Week 5 Flashcards by caitlin gill

what are the 2 categories of maternal death?

direct and indirect

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What is direct maternal death?

deaths are those resulting from obstetric complications of pregnancy or its management

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What is indirect maternal death?

Indirect maternal deaths are those resulting from diseases or conditions that were not due to a direct obstetric cause, but were aggravated by the physiologic effects of pregnancy

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define parity

Parity refers to a woman’s number of previous pregnancies, excluding the current pregnancy, carried to a viable gestational age (usually 20 weeks).

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how much more common is VTE in pregnant woman than women in general?

10x

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What is VTE?

Venous Thromboembolism

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What are some risk factors for VTE?

Age >35
Obesity
Parity >4
History of thromboembolism
Prolonged travel
Operative delivery
Instrumental vaginal delivery
Prolonged labour >12 hours
>4 days bed rest (immobility)

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How would you manage a patient with PE or VTE?

Consult PIPER/clinician
MICA early
Upright position
Oxygen
Rapid transport with notification

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what happens in amniotic fluid embolism?

Usually during labour or procedure: amniotic fluid/debris enters maternal circulation
Anaphylaxis or activation of the complement cascade (or both!)

Progression is in 2 phases

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what are the s&s for amniotic fluid embolism?

Normal scenario is: women has acute resp distress then collapses often after doing a big push during labour or after delivery.

Common “premonitory” symptoms:

breathlessness
chest pain
cold and light headed
restless-panicked and distressed
pins and needles in fingers
nausea and vomiting

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what should always be a differential in a pregnant patient with ATYPICAL chest pain?

especially if pain is interscapular with hypertension

Aortic dissection

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What should be suspected if there is sever headache during pregnancy or post natal period?

Intercranial haemoorhage

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What is associated with hypertensive diseases in pregnancy?

intercranial haemorrhage

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What are risk factors for genital tract sepsis?

obesity
vaginal discharge
vaginal trauma during birth
anaemiaq

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what are some causes of sepsis prior to birth?

miscarriage
termination of pregnancy
cervical suture
ruptured ectopics

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what are some causes of sepsis post to birth?

retained products

- postoperative infections

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what is the mortality rate of sepsis in pregnant patients?

20-40%

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What is a differential for placental abruption

Sepsis

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What are S&S for sepsis in pregnancy?

everything you’d expect in a non
pregnant patient +
vaginal discharge
Abdo pain
D & V

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what are some minor disorders of the digestive system seen in pregnancy?

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Morning sickness
Heart burn
Constipation
Ptyalism (excessive salvation)
Pica (cravings)

How do you treat morning sickness?

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dry biscuits and fluid

What complications can arise from morning sickness?

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–Hyperemesis
•leading to Weight loss;
–Dehydration;
–Electrolyte imbalances

Whats the cause of heartburn in prego patients?

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progesterone relaxes cardiac sphincter

usually occurs in late pregnancy

how do you manage heartburn in pregnant patients?

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Avoid bending over
Small meals
Sleep semi-recumbent or right side
If severe → antacids

What causes constipation in pregos?

Progesterone relaxes bowel Bowel displaced by growing uterus Iron supplements Occurs throughout the pregnancy

How do you treat constipation?

Hi fibre diet & water +++ Moderate exercise Aperients last resort

How do you treat Ptyalism & Pica?

Effective reassurance if uncomfortable Craving may be potentially dangerous –Requires further investigation

what are some minor disorders of the circulatory system seen in pregnancy?

Anaemia Fainting Varicosities Supine Hypotension

WHat causes Anaemia in oregnancy?

Circulating blood/plasma volume ↑’s 50% Red blood cells ↑18% Considered normal –unless physiologically compromised

What causes fainting in pregnancy?

1.Vasodilatation & poor return to heart •May occur throughout pregnancy 2.Supine Hypotension •Later in pregnancy: middle of 2nd trimester to birth

How do you treat fainting in pregnancy?

1. Avoid long periods of standing if vasodilation | 2. Avoid lying on back later in pregnancy

What causes varicosities - varacose veins

Progesterone relaxes sooth muscle | ↑’ing weight & pelvic congestion

How do you manage varacose veins?

Leg exercises Raising legs when able Support stockings Reassure will cease a few months after delivery

what are some minor musculosketal disorders seen in pregnancy?

``` Back aches Sciatica Sublaxations & dislocations Cramps Pelvic floor damage ```

What causes back aches/sciatica/sublaxations?

Progesterone (& relaxin later) muscle relaxant Change in centre of gravity of growing uterus –occurs any time but usually in 3rdtrimester

How do you manage cramps in pregnancy?

Elevate feet slightly Moderate exercise & leg movements Warm bath prior to sleep

What causes pelvic floor damage?

- Cause - Progesterone - ↑’ing weight on pelvis

what are some minor disorders seen in genitourinary system during pregnancy?

- frequency of urine | - leucorrhoea

What causes an increase in frquency of urination in pregnancy?

Bladder competes for space in pelvis with growing uterus & later with foetal head UTI’s more common in pregnancy

What is Leucorrhea?

Increased benign white vaginal discharge

what causes carpal tunnel syndrome in pregnancy?

Oedema and pressure on the median nerve | Occurs most commonly in the morning

what is Linea Nigra?

line from belly button to pelvis

what IS CHLOASMA?

butterfly shaped pigmentation on face

how much blood can a pregnant patient lose without showing symptoms?

30-50%

What are some potential complications with trauma in a pregnant patient?

* Placental abruption * Cardiorespiratory arrest * Labourand birth * Preterm labour * Spontaneous abortion * Uterine rupture * Pelvic fractures * Haemorrhageand shock * Prematurity and low birth weight

what is the acronym for possible causes of maternal cardiac arrest?

BEAUCHOPS

What does BEAUCHOPS stand for?

B- Bleeding/DIC E - Embolism cardiac/pulmonary/amniotic fluid A - Anaesthetic complications U - Uterine atony C - Cardiac disease: MI/ischemia/aortic dissection/cardiomyopathy H - Hypertension/preeclampsia/eclampsia O - Other -Review standard ACLS guidelines (Hs and Ts) P - Placental abruptio, previa S - Sepsis

WHat are the 4 H's & T's for causes of cardiac arrest?

- hypoxia - hypothermia - hyperkalaemia - hypovolaemia - tamponade - TPT - thrombosis - toxins

Week 5 Flashcards

(48 cards)