Obstetric 2

Question 1

What is a high risk pregnancy?

Answer 1

any fetal or maternal condition that can adversely affect the pregnancy, usually with a premature delivery

Question 2

What types of maternal pre-existing conditions may cause a high risk pregnancy?

Answer 2

• heart/lung disease
• DM
• chronic illness
• disability
• substance abuse
• lack of prenatal care

Question 3

What are some complications that may make a pregnancy high risk?

Answer 3

• preeclampsia
• preterm labor
• multiple gestation
• premature rupture of membranes
• hyperemesis gravidarum
• pulmonary edema
• cardiomyopathy

Question 4

Who does preeclampsia affect?

Answer 4

• both mother and fetus

- can be fatal!

Question 5

preeclampsia is characterized by:

Answer 5

• HTN
• presence of protein in urine

may also include:

• swelling/sudden weight gain
• HA
• vision changes

Question 6

When does preeclampsia typically occur?

Answer 6

20 weeks gestation to 6 weeks postpartum

Question 7

outdated terms you might hear for preeclampsia

Answer 7

• pregnancy-induced HTN

- toxemia

Question 8

variants of preeclampsia (2)

Answer 8

• HELLP syndrome

- eclampsia

Question 9

HELLP syndrome =

Answer 9

H: hemolysis
EL: elevated liver enzymes
LP: Low Platelet count (thrombocytopenia)

Question 10

eclampsia =

Answer 10

seizures

Question 11

progression of preeclampsia or inability to manage usually results in

Answer 11

• delivery of the baby, regardless of gestational age

- increased risk for whole host of issues for the baby

Question 12

PROM =

Answer 12

• premature rupture of membranes

- rupture of membranes prior to onset of labor

Question 13

When does membrane rupture usually occur?

Answer 13

• typically occurs at term

- apoptosis appropriately initiates rupture

Question 14

PROM: pathology

Answer 14

inflammation or infection of the membranes

Question 15

PROM: risk factors

Answer 15

• low socioeconomic status
• low BMI
• tobacco use
• preterm labor hx
• UTI
• vaginal bleeding
• cerclage
• amniocentesis

Question 16

What is hyperemesis gravidarum?

Answer 16

nausea so severe, excessive vomiting occurs

Question 17

hyperemesis gravidarum: can quickly lead to

Answer 17

• dehydration
• electrolyte imbalances
• WL

Question 18

hyperemesis gravidarum: cause?

Answer 18

• unknown

- may be linked to hormonal changes

Question 19

hyperemesis gravidarum: tx

Answer 19

requires hospitalization

Question 20

When do sx of typical morning sickness or hyperemesis gravidarum usually subside?

Answer 20

13 weeks (end of 1st trimester, first part of 2nd)

Question 21

bedrest prescription: high risk pregnancies

Answer 21

~ 18% of the time (think about how decreased WB produces changes in every body system)

extremely relevant to PT practice

Question 22

procedure used to address incompetent cervix

Answer 22

cerclage

Question 23

What are other common conditions that warrant communication with the PCP during pregnancy?

Answer 23

• ectopic pregnancy
• placental abruption
• placenta previa

Question 24

ectopic pregnancy =

Answer 24

egg implanted in fallopian tube instead of uterus

Question 25

placental abruption =

Answer 25

- placenta peels away from uterus - may deprive fetus of oxygen - may require early delivery

Question 26

placenta previa =

Answer 26

- placenta covering cervix | - may resolve itself, or may require early delivery

Question 27

Where might an ectopic pregnancy occur?

Answer 27

- fallopian tube - ovary - peritoneum