Maternal Emergencies and Diabetes Practise Flashcards

A comprehensive set of 125 vocabulary flashcards covering diabetic emergencies, substance abuse, fetal conditions, and bleeding disorders in pregnancy based on lecture notes.

Maternal Hyperglycemia

Maternal blood glucose that crosses the placenta and affects fetal development.

Fetal Hyperinsulinemia

Condition where the fetus produces excess insulin in response to maternal hyperglycemia; it persists after birth and can lead to hypoglycemia.

Neonatal Hypoglycemia

The most common complication for infants of diabetic mothers, occurring in $20$ to $50\%$ of cases.

Macrosomia

A bigger than average infant, which increases the risk for dystocias and birth trauma.

Caudal Regression Syndrome

A congenital anomaly associated with poor maternal glycemic control during the first trimester.

Shoulder Dysplasia

A complication and risk during birth often caused by macrosomia in diabetic pregnancies.

$$6.5\%$$

The target $\text{HbA1c}$ level for a planned pregnancy to ensure the risk of complications is low.

Gestational Diabetes

Glucose intolerance with onset or first recognition during pregnancy, usually diagnosed in the second or third trimester.

Preexisting Diabetes

Type $1$ or Type $2$ diabetes that was present prior to the pregnancy.

GDM Screening Window

Prenatal screening for diabetes that occurs between $24$ and $28$ weeks gestation.

Oral Tolerance Test

The screening method used to diagnose diabetes in pregnant patients.

Postpartum Glucose Screening

Follow-up screening performed $6$ to $12$ weeks after delivery and then every $1$ to $3$ years.

Substance Use Disorder

Involves continued use of substances despite harm; often begins before pregnancy and continues through it.

Fetal Enzyme System

The immature system in a fetus that cannot effectively metabolize substances, leading to prolonged exposure and accumulation.

Tobacco Exposure rate (Canada)

Estimated to affect approximately $10.5\%$ of pregnancies.

Alcohol Exposure rate (Canada)

Estimated to affect approximately $10.5\%$ of pregnancies.

Cannabis Exposure rate (Canada)

Estimated to affect approximately $2\%$ of pregnancies.

Opioid Exposure rate (Canada)

Estimated to affect approximately $1\%$ of pregnancies.

Vasoconstriction (Tobacco)

Physiological effect of smoking that causes decreased uteroplacental blood flow and low birth weights.

Placental Abruption (Stimulants)

A severe risk associated with cocaine or stimulant use due to severe vasoconstriction and hypertension.

Fetal Alcohol Spectrum Disorder (FASD)

A lifelong condition caused by prenatal alcohol exposure affecting development, brain function, and learning.

Teterrigen

A classification for alcohol, indicating it is an agent that causes malformation of an embryo.

Fetal Alcohol Syndrome (FAS)

A specific condition within the FASD spectrum often characterized by classic facial features and growth restriction.

Alcohol Related Neurodevelopmental Disorders (ARND)

A category within FASD focusing on brain and behavioral impairments.

Alcohol Related Birth Defects (ARBD)

A category within FASD referring to physical abnormalities caused by alcohol exposure.

Small Head Circumference

A common physical finding in severe cases of Fetal Alcohol Syndrome.

Short Palpebral Fissures

Small eye openings, a classic facial feature associated with FAS.

Smooth Philtrum

The absence of the groove between the nose and upper lip, a classic sign of FAS.

Thin Upper Lip

A classic facial feature observed in patients with Fetal Alcohol Syndrome.

Epicanthal Folds

Skin folds of the upper eyelid covering the inner corner of the eye, associated with FAS.

Neonatal Abstinence Syndrome (NAS)

A withdrawal syndrome in newborns exposed to substances like opioids or benzos in utero.

Typical NAS Onset

Symptoms usually begin $24$ to $72$ hours after birth.

Finnegan Neonatal Abstinence Scoring System

An assessment tool used to grade the severity of withdrawal in newborns to guide treatment.

Non-pharmacological NAS Management

First-line options including rooming-in, skin-to-skin contact, swaddling, and reducing noise and lights.

Rooming In

The practice of keeping the mother and newborn in the same room to facilitate bonding and reduce NAS severity.

Skin-to-Skin Contact

A supportive care technique used to stabilize neonates experiencing withdrawal.

Swaddling

A non-pharmacological intervention for NAS used to provide comfort and reduce tremors.

Rh Allele Immunization

Occurs when an Rh negative woman is exposed to Rh positive fetal red blood cells and develops antibodies.

RhD Antigen

The specific antigen on red blood cells used to determine if an individual is Rh positive or negative.

Anti-D Antibodies

Antibodies produced by an Rh negative mother's immune system that can attack fetal Rh positive cells.

Maternal Sensitization

The process where the maternal immune system recognizes fetal Rh positive cells as foreign and produces antibodies.

Hemolytic Disease of the Fetus and Newborn

Condition resulting from maternal antibodies crossing the placenta and destroying fetal red blood cells.

Hydrops Fetalis

A serious condition in neonates resulting from severe fetal anemia, causing heart failure and generalized edema.

Kernicterus

Permanent neurological injury in neonates caused by bilirubin deposition in the brain.

Rh Immune Globulin (RhIg)

A medication containing anti-D antibodies that prevents maternal sensitization by binding fetal Rh positive cells.

$28$ Weeks Gestation

The typical time during pregnancy when Rh immune globulin is administered to Rh negative individuals.

Group B Streptococcus (GBS)

A common bacterium in the GI/genital tract that can cause neonatal sepsis, pneumonia, and meningitis.

$10$ to $30\%$

The percentage of pregnant patients who carry Group B streptococcus in the vagina or rectum.

