PATHOLOGIE ZWANGERSCHAP
Inhoudsopgave
1. Bloedingen na 20 weken................................................................................................. 1
1.1 Evi Geuten................................................................................................................. 1
1.2 Francesca Russo........................................................................................................ 2
1.2.1 Bloedingen uit de cervix......................................................................................3
1.2.2 Bloedingen uit de placenta..................................................................................3
1.2.3 Bloedingen uit de navelstreng.............................................................................4
1.2.4 Bloedingen uit de uterus......................................................................................4
1.2.5 Niet-gynaecologische bloedingen........................................................................4
1.2.6 Wat te doen bij bloeding......................................................................................4
2. Hypertensie.................................................................................................................... 5
2.1 Evi Geuten................................................................................................................. 5
2.2 Lore Lannoo............................................................................................................... 6
2.2.1 Bloeddruk............................................................................................................ 6
2.2.2 Hypertensie......................................................................................................... 6
2.2.3 Pre-eclampsie...................................................................................................... 7
2.2.4 Eclampsie............................................................................................................ 8
2.2.5 HELLP.................................................................................................................. 8
2.2.6 Zwangerschapscholestase...................................................................................8
3. PPROM............................................................................................................................ 9
3.1 Evi Geuten................................................................................................................. 9
3.2 Jute Richter................................................................................................................ 9
4. Preterme arbeid............................................................................................................ 10
4.1 Evi Geuten............................................................................................................... 10
4.2 Jute Richter.............................................................................................................. 10
4.2.1 Preterme arbeid - PPROM..................................................................................10
4.2.2 Cervixlengtemeting........................................................................................... 10
4.2.3 Koorts – Chorio-amnionitits................................................................................10
4.2.4 Sepsis – Septische shock...................................................................................11
1. BLOEDINGEN NA 20 WEKEN
1.1 EVI GEUTEN
1
Evi Geuten
, PATHOLOGIE ZWANGERSCHAP
Shock: initiële fase verminderde veneuze retour naar hart – hypotensie -
tachycardie
compensatie fase constrictie bloedvaten – hartslag neemt toe om BD te
verhogen
progressieve fase multi-orgaan falen – stop compensatiemechanismen
irreversibele fase overlijden patiënt
Bloedverlies Systolische BD Signs & symptoms Graad van shock
500 – 1000 ml Normaal Hartkloppingen, Gecompenseerd
10-15% duizelig, tachycardie
1000 – 1500 ml Licht gedaald Zwakheid, zweten, Mild
15-52% tachycardie
1500 – 2000 ml 70 – 80 mmHg Rusteloos, bleek, Matig
25-35% oligurie
2000 – 3000 ml 50 – 70 mmHg Verlies bwz, Ernstig
34-45% ademnood, anurie
SOAPS: senior midwife extra
obstetrician gynaecoloog
anesthesist voor spoed-sectio
pediatrician
scriber notulist bij acute situaties
4 pijlers: communicatie tussen hulpverleners
reanimatie
monitoring & onderzoeken
stop bloedverlies door partus
Gegevens: airway problemen
breathing aantal/minuut – saturatie – hoe
circulation BD – bpm – saturatie – CTG baby
disability bewustzijn
exposure bleek – pijn – bloedverlies
full set of vitals ligging placenta – psyche – kindsbewegingen –
roken - …
MEOWS: modified
early
obstetric
warning
system
Diagnoses: hypovolemische shock
placenta abruptio
placenta preavia
uterusruptuur
tekenen – show
na seks
1.2 FRANCESCA RUSSO
2
Evi Geuten
Inhoudsopgave
1. Bloedingen na 20 weken................................................................................................. 1
1.1 Evi Geuten................................................................................................................. 1
1.2 Francesca Russo........................................................................................................ 2
1.2.1 Bloedingen uit de cervix......................................................................................3
1.2.2 Bloedingen uit de placenta..................................................................................3
1.2.3 Bloedingen uit de navelstreng.............................................................................4
1.2.4 Bloedingen uit de uterus......................................................................................4
1.2.5 Niet-gynaecologische bloedingen........................................................................4
1.2.6 Wat te doen bij bloeding......................................................................................4
2. Hypertensie.................................................................................................................... 5
2.1 Evi Geuten................................................................................................................. 5
2.2 Lore Lannoo............................................................................................................... 6
2.2.1 Bloeddruk............................................................................................................ 6
2.2.2 Hypertensie......................................................................................................... 6
2.2.3 Pre-eclampsie...................................................................................................... 7
2.2.4 Eclampsie............................................................................................................ 8
2.2.5 HELLP.................................................................................................................. 8
2.2.6 Zwangerschapscholestase...................................................................................8
3. PPROM............................................................................................................................ 9
3.1 Evi Geuten................................................................................................................. 9
3.2 Jute Richter................................................................................................................ 9
4. Preterme arbeid............................................................................................................ 10
4.1 Evi Geuten............................................................................................................... 10
4.2 Jute Richter.............................................................................................................. 10
4.2.1 Preterme arbeid - PPROM..................................................................................10
4.2.2 Cervixlengtemeting........................................................................................... 10
4.2.3 Koorts – Chorio-amnionitits................................................................................10
4.2.4 Sepsis – Septische shock...................................................................................11
1. BLOEDINGEN NA 20 WEKEN
1.1 EVI GEUTEN
1
Evi Geuten
, PATHOLOGIE ZWANGERSCHAP
Shock: initiële fase verminderde veneuze retour naar hart – hypotensie -
tachycardie
compensatie fase constrictie bloedvaten – hartslag neemt toe om BD te
verhogen
progressieve fase multi-orgaan falen – stop compensatiemechanismen
irreversibele fase overlijden patiënt
Bloedverlies Systolische BD Signs & symptoms Graad van shock
500 – 1000 ml Normaal Hartkloppingen, Gecompenseerd
10-15% duizelig, tachycardie
1000 – 1500 ml Licht gedaald Zwakheid, zweten, Mild
15-52% tachycardie
1500 – 2000 ml 70 – 80 mmHg Rusteloos, bleek, Matig
25-35% oligurie
2000 – 3000 ml 50 – 70 mmHg Verlies bwz, Ernstig
34-45% ademnood, anurie
SOAPS: senior midwife extra
obstetrician gynaecoloog
anesthesist voor spoed-sectio
pediatrician
scriber notulist bij acute situaties
4 pijlers: communicatie tussen hulpverleners
reanimatie
monitoring & onderzoeken
stop bloedverlies door partus
Gegevens: airway problemen
breathing aantal/minuut – saturatie – hoe
circulation BD – bpm – saturatie – CTG baby
disability bewustzijn
exposure bleek – pijn – bloedverlies
full set of vitals ligging placenta – psyche – kindsbewegingen –
roken - …
MEOWS: modified
early
obstetric
warning
system
Diagnoses: hypovolemische shock
placenta abruptio
placenta preavia
uterusruptuur
tekenen – show
na seks
1.2 FRANCESCA RUSSO
2
Evi Geuten
