Ob exam 3 management of pregnancy risk of special populations

What is normal glucose use in pregnancy?

1st trimester increased use of glucose

2nd trimester increased insulin resistance

What is gestational diabetes?

carb intolerance, associated with neonatal complications at birth and long term maternal consequences

What are risks for pregestational diabetes?

miscarriage, macrosomia, HTN, preeclampsia, polyhydraminos, infections, ketoacidosis, hypoglycemia, perinatal mortality, congenital malformations, birth injuries (WANT A1C under 7%

What is cytomegaly virus in birth?

common, leading cause of hearing loss and intellectual disability in the US

What is toxoplasmosis in birth?

parasitic infection leading to congenital abnormalities and fetal death

What is Herpes virus in birth?

is transmitted and can lead to spontaneous abortion, birth abnormalities, preterm labor, death or neurological impairment

What are some other viruses that can present in birth?

hep B, parvovirus B19, HIV, varicella, GBS

What is dystocia?

the abnormal progression of labor increases risks of complications (hypertonic/hypotonic uterus and inadequate bearing down)

What is macrosomia?

high birth weight baby and can cause shoulder dystocia which is EMERGENCY

What is precipitous labor?

❤ hours from start to finish can lead to maternal injury, uterine rupture, cervical lacerations and can result in fetal injury

What are risk factors for dystocia?

short stature, obesity, hydramnios, uterine abnormalities, fetal malpresentation, CPD, high oxytocin, maternal exhaustion, poor positioning, maternal anxiety and fear

What do we need to know about preterm labor?

may go through progesterone therapy, may have antenatal steroids, will be monitored if previous preterm labor,

What are risk factors for prolonged pregnancy?

obesity, first baby, previous post term, advanced maternal age, genetics (will be frequently monitored and may have labor induced)

What is labor induction?

stimulating contractions via medical or surgical means

What is labor augmentation?

enhancing ineffective contractions after labor has begun

How do we assess if someone needs labor iduction/augmentation?

score <5 on bishop scale is less favorable

What is cord prolapse?

cord goes below where it should be, may see variable decels and catch it on a cervical exam

What is uterine rupture

tear of uterus will see sudden fetal distress, continuous abd pain, hemorrhaging and shock

What is amniotic fluid embolism/anaphylactic syndrom of pregnancy?

life-threatening complication where amniotic fluid contains particles of debris enters maternal circulation and obstructs the pulmonary vessels causing circulatory collapse

What are operative/assisted births?

forceps or vacuum apply friction/suction to help guide fetus or turn the head but cannot be applied until 2+ station