Leading cause of maternal mortality - answer hemorrhage
Danger signs in pregnancy - answer Absence of movement
Chest pain
Bleeding/fluid from vagina
Burning on urination
Chills/fever
Continuous vomiting
Sight/visual disturbances
Severe headache
Bleeding in pregnancy is always - answer Abnormal
Signs of bleeding in pregnancy - answer Decrease in BP
Increase in HR
Increase RR
Cold/clammy skin
Decreased urine output
Dizziness
Decreased LOC
Threatened spontaneous abortion - answer possible mild cramps, spotting to
moderate bleeding, no tissue passed
Missed abortion - answer Death of a fetus within the uterus that is not naturally
expelled after death
(needs removal)
Complete abortion - answer Death of fetus. All contents expelled.
Incomplete abortion - answer Incomplete expulsion of the products of conception
Complications of abortion - answer Hemorrhage
Infection (100.4 F)
Iso-immunization (Rh-)
Ectopic pregnancy - answer Implantation of the fertilized egg outside of the uterus
Ectopic pregnancy S/S - answer Low abdominal pain (sharp/stabbing, unilateral)
bHCG positive
Rupture ectopic pregnancy - answer EMERGENCY***
,IV 18 gauge
Administer O2
Lab: bHGC, CBC, Type/Cross
Surgery
RhoGam for Rh-
Second trimester bleeding is likely - answer Placenta previa
Third trimester bleeding is likely - answer Placental abruption
Placenta previa - answer Implantation of the placenta over the cervical opening or in
the lower region of the uterus
Placenta previa is assessed via - answer Ultrasound
Placenta previa S/S - answer Painless
Bright red blood
Soft abdomen
Placenta previa interventions - answer Nothing in vagina
No vaginal exams
Bed rest w/ side lying
Can deliver at 37wks
C-section ALWAYS
Betamethasone use in pregnancy - answer Steroid for lung development in
fetus/infants less than 34wks
Placental abruption - answer Premature separation of the placenta from the uterine
wall after 20 weeks' gestation and before the fetus is delivered.
Placental abruption S/S - answer Severe pain
Dark bleeding
Board-like rigid abdomen
Major risk of placental abruption - answer DIC resulting in hemorrhage
Predisposing factors to placental abruption - answer Advanced maternal age
Short umbilical cord
HTN or PIH
Direct trauma
Vasoconstriction (stimulants)
Thrombotic conditions
Preterm labor - answer Prior to 37 weeks
, Cause of preterm labor - answer Unknown
Problems associated with preterm labor - answer Dehydration
UTI
Chorioamnionitis
AA women
Adolescents
No prenatal care
Amniocentesis
Strenuous work
Preterm labor S/S - answer Persistent, low, dull back ache
Pelvic pressure/abd tightening
Menstrual-like cramping
Spotting/increased discharge
Uterine contractions
Intestinal cramping
Predictors for preterm labor - answer Fetal Fibronectin (fFN) in vaginal mucous (10-
14 days before)
Shortened cervix
When can you stop preterm labor? - answer If membranes are intact
No signs of fetal distress
No bleeding
< 4-5cm dilation
< 50% effacement
Preterm labor interventions - answer Side-lying/bed rest
IV fluids
Vaginal culture (Beta strep)
Clean-catch urine
Administer tocolytic
(Antibiotics if membrane broke)
(Maybe corticosteroid for lungs)
Magnesium sulfate uses in pregnancy - answer Preterm labor (tocolytic)
Preeclampsia (anti-HTN)
Eclampsia (anti-seizure)
Assessments for Magnesium sulfate - answer Deep tendon reflexes (absent)
Urine output (<30m)
Level of consciousness
Respiration rate/depth (RR<12)