Module 8
**What happens with an incomplete abortion if they are further than 14 weeks?
Given IV pitocin to stimulate contractions
What does Methotrexate do?
Folic acid antagonist
What are signs of Placenta Previa?
Painless
Bright red vaginal bleeding
What is therapeutic management of Preeclampsia?
Delivery is the only definitive treatment
If baby is less than 34 weeks attempt to delay birth for 48 hours and give betamethasone to help with surfactant
If mild home management
What is the treatment for Mag toxicity?
Calcium Gluconate
What would you give someone who has had habitual abortion if they are trying to get pregnant?
Progesterone
What are the education points with taking methotrexate?
No alcohol
No prenatal vitamins
No sexual intercourse until hCG levels are undetected
What are signs of Abruptio placentae?
Increase in fundal height
Hard, Boardlike abdomen
High uterine baseline tone
Persistent abdominal pain
Systemic sign of early hemorrhage
Persistent late decelerations
Vaginal bleeding
Why are you given magnesium sulfate?
To prevent seizures with moms who have preeclampsia
What is the glucose challenge test?
Done between 24-28 weeks
Do not need to fast
If glucose is greater than 140 then they go to OGTT test
What are the biggest risk factors for ectopic pregnancy?
Hx of STD
Hx of previous ectopics
Used of IUDS
Multiple induced abortion
Maternal age greater than 35
Vaginal douching
Cigarette smoking
Anatomic or functional defects in fallopian tubes
What is Gestational Trophoblastic disease?
When placenta develops but fetus doesn’t
What are the risk factors for Abruptio Placentae?
Hypertension
Smoking
Multigravida
Abdominal trauma
Hx of previous abruption
Maternal use of cocaine
Monitor with Magnesium sulfate?
CNS depression
Decreased urine output
Monitor BP
Deep tendon reflex
Respiratory status
What is the OGTT test?
Women ingest 100g of glucose
Blood drawn at 1,2, 3 hours
If two or more higher than she is diagnosed
What are symptoms of Ectopic pregnancy?
Missed period
Severe abdominal pain/pelvic pain
Rectal pressure
Vaginal spotting or light/heavy bleeding
What is the management of Gestational Trophoblastic disease?
Evacuation of molar pregnancy
Follow up for a 1 year
Avoiding pregnancy for 1 year
How is gestational hypertension classified?
Blood pressure elevation after 20 weeks of pregnancy
What is HELLP?
Typically caused by preeclampsia
What happens if the mother gets a rubella infection in the first trimester?
90% of babies will have congenital rubella syndrome
How to diagnose ectopic pregnancy?
Transvaginal ultrasound
HCG level would be high
What is a total Placenta previa?
Completely covers internal cervical
What are the signs of preeclampsia?
Hypertension at 20 weeks
Proteinuria
Edema - facial/extremity
Signs of HELLP?
Hemolysis
Elevated Liver Enzymes
Low Platelets
What is shoulder dystocia?
Shoulder impacted above the symphysis pubis