44 terms

Ch 3 Antenatal Assessment and High-risk Delivery

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What is a teratogen?
agent or factor that causes malformation of the fetus (i.e. alcohol)
How much less is the average weight of babies whose mothers smoke during pregnancy?
200 g less
What abnormalities can cocaine cause to the baby?
congenital malformations of the:
limbs
heart
brain
genitourinary tract
What abnormalities can opiates and amphetamines cause to the baby
withdrawal symptoms after birth
small for gestational age
What 3 things make up preeclampsia?
hypertension
proteinuria
generalized edema
What other form of birth might be recommended for a mom with preeclampsia?
C section
What is eclampsia?
hypertension
Grand mal seizure or tonic clonic
How do you treat preeclampsia?
by delivering the baby
What is used to prevent seizures?
magnesium sulfate
What is the recurrence rate of preeclampsia?
25%
What are women with pregestational diabetes at risk for?
diabetic ketoacidosis
proliferative retinopathy
preeclampsia/eclampsia
What is gestational diabetes mellitus (GDM)?
abnormal glucose tolerance that occurs or is first recognized during pregnancy
What are babies of moms with GDM at risk for?
macrosomia (big baby)
idiopathic respiratory distress syndrome
What are some long term risks for women with GDM?
type 2 diabetes (50% within 2 years)
What organism can affect pregnancy outcome?
group B Streptococcus (GBS)
Severe morbidity is a risk for the babies of moms with GBS with what conditions?
premature birth
prolonged rupture of the fetal membranes
What percent of kids exposed to HIV will acquire the infection?
30%
What can reduce perinatal HIV transmission and by how much?
6 week chemoprophylaxis and by 8.3%
Can HIV be transmitted through breast milk?
Yes
What can placental abruption cause?
fetal distress
death
What is placental abruption commonly associated with?
trauma
cigarette smoking
What is placenta previa?
When the placenta covers the cervical os. C section usually required
What is oligohydramnios?
too little amniotic fluid
amniotic fluid index < 5 cm
What is the normal amniotic fluid index?
8-18 cm
What is polyhydramnios?
too much amniotic fluid
amniotic fluid index > 24 cm
frequently associated with fetal malformations
What is a breech presentation?
legs first (instead of head first)
C section might be required
What can be used to assist vaginal delivery?
forceps
vacuum
What is an ultrasound?
ultrahigh-frequency sound waves that obtain real-time images
What measures blood flow to fetal organs?
doppler flow studies
How is amniocentesis performed?
A needle is inserted through the skin and uterine wall to obtain a sample of fluid from the amniotic sac
How is assessment of placental function commonly done?
Monitoring the fetal HR when it moves spontaneously (Nonstress test)
When the fetus moves in response to induced uterine contractions (Contraction stress test)
In the fetus, how does cardiac output increase?
by increasing the heart rate
What drugs are widely used for the treatment of preterm labor?
tocolytics
When is pre term labor?
< 37 weeks
How does small size play a role in preterm birth?
small size has more risks
What are risk factors for preterm delivery?
Previous preterm delivery
Premature rupture of membranes
Genital infections (Chlamydia)
Neogenital infections (Pneumonia)
Chorioamnionitis (infection of fetal membranes and amniotic fluid)
Overdistention of the uterus
Placental conditions
Signs of preterm labor
Back Pain
Menstrual like pains
Vaginal discharge
Vaginal bleeding
What is the diagnosis of pre term labor based on?
6 contractions in 1 hour with cervical changes
How do you treat pre term labor?
Stop the labor
Bed rest
Magnsium sulfate
Indomethacin
Tocolytics
When are women candidates for antenatal corticosteroid therapy?
between 24-34 weeks of gestation with preterm labor and intact membranes
When do steroids have the most effect?
48 hours after administration
How much % does corticosteroids reduce the risk of RDS and neonatal morbidity?
50%
How much does a fetal macrosomia baby weigh?
> 4000 g. Also increases the risk for C section
When is meconium aspiration most common?
after 42 weeks of gestation