Early Onset GBS Disease

GBS infection occurring within the first week of life, often within the first $24$ hours.

Late Onset GBS Disease

GBS infection occurring after the first week of life, commonly presenting as meningitis.

Penicillin G (Pen G)

The treatment of choice for providing antibiotic prophylaxis against Group B strep during labor.

Amniotic Fluid Index (AFI)

An ultrasound measurement used to assess amniotic fluid volume.

Polyhydramnios (Volume)

The presence of excessive amniotic fluid, typically defined as over $2,000\,mL$.

Polyhydramnios (AFI)

Condition diagnosed when the AFI is greater than $20\,cm$ or the deepest pocket is $8\,cm$.

Oligohydramnios (Volume)

The presence of too little amniotic fluid, typically defined as less than $500\,mL$.

Oligohydramnios (Fundal Height)

Often presents with a fundal height that is less than expected for the gestational age.

Uterine Rupture

A catastrophic tearing of the uterus, most commonly occurring at a previous uterine scar site.

Classical Vertical Incision

A type of previous C-section scar that carries a particularly high risk for uterine rupture.

Low Transverse Incision

The most common type of C-section incision, which carries a lower risk of future uterine rupture.

Fetal Bradycardia

Often the earliest and most reliable sign of fetal compromise or uterine rupture.

Loss of Fetal Station

A clinical sign of uterine rupture where the fetus is no longer engaged in the pelvis.

$30$ to $50\%$

The increase in circulating blood volume during pregnancy, which can mask early signs of shock.

Hypovolemic Shock Lag

The phenomenon where a pregnant patient loses $20$ to $30\%$ of blood volume before hypotension occurs.

Supine Hypotension Syndrome

Dizziness and hypotension caused by the enlarged uterus compressing the inferior vena cava when the patient lies flat.

Maternal Oxygen Consumption

Increases by $20$ to $30\%$ during pregnancy, making patients desaturate rapidly during apnea.

Left Lateral Tilt

The recommended positioning for pregnant patients to improve venous return and cardiac output.

Manual Uterine Displacement

A CPR technique in pregnancy where the uterus is pushed to the left to improve chest compression effectiveness.

Hypercoagulable State

A natural state in pregnancy to reduce childbirth hemorrhage, which increases risks for DVT and PE in trauma.

$24$ Weeks

The standard gestational threshold used to determine if a fetus is considered viable for delivery efforts.

$$\ge 95\%$$

The target $\text{SpO2}$ for pregnant trauma patients to ensure adequate fetal oxygenation.

Spontaneous Abortion

Pregnancy loss occurring before the $20$ week gestation or a fetal weight of $500\,g$.

Early Pregnancy Loss

Pregnancy loss that occurs before $13$ weeks gestation.

Second Trimester Abortion Timing

Pregnancy loss occurring between $13$ and $20$ weeks gestation.

Stillbirth Definition

Post-viable pregnancy loss occurring after $20$ weeks gestation or if the fetus is greater than $500\,g$.

Threatened Abortion

Vaginal bleeding and pelvic pain with a closed cervix; about half of these pregnancies continue successfully.

Inevitable Abortion

Active bleeding with severe cramping where the cervix is open and loss cannot be prevented.

Incomplete Abortion

Pregnancy loss where the cervix is open and products of conception are partially expelled.

Complete Abortion

Condition where all tissue has passed, and bleeding/pain begins to subside.

Missed Abortion

Condition where the pregnancy is no longer viable but there is no bleeding or cramping.

Habitual Abortion

The occurrence of three or more consecutive spontaneous abortions.

Misoprostol (Cytotec)

A prostaglandin that stimulates uterine contractions and cervical dilation to expel products of conception.

Mifepristone

A progesterone receptor antagonist that destabilizes the uterine lining, often used in combination with Cytotec.

Ectopic Pregnancy

Occurs when a fertilized ovum implants outside the uterine cavity, most commonly in the fallopian tube.

Ampulla

The most common specific location within the fallopian tube for an ectopic pregnancy.

Ectopic Pregnancy Triad

The classic findings of abdominal pain, amenorrhea (missed period), and vaginal bleeding.

Shoulder Pain (Referred)

A classic sign of ectopic rupture caused by diaphragmatic irritation from internal bleeding.

Methotrexate

A medication used in stable ectopic pregnancy patients as a non-surgical management option.

Gestational Trophoblastic Disease (GTD)

A spectrum of abnormal disorders involving the proliferation of cells that normally develop into the placenta.

Complete Hydatidiform Mole

A molar pregnancy developed from an empty egg fertilized by sperm, containing no fetal tissue.

Partial Hydatidiform Mole

A molar pregnancy where some fetal tissue may be present, occurring when two sperm fertilize an ovum.

Choriocarcinoma

A malignant form of gestational trophoblastic disease.

Cervical Insufficiency

Premature painless dilation of the cervix during the second or early third trimester without contractions.

Cervical Cerclage

A surgical procedure where the cervix is reinforced with sutures to prevent premature dilation.

Placenta Previa

Implantation of the placenta in the lower uterine segment, partially or completely covering the internal os.

Complete Placenta Previa

The placenta completely covers the internal os of the cervix.

Partial Placenta Previa

The placenta partially covers the internal os.

Marginal Placenta Previa

A low-lying placenta that is within $2\,cm$ of the internal os but does not cover it.

Painless Bright Red Bleeding

The classic clinical presentation for placenta previa in the second half of pregnancy.

Digital Vaginal Exam Risk

Contraindicated in suspected placenta previa as it can disrupt the placenta and cause severe hemorrhage.

Abruptio Placenta

Premature separation of the placenta from the uterine wall, leading to bleeding and fetal hypoxia.