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High Risk Pregnancy and Hypertensive Disorders - Maternal
Terms in this set (43)
this risk factor originates with the mother or the fetus
may affect developmental functioning of both
genetic disorder, nutritional and general health status, and medical or OB related illnesses
this risk factor is due to maternal behaviors and adverse lifestyles that have a negative effect on the health of mother or fetus
may include emotional distress and disturbed interpersonal relationships
inadequate social support
unsafe cultural practices
this risk factor arises from mother and her family, lack of prenatal care, low income, marital status, ethnicity
this risk factor involves hazards in workplace and woman's general environment
may include chemicals, anesthetic gases, and radiation
this is used to monitor the fetus with pregnancies complicated with oxygenation, aka kick counts
a count of fewer than three kicks in 1 hr warrants further evaluation by a nonstress test
fetal alarm signal
daily fetal movement count
most valuable diagnostic tool used in OB
levels of ultrasound
what risks are reduced with an ultrasound?
what can you evaluate with magnetic resonance imaging?
fetal structure, overall growth
quantity of amniotic fluid
biochemical status of tissues and organs
soft-tissue, metabolic or functional anomalies
what does amniocentesis obtain>
used for genetic concerns, fetal maturity, fetal hemolytic disease
what is chorionic villus sampling used for?
10-13 wks gestation
removal of small tissue specimen from fetal portion of placenta
transcervically or transabdominally
percutaneous blood sampling
direct access to fetal circulation to the second and third trimesters
widely used for fetal blood sampling and transfusion
insertion of needle directly into fetal umbilical vessel under ultrasound guidance
bleeding from cord puncture site is most common complication of procedure
bradycardia can also occur
maternal serum alpha-fetoprotein
maternal serum levels used as screening tool for neural tube defects in pregnancy
triple and quad screening to detect autosomal trisomies
multiple marker screens
screening to detect fetal chromosomal abnormalities
screens fetuses with trisomy 21 and 18
screening for Rh incompatibility
detects antibodies that may place fetus at risk for incompatibility with maternal anitgens
cell-free DNA screening in maternal blood
noninvasive prenatal testing
definitive diagnosis for fetal Rh status, fetal gender, and gene disorders
A method for evaluating fetal status during the antepartum period by observing the response of the fetal heart rate to fetal movement.
Use of sound and vibration to elicit acceleration of the fetal heart rate.
contraction stress test
a stress test used to evaluate the ability of the fetus to tolerate the stress of labor and delivery
what is the major cause of perinatal morbidity and mortality worldwide?
what are the three most common types of hypertensive disorders occurring in pregnancy?
chronic essential hypertension
the onset of this hypertension occurs without proteinuria or other systemic findings, diagnostic for preeclampsia after week 20 of pregnancy
what is the bp for gestational hypertension
systolic greater than 140, diastolic greater then 90
resolves after giving birth
this is a pregnancy specific condition in which hypertension and proteinuria develops after 20 wks of gestation in a previously normotensive woman
in the absence of proteinuria, preeclampsia may be defined as hypertension along with the following:
impaired liver function
new-onset renal insufficiency
new-onset cerebral or visual disturbances
this disorder starts with onset of seizure activity or come in a woman with preeclampsie
this hypertension is present before pregnancy or diagnosed before wk 20 of gestation
this disorder may cause women to acquire preeclampsia or eclampsia and can be difficult to diagnose
chronic hypertension with superimposed preeclampsia
risk factors for preeclampsia
history of preeclampsia
preexisting diabetes and/or thrombophilias
women with limited sperm exposure with the same partner
this is a progressive disorder with the placenta as the root cause and begins to resolve after the placenta has been expelled
spiral arteries in the uterus become larger and thicker to handle increased blood volume
what does placental ischemia lead to?
endothelial cell dysfunction
what does preeclampsia lead to?
reduced kidney perfusion
plasma colloid osmotic pressure decreases
decreased liver perfusion
what is HELLP syndrome?
lab diagnosis for a variant of preeclampsia that involves hepatic disfunction characterized by hemolysis, elevated liver enzymes, and low platelets
result of arteriolar vasospasm, endothelial cell dysfunction with fibrin deposits, and adherence of platelets in blood vessels
what symptoms are associated with HELLP syndrome?
history of malaise
influenza - like symptoms
epigastric or right upper quadrant abdominal pain
symptoms worsen at night and improve during daytime
what can be given to help preeclampsia highrisk women
what should you assess for to identify preeclampsia?
deep tendon reflexes
right upper quadrant abdominal pain
intrapartum care for women with gestational hypertension and preeclampsia
continuous FHR and uterine contraction monitoring
bed rest with side rails up
assessed for signs of placental abruption
medication of choice for preventing and treating seizure activity (eclampsia)
magnesium sulfate, high alert medication
when are hypertensive medications indicated?
when systolic BP exceeds 160 mm hg or diastolic BP exceeds 110 mm Hg
who is at higher risk for chronic hypertension?
how can you manage chronic hypertension?
smoking and alcohol cessation, exercise, weight loss
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