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What is Hyperemesis Gravidarum?
excessive nausea and vomiting that interferes with food intake and fluid balance
How can you tell a women with Hyperemesis Gravidarum is dehydrated?
- Skin tenting
- Dry tongue and mucous membranes
- Scant/concentrated urine
- High Hematocrit level
What is treatment for a patient with Hyperemesis Gravidarum?
- Oral/IV fluids
- Antiemetic drugs
Cramping and backache with light spotting; cervix is closed and no tissue is passed?
Increased bleeding, cramping, cervix dilates
Bleeding, cramping, dilation of cervix, passage of tissue
Passage of all products of conception; cervix closes and bleeding stops
Fetus dies in utero, but is not expelled; uterine growth stops, sepsis can occur.
Two or more consecutive spontaneous abortions, usually caused by incompetent cervix or progesterone levels inadequate to maintain pregnancy
A pregnancy that occurs when the fertilized ovum is implanted outside the uterine cavity.
What are some manifestations of ectopic pregnancy?
- lower abd. pain
- light vaginal bleeding
What can happen if the tube ruptures in a tubal ectopic pregnancy?
- sudden severe abd. pain
- vaginal bleeding
- hypovolemic shock
- shoulder pain
Signs ans symptoms of hypovolemic shock ?
- FHR change
- inc. pulse
- inc. irregular resp.
- decr. blood pressure
- decr. urinary output
- cold clammy skin
Hydatidiform Mole occurs from what?
when chorionic villi abnormally increase and develop vesicles
What are some manifestations of Hydatidiform Mole?
- rapid uterine growth
- failure to detect fetal activity
- Hyperemesis Gravidarum
- Early GH
- High hCG levels
- Snowstorm pattern on ultrasound
What is the treatment for HM.
- Uterine evacuation
- Dilation and evacuation
What should a women who had HM have monitored?
hCG levels, because she has an increased risk for cancer
What is placenta previa?
abnormal implantation of the placenta
What is the manifestation of Placenta previa?
painless bright red bleeding
3 Degrees of Placenta Previa
Marginal: 2-3 cm within cervical opening
Partial: covers part of cervix
Total: covers cervix completely
What is Abruptio Placentae?
Normal implantation of the placenta that detaches from the uterine wall
What is the manifestation of Abruptio placentae
Painful dark red bleeding
Gestational hypertension with proteinuria
Gestational hypertension, CNS involvement
What can be a sign that a women has gestational hypertension?
edema of the hands and face
Risk factors for GH?
- 1st pregnancy
- Family Hx
- Age over 40, under 19
- multifetal pregnancy
- chronic hypertension
- renal disease
What is the TX for GH?
- Activity restriction
- BP monitor
- Daily weight
- Monitor Proteinuria
What is the drug of choice during pregnancy to control seizures?
Rh incompatibility occurs when?
- Mom is Rh negative and fetus is Rh positive and fetal blood leaks into moms blood
- the mom then makes antibodies against the RH + erythrocytes
What is Erythroblastosis Fetalis?
Occurs when the maternal anti Rh antibodies cross the placenta and destroy fetal erythrocytes
What is the TX for erythroblastosis fetalis?
RhoGAM to women 28 weeks gestation and 72 hours after birth
Glucose intolerance with the onset during pregnancy
Glucose usually returns to normal by 6 weeks postpartum
What are some hormones that are produced by the placenta,in regards to GDM?
What are the 2 functions of the hormones?
- Increase resistance of the cells to insulin
- Increase speed of insulin breakdown
What is the preferred medication for GDM
What are some factors linked to GDM
- Maternal obesity
- Large infant
- Maternal age ^ 25 yrs
- Previous still birth
- Hx of GDM
- Family Hx of DM
- Fasting glucose of 126-200
What is the TX for GDM?
- monitor blood glucose
- Ketone monitor
What are 3 reasons why mom needs iron?
- - to increase blood volume
- - transfer for fetus
- -cushion against expected blood loss during labor
Food high in iron?
meats, fish, liver, legumes, dark leafy greens, dried fruit
Foods high in folic acid?
green leafy veggies, whole grains, liver, fruit
Foods ^ in Vit. C
Citric foods, and juices, strawberry, cantaloupe, cabbage, peppers, potatoes
What foods are recommended to take with iron supplements.
Citric foods/vitamin C
What foods should be avoided with intake of iron supplement?
What is a TX for Iron deficiency anemia?
- Iron Supplements
- Vitamin C
Folic Acid Deficiency Anemia TX
Folic Acid supplement
Autosomal recessive disorder, which causes erythrocytes to become distorted in a sickle shape because of abnormal hemoglobin
Sickle cell anemia
What can happen to a mom with sickle cell anemia
- Pregnancy can cause a crisis
- also massive RBC destruction and vessel occlusion
Genetic trait causes abnormality in one or two chains of hemoglobin
What should you teach a women who has sickle cell anemia to avoid?
- Avoid dehydration and strenuous activities
- Avoid exposure to infections
- Avoid extreme heat/cold temps
What does the acronym TORCH describe?
- Other (STD)
True or False?
Rubella vaccine is given during pregnancy?
False - no live virus vaccines are given during pregnancy
Where can a mom pick up toxoplasmosis from?
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