Bleeding
This late-pregnancy complication presents with painless bright red bleeding and a soft, non-tender uterus
Placenta previa
This medication is given IV to prevent seizures in severe preeclampsia
Magnesium sulfate
Define tocolytic therapy
Use of medications to suppress uterine contractions
This is the first-line pharmacologic treatment for gestational diabetes if diet control fails
Insulin
Define polyhydramnios
Excessive amniotic fluid (>2000 mL)
For a patient with placenta previa, name two nursing actions you would take before ultrasound confirmation of placental location
Avoid vaginal exams and monitor fetal heart rate
State the therapeutic serum magnesium range when administering magnesium sulfate
4–7 mEq/L
What fetal benefit is the primary reason for administering betamethasone in preterm labor?
Accelerates fetal lung maturity
Name the placental hormone primarily responsible for insulin resistance in pregnancy
Human placental lactogen (hPL)
Name one maternal and one fetal risk associated with polyhydramnios
Maternal – postpartum hemorrhage; Fetal – cord prolapse
What type of placental complication involves premature separation from the uterine wall and presents with painful bleeding and a rigid uterus?
Placental abruption
A BP of 164/110 mmHg with +3 proteinuria indicates what severity of preeclampsia?
Severe preeclampsia
Which emergency is indicated by the “turtle sign” during delivery, and what is the first nursing action?
Shoulder dystocia; call for help immediately
Name two fetal complications associated with poorly controlled maternal diabetes
Macrosomia and neonatal hypoglycemia
Which cervical condition is treated with cerclage placement, and in which trimester is it usually done?
Cervical insufficiency; typically in the second trimester
A patient with a hydatidiform mole requires follow-up for 12 months. What specific lab is monitored to detect malignant changes?
Serial serum hCG levels
Name two clinical signs that would indicate magnesium sulfate toxicity
Absent deep tendon reflexes and respiratory rate <12/min
In a prolapsed umbilical cord, which maternal position reduces cord compression?
Knee–chest position or Trendelenburg
At what gestational age is routine GDM screening performed?
24–28 weeks
Name two postpartum hemorrhage risks associated with precipitous labor
Uterine atony and genital tract lacerations
Name one major maternal complication and one major fetal complication of abruptio placentae
Maternal – DIC or hemorrhagic shock; Fetal – stillbirth or hypoxia
Explain the pathophysiology of preeclampsia in one sentence
Widespread vasospasm reduces organ perfusion, causing endothelial damage, leaky vessels, and end-organ dysfunction
List three immediate nursing actions for shoulder dystocia (HELPER mnemonic)
McRoberts maneuver, suprapubic pressure, and calling for additional help
Explain why insulin needs typically increase during the second half of pregnancy
Placental hormones like hPL increase insulin resistance to prioritize glucose for the fetus
A patient with placenta accreta may require which major surgical intervention at delivery, and why?
Cesarean hysterectomy to control life-threatening hemorrhage from abnormal placental adherence