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Perfusion exam 2 definitions
Terms in this set (24)
-process where thromboblast cell displace endometrial cells at implantation site, and blastocyt embeds in endometrium in post or anterior fundal region.
-between 6-10 days after conception, the thromboblast secretes enzymes that enable it to burrow into the endometrium until the entire blastocyte is covered.
-endometrial blood vessels erode and implantation bleeding occurs(spotting)
purposeful interruption of pregnancy before 20 weeks gestation
termination performed for maternal or fetal health or disease
-fetal genetic disorders, maternal ill, or rape
First trimester abortion
-performed less than 9 weeks gestation
-method used include surgical(aspiration or vacuum suction) and medical abortion (drugs such as methotrexate and misoprostol given IM or vaginally)
-Misoprostol can be given orally 7 weeks after LMP
Second trimester abortion
in the US 10% are performed in this
-require dilation and evacuation of uterine products of contraceptive bc products are large.
type of miscarriage with no cervical dilation
type of miscarriage with cervical dilation and will end up with evacuation of products of conception
type of miscarriage with cervix open and come tissue remains in cervix. may require evacuation or remaining products of conception.
type of miscarriage where cervix has already closed after tissue passed
type of miscarriage where there is no spotting, no uterine cramping, no passage of tissue and no cervical dilation
type of miscarriage usually with dilated cervical is with products or none but women presents with fever and cervical swabs confirm infection
A pregnancy in which the fertilized ovum is implanted outside the uterine cavity, aka tubal pregnancy
Hydatidiform Mole (Molar pregnancy)
a benign proliferation growth of the placenta trophoblast in which the chorionic villi will develop into edematous cystic, avascular transparent vesicles that hang in a grapelike cluster
the placenta is implanted in the lower uterine segment such that is completely or partially covers the cervical os (opening of cervix)
-occurs when women carrying male fetuses or multiple gestations.
-risk factors are previous C-section or Hx of advanced maternal age and smoking
it is the premature separation of the placenta or detachment of part or all of a normally implanted placenta from the uterus
-separation occurs in the area of decidua basalis after 20 weeks of gestation and before the birth of infant
-when fetal vessels lie over cervical os
-rapture of membranes ROM or traction on the cords may rapture one or more of the fetal vessels causing fetal bleeding and death
-risk factors include low-lying placentas and multiple gestations as well as assistive reproductive technology
Velamentous insertion of the cord
occurs when the cord vessels begin to branch at the membranes and then course on to the placenta
form of vasa prevue in which the placenta has divided into two or more lobes rather than remaining a single mass.
-fetal vessels then run between the lobes of the placenta
-during labor, one of the lobes of the placenta could remain in uterus causing high risk for postpartum hemorrhage
Battledore(marginal) cord insertion
marginal insertion of cord into the placenta
-increases risk for fetal hemorrhage especially after marginal separation of placenta
screening tool for Rhesus incompatibility. if maternal titer for Rh antibodies >1:8 amniocentesis for determination of bilirubin in amniotic fluid is indicated to establish the severity of fetal hemolytic anemia
Fetal monitoring: Nonstress test
NST is most widely applied technique for antepartum eval of fetus.
-basis for test is that the normal fetus produces characteristic heart rate patterns in response to fetal movement, uterine contractions or stimulation.
-in term fetus, accelerations are associated with movements >85% of the time
Contraction Stress Test (CST)
electronically fetal assessment test. devised as a graded stress test of the fetus to ID the jeopardized fetus that was stable at rest but showed evidence of compromise under stress.
-uterine contractions decrease uterine blood flow and placenta perfusion
-if this decrease is sufficient to produce hypoxia in fetus, a deceleration in FHR results
Interpretation of CST
CST results are negative, positive suspicious, or unsatisfactory.
-if no late decelerations are observed with contractions, the findings are considered negative
-repetitive later decelerations render the test results positive
Essential to know about fetal monitoriing
if caring for laboring women on an external contraction monitor in active labor and the FHR for more than 5 sequential contractions begins to decelerate late in contraction, with the nadir of the decelerations occurring after the peak of the contraction, the nurse must first change the women's position incase the fetus is pressing on the large blood vessels.
-the nurse must understand that later FHR decelerations are caused by uteroplacental insufficiency
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