ANSWERS TAGGED A+
✔✔3 CHARACTERISTICS of preeclampsia - ✔✔1. generalized
vasospasm/vasoconstriction
2. dysfunctional cascade of coagulation
3. leaky vessels
✔✔how is placenta/fetus affected in preeclampsia - ✔✔- Not receiving enough O2
- Asymmetric IUGR
- Cord compression: less wartons jelly
Oligohydramnios
✔✔Signs and symptoms of preeclampsia - ✔✔HTN, proteinuria, edema, headache,
seizures, visual symptoms, epigastric pain (Due to liver edema and subcapsular
hematoma), SOB (pulm edema), chest pain with exertion, decreased UO, N/V,
increased live ezymes, decreased delta growth, Clotting disorders (DIC)
✔✔Adverse reactions to fetus in preeclampsia - ✔✔IUGR + OLIGO
uteroplacental insufficiency
fetus adapts by decreasing movement and shunting blood
ASYMETRICAL IUGR
stillbirth
smaller umbilical cord , less wartons jelly, --> expect to see variable decels
✔✔Antepartum testing can include - ✔✔FMC
NST
- Biophysical profile (BPP): a real-time ultrasound that includes fetal breathing
movements, fetal movements, fetal tone, and fetal heart rate. → reflect the status of the
central nervous system (CNS). ALSO amniotic fluid volume → provides information on
placental function
- Doppler blood flow analysis
✔✔Placental Abruption: - ✔✔The partial or total separation of the placenta from the
decidua lining of the uterus after 20 weeks gestation
✔✔Abruption risk factors - ✔✔● previous abruption
● smoking
trauma
● thrombophilia
● pre-labour rupture of membranes
● cocaine use
,Complications: DIC, Shock
✔✔S+S of abruption - ✔✔-dark red bleeding (or none if concealed)
-abdo/low back pain
-uterine irritability/tenderness/contractions
fetal distress
signs of hypovolemia
✔✔Abruption maternal impacts: - ✔✔· Hemorrhage
· DIC
· Anemia
· Shock
✔✔Abruption fetal impacts: - ✔✔· Fetal Distress
· Hypoxia
· Neonatal prematurity
· IUGR
· Cerebral Palsy
Fetal/Neonatal Death
✔✔WHat happens if abruption is concealed ? - ✔✔This concealed bleeding may lead to
a retroplacental clot or hematoma, which then leads to the release of thromboplastins
into maternal circulation. → This may then lead to disseminated intravascular
coagulopathy (DIC)
would only see myometrium irritability and contraction
✔✔Placenta previa - ✔✔implantation of the placenta over the cervical opening or in the
lower region of the uterus (<2cm from os)
✔✔Risk factors for placenta previa - ✔✔Previous C-section
Multiparity
AMA
TWINS
hx of D+C
Endometrial scarring
previous previa
smoking
✔✔Maternal effects of placenta previa - ✔✔· Hemorrhage
Hypovolemic Shock
· Sepis
· RH incompatibility
· Postpartum Anemia
, · Risk for Future Creta
✔✔fetal ·effects of placenta previa - ✔✔· Prematurity
· Preterm Birth
· Still Birth
· Malpresentation
· Fetal Anemia
· IUGR
Potential C-section
✔✔S+S of placenta previa - ✔✔painless bright red vaginal bleeding and/or fetal
malpresentation in later pregnancy
uterus remains soft
✔✔Why are you at higher risk if PPH if you have placenta previa? - ✔✔Because the
lower segment of the uterus does not have the same contractility of the upper segment,
women who have a placenta previa are at increased risk of PPH → Failure of the lower
segment of the uterus to contract would be a tone issue
✔✔S/S of hypovolemic shock - ✔✔hypotension,
tachycardia
, increased respiratory rate,
cold clammy skin
, pallor, and dizziness.
✔✔Vasa Previa - ✔✔occurs when the umbilical cord vessels cross lie over cervix
Rather than the vessels being implanted into the placenta, they are in the amniotic
membranes.
This and the fact they are over the cervical os make them vulnerable to rupture and/or
compression → if the vessels rupture, the fetus can quickly bleed to death
✔✔6 Lamaze health birthing practices - ✔✔SPIMBS: separation, pushing, interventions,
begins, support ...........................................................................labor begins on its own,
freedom of movement, CLS, limit routine interventions,
spontaneous pushing in second stage, no separation of mother and infant
✔✔S+S of vasa previa - ✔✔Vaginal bleeding if vessels are torn or rutured, no abdo
pain, uterus is soft
✔✔risk factors of vasa previa - ✔✔low-lying placenta, multiple gestation, and
pregnancies from assisted reproductive technology
● 60% fetal loss if not identified before delivery