● Preeclampsia: Multisystem hypertensive disease unique to pregnancy, with
hypertension accompanied by proteinuria after 20th week (140/90+)
● Eclampsia: onset of convulsions or seizures that cannot be attributed to other causes in a
woman with preeclampsia
● Gestational hypertension: >140/90 for the first time after 20 weeks without signs of
preeclampsia
● Chronic hypertension: >140/90 before conception. Predates conception or before 20
weeks.
● Chronic hypertension with superimposed preeclampsia:
○ Women with hypertension only in early gestation who develops proteinuria after
20 weeks
○ Woman with hypertension and proteinuria before 20 weeks developing
exacerbation of symptoms (RUQ pain, increase in liver enzymes, pulmonary
edema, severe headaches)
■
● Risks for diabetic patients with uncontrolled sugars.
○ Risks
■ Maternal
● Hypoglycemia / DKA
● Hypertensive disorders 10-15%
● PTL 25%
● Spontaneous AB 30+%
● Polyhydramnios / Oligohydramnios
● Cesarean delivery
● Exacerbation of chronic related conditions
● Infection
● Induction of labor
, ■ Neonatal
○ Hypoglycemia
○ IUGR
○ RDS
○ Polycythemia
○ Hyperbilirubinemia
○ Prematurity
○ Congenital defects
○ Macrosomia
○ Birth injury
○ Stillbirth
● Elevated HGBA1C what defect can happen in the baby?
○ heart defects and birth defects of the brain and spine called neural tube defects
(also called NTDs).
● Primary assessments on the newborn at delivery.
●
● Definitions of patent ductus arteriosus, acrocyanosis, Mongolian spots, patent foramen
ovale.
○ patent ductus arteriosus- ductus arteriosus remains open after birth
■ this is GOOD in fetal circulation
■ BAD in neonatal (bc no blood will go to lungs if you have an open
ductus… should be closed at delivery)
○ Acrocyanosis- blue hands & feet (normal, cyanosis elsewhere is not normal)
○ Mongolian spots-Flat, bluish discolored area on the lower back and/or buttock.
seen > in African American, Asian, Hispanic, & Native American infants.
○ patent foramen ovale- The foramen ovale is an opening between the right & left
atria. Blood high in oxygen is shunted to the left atrium via the foramen ovale.
■ After delivery, the foramen ovale closes in response to increased blood
returning to the left atrium. It may take up to 3 months for full closure.
, ■ → sometimes will make you hear a murmur: okay in the first 24 hours,
but after 2-3 days you shouldn’t hear this
● Cardiovascular adaptation newborn. What happens when the cord is clamped, fetal vs
neonatal circulation?
○ Fetal circulation- pressure in the lungs of fetus should be high (pulmonary
pressure) bc it keeps the blood away
○ Neonatal circulation- ductus closes and blood supply goes to the lungs,
oxygenation, when the cord is clamped the pulmonary pressure has to decrease
○
●
●
●
hypertension accompanied by proteinuria after 20th week (140/90+)
● Eclampsia: onset of convulsions or seizures that cannot be attributed to other causes in a
woman with preeclampsia
● Gestational hypertension: >140/90 for the first time after 20 weeks without signs of
preeclampsia
● Chronic hypertension: >140/90 before conception. Predates conception or before 20
weeks.
● Chronic hypertension with superimposed preeclampsia:
○ Women with hypertension only in early gestation who develops proteinuria after
20 weeks
○ Woman with hypertension and proteinuria before 20 weeks developing
exacerbation of symptoms (RUQ pain, increase in liver enzymes, pulmonary
edema, severe headaches)
■
● Risks for diabetic patients with uncontrolled sugars.
○ Risks
■ Maternal
● Hypoglycemia / DKA
● Hypertensive disorders 10-15%
● PTL 25%
● Spontaneous AB 30+%
● Polyhydramnios / Oligohydramnios
● Cesarean delivery
● Exacerbation of chronic related conditions
● Infection
● Induction of labor
, ■ Neonatal
○ Hypoglycemia
○ IUGR
○ RDS
○ Polycythemia
○ Hyperbilirubinemia
○ Prematurity
○ Congenital defects
○ Macrosomia
○ Birth injury
○ Stillbirth
● Elevated HGBA1C what defect can happen in the baby?
○ heart defects and birth defects of the brain and spine called neural tube defects
(also called NTDs).
● Primary assessments on the newborn at delivery.
●
● Definitions of patent ductus arteriosus, acrocyanosis, Mongolian spots, patent foramen
ovale.
○ patent ductus arteriosus- ductus arteriosus remains open after birth
■ this is GOOD in fetal circulation
■ BAD in neonatal (bc no blood will go to lungs if you have an open
ductus… should be closed at delivery)
○ Acrocyanosis- blue hands & feet (normal, cyanosis elsewhere is not normal)
○ Mongolian spots-Flat, bluish discolored area on the lower back and/or buttock.
seen > in African American, Asian, Hispanic, & Native American infants.
○ patent foramen ovale- The foramen ovale is an opening between the right & left
atria. Blood high in oxygen is shunted to the left atrium via the foramen ovale.
■ After delivery, the foramen ovale closes in response to increased blood
returning to the left atrium. It may take up to 3 months for full closure.
, ■ → sometimes will make you hear a murmur: okay in the first 24 hours,
but after 2-3 days you shouldn’t hear this
● Cardiovascular adaptation newborn. What happens when the cord is clamped, fetal vs
neonatal circulation?
○ Fetal circulation- pressure in the lungs of fetus should be high (pulmonary
pressure) bc it keeps the blood away
○ Neonatal circulation- ductus closes and blood supply goes to the lungs,
oxygenation, when the cord is clamped the pulmonary pressure has to decrease
○
●
●
●
