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L&D6

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juniperk's version from 2017-11-18 21:47

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Question Answer
Most common cause of late spontaneous abortion?Incompetent cervix
Clinical manifestations of spontaneous abortions:Vaginal spotting or bleeding w/ possible clot passage. 2 cramping, backaches. 3. Falling Hcg
How can a SA be diagnosed?Ultrasound and 'just don't feel pregnant anymore'
Medical intervention for SARhogam for RH- moms w/in 72 h. D&C
Nursing interventions for SAAssess bleeding. Monitor for Shock/DIC 3. Freq VS 4. Instruct to save all clots and tissues passed 5. Emotional support
What is incompetent cervix?PAINLESS cervical effacement & dilation that is not assoc w/contractions. Happens in 2nd trimester.
What causes incompetent cervix?The cervix can't handle wt of gravid uterus
Medical intervention for incompetent cervixcerclage - removed at 34-36 weeks
Where does the invasive trophoblastic moles penetrate?uterine muscle wall
3 Common complications of molar pregnancysevere hyperemesis, severe preg induced HTN &/or preeclampsia, hyperthyroidism
Name 3 variations of placental implantation disorders and what are they.Placenta Accreta- most common- placental villi attach too deep into uterine wall but does not penetrate the uterine muscle. Placenta Increta- Placental villi attach into the uterine muscle. Percreta- Placental villi go through the uterine myometrium & serosa (may attach onto the abdominal wall or organs)
Whose at risk for placental implantation disorder?Prior C-section
Medical mgmt for Placental implantation disorderIf condition is discovered before delivery, C section can save the uterus w/ accreta. Hysterectomy will be req for both increta & percreta
What is placenta previa?Implantation of the placenta in the lower uterine segment, near or over the internal cervical os.
If placenta is covering complete, partial and marginal cervical os what can be done?c section only. Partial may move up uterine wall
What 7 things increase the risk for placenta previa?1. Expectant moms of multiples, 2. Diabetic, 3. previous previa, 4. short interval between pregnancies, 5. multip,6. Pt w/ uterine scarring, 7. smokers
Clinical manifestation for placenta previaPainless, bright vaginal bleeding. starts 27th-32nd week, Normal uterine resting tone is soft b/t contractions, shock symptoms
What does Kleihauer-Betke test for?est amount of fetal blood in mom's circulation
What are the 5 complications of placental previa?1. Placenta accreta. 2. Hemorrhage. 3. Uterine rupture. 4. Abnormal placental development & cord insertion. 5. Fetal malpresentation
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