HIGH RISK PERINATAL CARE/GESTATIONAL CONDITIONS
Gestational conditions are disorders non existent before pregnancy:
-Gestational hypertension
-Preeclampsia
-Hyperemesis gravidarum
-Miscarriage
-Cervical insufficiency
-Ectopic pregnancy
-Molar pregnancy
-Placenta previa
-Premature placental abruption
-Disseminated Intravascular Coagulation (DIC)
Gestational hypertension– onset of hypertension without proteinuria after 20th week;
Early S&S: weight gain, ↑BP
Preeclampsia– ↑BP, proteinuria
-vasospastic systemic disorder is progressive from mild to severe
Risk factors:
➢ Family history
➢ Multifetal pregnancy
➢ African-American race
➢ Obesity
➢ Before 19 and after 40 years old– young and old pregnancy
➢ Pre-existing medical or genetic conditions
Caused by disruptions in placental perfusion and cell dysfunction
Reduced kidney perfusion= ↓output, ↑BUN↑creatinine (kidney failure/damage)
● HELLP Syndrome– Hemolysis, Elevated Liver enzyme, Low Platelet
Labs: H&H, CBC, AST, ALT, SGOT,SGPT, PTT/INR, BUN, creatinine
Eclampsia–seizure activity or coma in woman with preeclampsia
- Women without history of seizure
- Can occur before, during, or after birth
**Physical examination:
- dependent edema
- pitting edema
- DTR (+2 is normal) if DTR more than 2, magnesium sulfate given, seizure precautions, if
DTR is absent (mag sulf toxicity) give calcium gluconate to reverse
Gestational conditions are disorders non existent before pregnancy:
-Gestational hypertension
-Preeclampsia
-Hyperemesis gravidarum
-Miscarriage
-Cervical insufficiency
-Ectopic pregnancy
-Molar pregnancy
-Placenta previa
-Premature placental abruption
-Disseminated Intravascular Coagulation (DIC)
Gestational hypertension– onset of hypertension without proteinuria after 20th week;
Early S&S: weight gain, ↑BP
Preeclampsia– ↑BP, proteinuria
-vasospastic systemic disorder is progressive from mild to severe
Risk factors:
➢ Family history
➢ Multifetal pregnancy
➢ African-American race
➢ Obesity
➢ Before 19 and after 40 years old– young and old pregnancy
➢ Pre-existing medical or genetic conditions
Caused by disruptions in placental perfusion and cell dysfunction
Reduced kidney perfusion= ↓output, ↑BUN↑creatinine (kidney failure/damage)
● HELLP Syndrome– Hemolysis, Elevated Liver enzyme, Low Platelet
Labs: H&H, CBC, AST, ALT, SGOT,SGPT, PTT/INR, BUN, creatinine
Eclampsia–seizure activity or coma in woman with preeclampsia
- Women without history of seizure
- Can occur before, during, or after birth
**Physical examination:
- dependent edema
- pitting edema
- DTR (+2 is normal) if DTR more than 2, magnesium sulfate given, seizure precautions, if
DTR is absent (mag sulf toxicity) give calcium gluconate to reverse
