cabillan

Vaginal Bleeding

potentially serious, may occur at any point during pregnancy and is always frightening

abortion

medical term for any interruption of a pregnancy before a fetus is viable

viable fetus

fetus more than 20-24 weeks; weighs at least 500g

weeks 6 and 12

stage of attachment where it is most severe, even live-threatening bleedings

abnormal fetal development

most frequent cause pf miscarriage in the 1st trimester of pregnancy

threatened miscarriage

begins as vaginal bleeding, only scant and bright red

threatened miscarriage

slight contraction of the uterus without cervical dilatation

D&C , D&E

performed by the healthcare provider if no fetal heart sounds are detected and an utz reveals an empty fetus or nonviable fetus

complete miscarriage

entire products of conception are expelled

incomplete miscarriage

part of the conceptus is expelled but the membranes or placenta are retained in the uterus

missed miscarriage

commonly referred to as early pregnancy failure

missed miscarriage

the fetus dies in the utero but is not expelled

imminent miscarriage

end of pregnancy

spontaneous, threatened, imminent, incomplete, complete, missed

types of miscarriages

habitual aborters

women who had 3 spontaneous miscarriages that occurred at the same gestational age

antiphospholipid antibody syndrome

autoimmune disease that occurs more frequently in women than in men

hemorrhage and infection

two most likely complications after miscarriage

escherichia coli

organisms responsible for infection after miscarriage

septic abortion

abortion complicated by infection; who self-aborted or aborted illegally using a non-sterile instruments

ectopic pregnancy

implantation occurred outside the uterine cavity

fallopian tube

common site of ectopic pregnancy?

MRI

effective for ectopic pregnancy

laparoscopy

used to visualize the fallopian tube if the symptoms don’t reveal a clear picture of what has happened

hyatidiform mole

abnormal proliferation and then degeneration of the trophoblastic villi; clear fluid-filled, grape-sized vesicles.

h mole

embryo fails to develop beyond a primitive start

complete mole

all trophoblastic villi swell and become cystic; karyotype is normal; chromosome compenent is only contributed by the father, or an “empty ovum” is fertilized

partial mole

some of the villi form normally; synctiotrophoblastic layer of the villi is swollen and misshapen

partial mole

could also occur if one set pf 23 chromosomes was supplied by one sperm and an ovum that fid not undergo reduction division supplied 46

premature cervical dilitation

incompetent cervix

PCD

cervix that dilates prematurely and therefore cannot retain a fetus until term

cervical cerclage

surgical operation performed if the loss of one child of PCD para ma prevent an PCD ha second pregnancy

Mcdonald and shirodkar

sutures that serve to strengthen the cervix and prevent it from dilating until the end of pregnancy

Mcdonald

nylon sutures are placed horizontally and vertically across the cervix and pulled tight to reduce the cervical canal to a few mm in diameter

shirodkar

sterile tape is threaded in a purse- string manner umder the submucous layer of the cervix

placenta previa

condition of pregnancy in which the placenta is implanted abnormally in lower part of the uterus

placenta previa

common cause of painless bleeding in the 3rd trimester

kleihauer betke test

used go detect whether the blood is fetal or maternal origin

abruptio placenta

premature separation of the placenta

abruptio placenta

most frequent cause of prenatal death

placenta appears to have been implanted correctly

disseminated intravascular disorder

acquired disorder of blood clotting in which the fibrinogen level falls to below effective limits

DIC

occurs when there is such extreme bleeding and so many platelets and fibrin from the general circulation rush to the site that there is not enough left in the rest of the body

preterm labor

occurs before the end of week 37 of gestation

premature labor

responsible for almost two-thirds of all infant deaths in the neonatal period

terbutaline

drug approved to prevent and treat bronchospasm

magnesium sulfate

drug to prevent seizure

halts calcium uptake bu muscles; deug of choice to manage gestational hypertension

preterm rupture od membranes

rupture of fetal membarnes with loss of amniotic fluid before 37 weeks of pregnancy

potter-like syndrome

condition that is a risk to the fetus of remaining in a non-fluid filled environment

gestational hypertension

condition in which vasospasm occurs in both small and large arteries during pregnancy

gestational hypertension

occurs in:

• woman of color

• multiple pregnancy

• primi younger than 20 or older than 40

• women w low socioeconomic bg

gestational hypertension

• bp = 140/90 ; returns to normal after birth

• no proteinuria pr edema

mild pre-eclampsia

• bp = 140/90

• proteinuria = 1+ -2+

• weight gain 2lbs in 2nd trimester and 1lb in 3rd

• mild edema in upper extremities or face

severe preeclampsia

• bp = 160/110

• proteinuria = 3+ -4+

• cerebral or visual disturbances

• extensive peripheral edema

• hepatic dysfunction

• epigastric pain

eclampsia

either seizure or coma accompanied by s&s of preeclampsia r present

diazepam

anti seizure

hydralazine

hypotensive drug that can cause maternal tachycardia

tonic-clonic

• seizure han eclampsia

• last for 20 secs

10-14 days

days han postpartum hypertension

HELLP Syndrome

• hemolysis that leads to anemia

• elevated liver enzymes that lead to epigastric pain

• low platelets that lead to abnormal bleeding

• petechia

HELLP Syndrome

serious syndrome bcs it results to maternal mortality rate as high as 24% and an infant mortality rate as high as 35%

fresh frozen platelets and plasma

therapy for HELLP

multiple gestation

considered a complication of pregnancy because a womans body must adjust to the effects of more than one fetus

identical twins

begin w a single ovum and spermatozoon

same gender

single-ovum twins

one placenta, one chorion, two amnions and two umbilical cords

fraternal twins

fertilization of two separate ova by two separate spermatozoa

diff gender

double-ova twins

two placenta, two chorions, two amnions, two umbilical cords

hydramnios

occurs when there is excess fluid of more than 2k ml of an amniotic fluid index above 24cm

oligohydramnios

pregnancy w less than the average amount of amniotic fluid bc part of the volume of AF if formed by the addition of fetal urine

postterm pregnancy

pregnancy os 38 to 42 weeks

infant is considered as postmature

pseudocyesis

false pregnancy

can feels symptoms but is not pregnant

wish-fulfillment, conflict, depression theory

theories regarding the phenomenon of pseudocyesis

wish-fulfillment

woman’s desire to be pregnant causes physiologic changes to occur

conflict theory

desire for and fear of pregnancy create an internal conflict

depression theory

attributes to the major cause of depression

isoimmunization (rh incompatibility)

occurs when rh-neg mother carries a fetus w an rh-pos blood type

homozygous

100% of the couples children will be rh positive

heterozygous

50% of the couples children are rh positive

RhoGAM

given by injection to the mother in the first 72 hours after birth ofa an rh positive child to further prevent the mother from forming natural antibodies

fetal death

one of the most severe complications of pregnancy