High-Risk Pregnancy
What are the classic symptoms a patient with a ruptured ectopic pregnancy may present with?
Abdominal/pelvic pain, referred shoulder pain, symptoms of hypovolemic shock
What are the four categories of factors associated with male infertility?
Hormonal disorders
Testicular factors
Problems associated with sperm transport
Idiopathic male infertility
What are the three concerning symptoms a patient with severe preeclampsia may exhibit that result from vasospasm?
Headache (cerebral spasm)
Vision change/scotoma (retinal spasm)
URQ/epigastric pain (hepatic spasm/microemboli)
What are some fetal and neonatal risks that occur with unidentified pre-diabetes or uncontrolled diabetes in pregnancy?
Cardiovascular system anomalies
Neurodevelopmental disorders
Skeletal malformations
Prematurity & Respiratory Distress Syndrome
Intrauterine Fetal Demise (IUFD)
What is Goodell's sign?
What education is essential for a patient that recently experienced a molar pregnancy?
Needs frequent ultrasounds, beta hCG levels & pelvic exams. Needs to utilize good contraceptive for a full year to avoid pregnancy that may be confused with recurrance or a reproductive cancer.
In addition to tests like ultrasound, what therapeutic gynecological procedure is undertaken in the presence of female infertility to investigate anatomy and reproductive tract patency?
Hysterosalpingogram
What result in a 24-hour urine protien sample is indicative of a diagnoses of preeclampsia when combined with hypertension?
> 300 mg
What is an abnormal result of a 1-hour glucose tolerance test in pregnancy? What is an abnormal glycosylated hemoglobin (A1C) result?
Abnormal glucose tolerance of >140
Abnormal A1C > 6.5%
Explain what Braxton Hicks contractions are.
Painless, irregular contractions that do not cause the cervix to change. They don't increase in intensity/duration and usually subside with walking.
ABO incompatibility of pregancy is an example of a ________________ disease.
Hemolytic
What two low-intervention assessment techniques can a woman use at home to ensure intercourse occurs in relation to ovulation?
Assess basal body temperature and cervical mucus
What serious placental event is the preeclamptic patient at higher risk for developing when blood pressures are uncontrolled?
Abruptio placenta
Insulin needs are ____________ in the first trimester of pregnancy.
Reduced
What is Ptyalism?
Increased salivation with bitter taste in mouth caused by estrogen & hCG
What disorder is characterized by clotting proteins becoming abnormally active?
Disseminated Intravascular Coagulation (DIC)
What is an important consideration for hormonal replacement therapy when a woman with vasomotor symptoms has had a hysterectomy?
She should not take progesterone therapy because of its association with endometrial cancer.
What is the first sign of magnesium sulfate toxicity?
Absent DTR's
What delivery complication may result when a diabetic patient is delivering a macrosomic fetus?
Shoulder dystocia
Your patient in her first trimester is complaining of urinary frequency. What do you do?
Assess if she feels any other symptoms besides frequency. Frequency is expected but other signs of UTI (dysuria/urgency, flank pain, etc.) are not expected.
Name the four most common tocolytic medications.
Terbutaline
Nifedipine
Indomethacin
Magnesium sulfate
Describe the symptoms of Ovarian Hyperstimulation Syndrome.
Abdominal pain
Fluid collections like ascites or pulmonary edema
Ovarian enlargement
If a pregnant, severely preeclamptic woman develops nausea and vomiting, what must be suspected?
HELLP Syndrome
If a patient with hypoglycemia is treated with a glucose source, what should the follow-up meal or snack include to maintain glycemic control?
The maternal pulse will increase an average of ______ to ________ bpm during the length of the pregnancy.
10-20 bpm