopian tube; may rupture causing internal hemorrhage.

Kehr’s Sign

Referred shoulder pain from diaphragmatic irritation due to ruptured ectopic bleed.

Cullen’s Sign

Periumbilical bruising indicating intraperitoneal bleeding.

Methotrexate Therapy

Folate antagonist given IM for unruptured ectopic pregnancy to stop trophoblastic growth.

Hydatidiform Mole

Gestational trophoblastic disease with grape-like vesicles & markedly ↑ hCG.

Complete Mole

46, paternal-only chromosomes; no fetal parts; high choriocarcinoma risk.

Partial Mole

Triploid (69 XXX/XXY); some fetal parts; lower malignancy risk.

Snowstorm Pattern

Ultrasound appearance diagnostic of molar pregnancy.

Choriocarcinoma

Malignant trophoblastic cancer; monitor with serial hCG after mole evacuation.

Suction & Curettage

Surgical evacuation method for hydatidiform mole.

Cervical Insufficiency

Painless dilation of cervix leading to mid-trimester loss.

McDonald Cerclage

Temporary purse-string suture around cervix placed at 12–14 weeks, removed at 37 weeks.

Shirodkar Cerclage

Permanent submucosal tape suture reinforcing cervix; may remain for future pregnancies.

Threatened Miscarriage

Bleeding without cervical dilation; pregnancy may still continue.

Inevitable Miscarriage

Bleeding with cervical dilation; loss of pregnancy unavoidable.

Incomplete Miscarriage

Partial expulsion of products of conception; requires D&C.

Missed Miscarriage

Fetal death without expulsion; retained >5 weeks risk DIC.

Septic Abortion

Infected miscarriage often from unsafe abortion; fever, foul discharge, sepsis.

Disseminated Intravascular Coagulation (DIC)

Consumptive coagulopathy triggered by prolonged fetal demise, abruption or severe pre-eclampsia.

Placenta Previa

Placenta implants in lower uterine segment causing painless bright-red bleeding.

Marginal Placenta Previa

Edge reaches but does not cover cervical os.

Total Placenta Previa

Placenta completely covers internal cervical os; elective CS required.

Double Set-Up Exam

Vaginal exam in OR with team prepped for immediate CS if placenta previa hemorrhage worsens.

Abruptio Placentae

Premature separation of a normally implanted placenta, causing painful dark bleeding.

Concealed Abruption

Central separation with trapped blood, board-like uterus, little visible bleeding.

Couvelaire Uterus

Blood infiltrates myometrium in severe abruption, impairs contractility.

Grade 2 Abruption

Moderate separation; fetal distress present, maternal BP stable.

Grade 3 Abruption

Severe separation; fetal death, maternal shock, possible DIC.

Hypofibrinogenemia

Low fibrinogen level indicating consumptive coagulopathy in abruption.

Low-Lying Placenta

Placental edge in lower uterine segment but >2 cm from os.

Bed Rest – Left Lateral

Position improving uteroplacental perfusion in previa or abruption.

Opportunistic Infection

Illnesses (PCP, candidiasis) exploiting weakened immunity in HIV/AIDS.

Protease Inhibitors

Class of antiretrovirals often combined with zidovudine to reduce HIV viral load.

Exchange Transfusion Complications

Hypocalcemia, hypoglycemia, hyperkalemia, hypothermia; monitor neonate closely.

Ketonuria

Presence of ketone bodies in urine, hallmark of severe vomiting or diabetic ketoacidosis.

Polyhydramnios

Amniotic fluid index >24 cm; associated with GDM and fetal anomalies.

Cephalopelvic Disproportion (CPD)

Fetal head too large for maternal pelvis, common with macrosomic infants.

Left-Sided Congestive Heart Failure

Pulmonary congestion leading to dyspnea, cough; potential pregnancy complication.

Petechiae

Pinpoint hemorrhages signaling subclinical bleeding, especially in valve prosthesis patients.

Hypokalemia

Serum K+ <3.5 mEq/L; potentiates digoxin toxicity when using loop diuretics.

Hyperbilirubinemia (Neonate)

Serum bilirubin >12 mg/dL from hemolysis or liver immaturity; risk kernicterus.

Snowflake / Snowstorm Ultrasound

Cluster of echoes without fetus typical of complete molar pregnancy.

Human Chorionic Gonadotropin (hCG)

Hormone markedly elevated in molar pregnancy; tracked until negative post-evacuation.

Total Parenteral Nutrition (TPN)

IV infusion of nutrients for severe hyperemesis when enteral intake impossible.