Medical Complications in Pregrancy

Question 1

What are concerns with bleeding with pregnancy

Answer 1

1st trimester
- abortion
- ectopic preg
2nd & 3rd tri
- placenta previa (painless)
- placetal abruption (painful)
- vasa previa
- bloody show

Question 2

What is placenta previa

Answer 2

painless vag bleed during preg due to abnormal placenta location

increase neonatal mortality rate

eval: US, uterus soft non-tender
txt: nothing per vag

Question 3

What is placenta abruption

Answer 3

def: separation of the placenta from implantation site

Risk: HTN, substance abuse, ROM, fibromyoma

SS:
vag bleed
tender uterus

Types:
class 0 - asymptomatic
class I - mild
Class II - moderate
class III - severe

Txt:
hemodynamics
monitor vitals
labs

Question 4

What is vasa previa

Answer 4

fetal vessels crossing cervical os

Question 5

Hypertension with pregs

Answer 5

preeclampsia-eclampsia = > 20 weeks increase bp

chronic HTN = BP increase before 20 weeks or does not resolve after birth

Question 6

How prevent pre-eclampsia

Answer 6

treat DBP > 105-110
ASA
calcium
MgSO4

Question 7

What is eclampsia

Answer 7

preeclampsia with seizures

Question 8

What is HELLP

Answer 8

Hemolysis, elevated liver enzymes, low platelet count

can become DIC

Question 9

What is diabetes classification

Answer 9

A1 - GDM no insulin
A2 - GDM with insulin
GDM inhibit development of lungs

Question 10

When do Csec

Answer 10

DM and baby > 4500 g
baby > 5000 g

during labor if arrest descent or prolonged second stage with DM

Question 11

What cause early postpartum hemorrhage

Answer 11

uterine atony - mc
oxytocin use
retained placental fragments
laceration of vag/cervix
uterine inversion
coagulopathy

txt by uterine massage, oxytocin, misoprostol

Question 12

Why important to get all placenta out of uterus

Answer 12

allows for proliferation of trophoblastic cells from placenta and cause cancer