Quizlet OB chap 19 PDF

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Maternal Child chapter 19 Study online at quizlet.com/_4xnwvv 1.

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Abortion

Loss of an early pregnancy usually before 20th week gestation

3.

Abruptio placentae

- premature separation of the implanted placenta after 20th week - leads to hemorrhage - typically presents 24-26 weeks maternal risks - hemorrhage - blood transfusion - emergency hysterectomy - DIC - renal failure - maternal death- rare but can happen

* HIGH FETAL MORTALITY- 50% **** 4.

Abruptio placentae patho

- unknown but possible rupture of vessel resultin in a clot between the placenta and the uterine wall. - the continued bleeding causes pressure to increase behind the placenta and results in separation CLASSIFICATIONS (extent of separation and blood loss): - Mild (grade 1) - min bleeding (1500ml) - severe separation >50% - profound shock - dark vaginal bleeding - agonizing abdominal pain - decreased maternal BP - significant maternal tachycardia - development of DIC * may be also classified as partial or complete or concealed or apparent*****

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Assessment finding for HABITUAL ABORTION

- Hx of 3 or more consecutive spontaneous abortion - Not carrying to viability or term

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Assessment finding MISSED abortion ( nonviable embryo retained in utero for at least 6 wks)

- absent uterine contractions - irregular spotting - possible progression to inevitable abortion

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Assessment findings COMPLETE ABORTION

- history vaginal bleeding and abdominal pain - passage of tissue with subsequent decrease in pain and vaginal bleeding

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Assessment findings INCOMPLETE ABORTION

- intense abdominal cramping - heavy vaginal bleeding - cervical dilation * DOES NOT PASS ALL OF TISSUE****

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Assessment findings of INEVITABLE ABORTION

- vaginal bleeding (much more than threatened) - rupture of membranes - cervical dilation - strong abdominal cramping - possible passage of products of conception

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BIOPHYSICAL FACTORS that place a woman at risk during pregnancy

-genetic conditions - chromosomal abnormalities - multiple pregnancy - defective genes - inherited disorders - ABO incompatibility - large fetal size - medical and ob conditions - preterm labor and birth - cardiovascular disease - chronic HTN - cervical insufficiency - placental abnormalities - infection - Diabetes - maternal collagen disease - thyroid disease - asthma - postterm pregnancy - hemoglobinopathies - nutritional status - inadequate dietary intake - food fads - excessive food intake - under/over weight - hct level less than 33% - eating disorder

** dont have to know them all just know what is in the classification***

11.

Blood incompatability

ABO INCOMPATABILITY - when mother with O type becomes pregnant with different blood type- A, B, AB

RH INCOMPATABILITY - RH NEG BLOOD - give rhogam 28 weeks and 72 hours after birth 12.

cervical insufficiency

- premature dilation of cervix - 2-3rd trimester - fetus dies unless dilation can be arrested ( usually 4-5 month gestation)

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Cervical insufficiency nursing assessment

RISK FACTORS - previous cervical trauma - preterm labor - fetal loss in second trimester - previous sx or procedures involving cervix

BE ALERT FOR C/O CERVICAL DISCHARGE OR PELVIC PRESSURE. DX of insufficiency remains difficult in many circumstances. CORNERSTONE OF DX is a hx of loss during 2nd or early 3rd trimester associated with painless cervical dilation.

DX TESTS - transvaginal US- 16-24 weeks (length, shortening, attempt to predict preterm. - most common time funneling and shortening develops is 16-24 weeks * a cervical length of...