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Pregnancy at Risk: Pregestational conditions
Transcript of Pregnancy at Risk: Pregestational conditions
"A Woman's Right To Know Information Material" BOOKLET
Pregnancy At Risk: Pregestational Problems
Blocks the reuptake of dopamine
Most commonly abused illicit drug
No evidence of teratogenic effects on fetus
May cause withdrawal symptoms after delivery.
Increases dopamine in the brain
Tachycardia, vasoconstriction, hypertension
Spontaneous abortions, placental abruption
Premature birth, low birth weight
Cleft palate, abnormal brain development
Too little glucose is produced
Cells become glucose resistant
Screening and Treatment
Screening at 24-28 weeks gestation for average risk individuals
Test: 1-hour GTT (glucose tolerance test)
3 hour oral GTT
Positive diagnosis of GDM is made when two or more values are met or exceeded
Screening and Treatment
Good prenatal care
Evaluation of fetal status
AFP, NST, Ultrasounds
Human immunodeficiency virus
Transmitted through blood, blood products or other body fluids
Decreases the body’s immune response
What it is...
IV drug use
History of multiple sex partners
History of sexually transmitted infections
Evaluation and treatment for other conditions
Monitor disease progression and complications
High risk pregnancy requires close monitoring
Peak hemodynamic changes occur between 28-32 weeks
Treat diagnoses that are causing stress
Teach patient and family s/s of problems
Provide nutritional counseling with family present
Increase fiber intake
Routine labor assessments
Arterial blood gases
A Swan-Ganz catheter
Continuous blood pressure and pulse oximetry
Continuous fetal monitoring
Keep head and shoulders elevated/sidelying
Medications for pain relief
First 24-48 hours is the most unstable time
Lung and heart auscultation
Phases of Care
information was taken from...
"The First 9 Months" BOOKLET by Vivki L. Dihle, PA-C Bradley G. Beck, M.D.
The STD Project: A Positive Voice Website by Janelle Marie
Just the facts.......
1 in 6 women smoke during pregnancy.
Nearly 10% of women admit to drinking while pregnant.
More than 5% of women report use of illicit drugs during pregnancy.
Maternal Effects: Tachycardia
Fetal Effects: Prematurity,
behavioral problems, irritability
Opioid similar to cocaine
Poor nutrition, anemia, preeclampsia
Higher incidence of STDS
Low birth weight, small head circumference, prematurity
Restlessness, inconsolable crying, seizures
Methodone is used as therapy for opioid addiction
Opiates (Oxycontin, Demerol, codeine)
CNS depressants (Xanax, Valium)
Remember pregnancy categories
Decreased placenta perfusion
Early Pregnancy: increased levels of estrogen, progesterone, and other hormones stimulate increased insulin production
Second half of Pregnancy: Placental secretion of human placental lactogen and prolactin cause an increase resistance to insulin and decreased glucose tolerance
Maternal And Fetal Risks
Urinary tract infections
Intrapartum/ Postpartum Management
Decreased insulin needs during labor
Glucose checks every 2 hours
Decreased insulin needs after birth
IF IT'S WET AND NOT YOURS PLEASE USE PPE!!!!
Focused on minimizing stress on the heart
Approximately 1% of pregnant women of childbearing age have preexisting heart disease
Leading cause of non-obstetric maternal mortality
Rheumatic fever is the leading cause of cardiac complications
Other types include mitral valve disease and congenital causes
Many changes that put strain on the heart:
increased intravascular volume
decreased systemic vascular resistance
cardiac output changes during labor and birth
major intravascular changes after delivery
Cardiovascular Disease in Pregnancy
Classification by degree of disability
Care and Management
Offer support and teaching based on learning needs
personal/familial medical history
Medications presently taking
Laboratory and Diagnostic Testing
Vitamins and Iron
Lasix for congestive heart failure