9 Causes Preterm Delivery?
- Cervical surgery
- Infection (BV, STI, GBS)
- Smoking
- Preg interval < 6 mos
- African American
- Multiple gestations
- Prior preterm
- ANEMIA
- Stress Give 17-hydroxyprogesterone caproate to decrease risk of preterm delivery if previous preterm.
Complications preterm infants?
- Necrotizing enterocolitis
- Intracranial hemorrhage
- PDA
- Infection
- Hypoglycemia
- Hypothermia
Post partum hemorrhage DDx?
- Uterine atony
- Birth trauma (vag or cerv laceration)
- Retained placental tissue
- Coagulation disorder
Risk factors uterine atony?
Boggy uterus! 3 categories…
- Multiple gestation / macrosomia / polyhydraminos (uterine distension)
- Chorioamnionitis
- Muscle fatigue: prolonged labor, prolonged oxytocin, IV mag sulfate
Risks placental abruption?
- Abdominal trauma
- Cocaine use
- Smoking
- HTN
- Multiparity
- Increased maternal age
Most common cause miscarriage?
Other causes?
Fetal aneuploidy or structural abnormalities cause 50% of all miscarriages:
- Trisomy 16 - most common trisomy in miscarriage
- Advanced maternal age (>35)
- Smokers
- Hx spontaneous miscarriage
Risks smoking while preggers?
- IUGR
- Prematurity
- SIDS in first year of life
- Abruption and previa
When see Pica think…
Anemia of pregnancy: often due to iron deficiency relative to need
Pica: crave things w/ no nutritional value (ice, clay, dirt).
Hb < 6 = oligohydraminos, premature delivery, spontaneous abortion, low birth weight, fetal death
Advanced Maternal Age Complications:
<35 yo
- Abortion/stillbirth
- Genetic abnormalities
- HTN diseases
- GDM
- Multiple gestation pregnancy
- maternal morbidity and mortality
Asthma in pregger…
- Risk decreased fetal oxygenation
- Increased risk spontaneous abortion
- Increased risk perinatal mortality
Cerebral Palsy and Pregnancy
CP = spastic muscle deformities + intellectual impairment
- IUGR assoc w/ cerebral palsy
IUGR: vascular abnormality
- smoking, HTN, DM, illicit drugs, placental abnormalities
Describe the APGAR score?
HR > 100 Respiratory effort Muscle tone Reflex irritability (cry, whimper, silence) Color
Ovarian tumor, producing estrogen = hormonally active Causing: - menstrual bleeding - pelvic pain - bleeding between periods What is elevated and what kind of tumor?
Granolas cell tumor
- inhibin is elevated
Might be described as a complex ovarian mass or an adnexal mass
Estrogen – hyperplasia – cancer
Connect these to an agent:
- neonatal sepsis
- anemia
- ventriculomegaly
- limb hypoplasia
- chorioretinitis
- hearing loss
- cicatricial skin lesions
- hydrops fetalis
Sepsis - GBS Aneima - parvovirus B19 Ventriculomegaly - CMV Limb hypoplasia - VZV Chorioretinitis: toxo or CMV or VZV Hearing loss: rubella or CMV Cicatrical skin lesions: VZV (give varicella zoster immune globulin) Hydrops fetalis: B19 or anti-Rh (anti-D)
CT shows:
- thick walls, septate features, solid components
- homogenous, fluid-filled, thin-walled
Malignant features
Benign features
Risk factors for endometrial cancer?
- Obesity
- Unopposed estrogen use
- DM
- HTN
- Tamoxifen
- Chronic anovulation
Neonatal abstinence syndrome
Child born to mother who used opioids:
- high pitched, inconsolable cry
- sweat, fever, yawning (autonomic dysfunction)
- hypertonia
- hyperactive primitive reflexes
- feeding, GI, sleep problems + failure to thrive
The withdrawal signs begin w/in first 24 hours after birth
Risks PPROM?
- Smoking
- Substance abuse
- Low socioeconomic status
- Extreme age (<18 , > 40)
- Hx PPROM
- Infections
Risk Placenta Previa
Previous C/S
