Studydroid is shutting down on January 1st, 2019

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High Risk Pregnancy
  • A concurrent disordere, pregnancy related complication, or external factor that jeopardizes the health of the mother, fetus, or both
  • Candidiasis: yeast infection in vag, treated with nystatin PO
  • Tricomoniasis: yellowish, gray, frothy discharge in mom, associated C preterm labor, PROM, post C/S infection, treated C Flagyl PO
  • Bacterial Vaginosis: fishy odor, can eat through the membranes, associated C PROM, preterm labor, amnioitc fluid infections treated C clindamicin x 7 days
STIs cont.
  • Chlamydia: associated C PROM, preterm labor, endometriosis, baby eye irritation, treated C vibramicin if not preg, amoxil or zithromax if preg
  • Syphilis: associated C miscarriage, preterm labor, stillbirth, congenital abnormalities, treated C PCN-G (24hrs of tachycardia, shock, muscle aches, fever)
  • Herpes Simplex type 2: associated C infections in the newborn, can be lethal to fetus/baby, primary infection can cross placenta, treated with zovirax or valtrex
STIs con.
  • Gonorrhea: associated C severe eye infection and blindness, treated C IV rocephin and posaprax
  • HPV: may obstruct birth canal, baby can be born C lesions
  • GBS: affected infant can develop pneumonia, Resp distress, meningitis
  • Hep B/C: if active baby needs hep imunogloibin
  • Assessment: flu-like symptoms, asymptomatic eriod, symptomatic period
  • Management: monitor CD4 count > 400, treat PCP C bactrim, kaposi sarcoma treated C chemo later in preg, may need platlets for thrombocytopenia, baby usually delivered c/s
Hematologic Disorders
  • Anemia: fatigue, CP, SOB
  • Iron deficiency anemia: needs prenatal C iron
  • Folic Acid deficiency: needs prenatal C iron
  • sickle cell anemia: preg can cause crisis, most common genetic disease in AA, Hgb 6-8. no iron needs, but yes on folate, possible exchange transfusions
Coagulation Disorders
  • Von Willebrand Disease" factor IIX issues, requires factor IIX to treat
  • Hemophilia B
  • Idiopathic thrombocytopenia purpura (ITP): can follow a viral infection or be triggered by the stress of preg, resolves on its own or may require platelets if < 30, can also be given steroids
Rheumatic Disorders
  • juvenile rheumatoid arthritis
  • Systemic Lupus erythematosus: 20-40 y/o women, autoimmune, can affect all organs, difficult to diagnose, ↑ thrombus production, risk for nephritis and spontaneous abortion, treated C steroids, NSAIDS, ASA
Endocrine Disorders
  • Diabetes Mellitus: DM is a metabolic disorder causes by defects in insulin secretion or action, which leads to abnormalities in the metabolism of carbs, lipids, and protein
  • Chronic Hyperglycemia associated C diabetes causes tissue damage in all organ systems
Gestational DM
  • any degree of glucose intolerance C onset of first recognition during pregnancy
  • accounts for 90% of all pregnancies complicated by DM
Metabolic alterations in pregnancy
  • In the first trimester, fasting blood glucose diminshes becuase insulin production and sensitivity slightly increases
  • by the end of the first trimester insulin sensitivity decreases with a responding increase in insulin production which leads to a diabetogenic state of pregnancy
  • should be maintained 3-6 months prior to conception
  • DM increases risk for neural tube defects, heart defects, caudal regression syndrome (no legs)
  • euglycemia is maintained in pregnancy b/c the pancreatic beta cells produce enough insulin to counteract increasing insulin resistance
Perinatal Implications of DM
  • fetal growth abnormalities (macrosomia and IUGR) d/t vascular problems from DM
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