High Risk Pregnancy in Physical Therapy
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Questions and Answers

What is characterized by hypertension and proteinuria, with or without edema, occurring mostly in the second half of pregnancy?

  • Chronic hypertension
  • Eclampsia
  • Gestational hypertension
  • Preeclampsia (correct)

    • What is diagnosed when the blood pressure is greater than 140/90 mmHg and there is more than 0.3 gm/Liter of protein in urine?

  • Severe preeclampsia
  • Mild preeclampsia (correct)
  • Gestational hypertension
  • Chronic hypertension

    • What occurs when a woman experiences seizures, convulsions, or fits during pregnancy?

  • Gestational hypertension
  • Preeclampsia
  • Chronic hypertension
  • Eclampsia (correct)

    • What type of hypertension is present prior to pregnancy or is diagnosed before the 20th week gestation?

    <p>Chronic hypertension</p> Signup and view all the answers

    What is diagnosed when the diastolic blood pressure exceeds 110 mmHg and protein excretion is greater than 3gm/day?

    <p>Severe preeclampsia</p> Signup and view all the answers

    What is hypertension that occurs for the first time during pregnancy, usually in the second half?

    <p>Gestational hypertension</p> Signup and view all the answers

    What is characterized by hypertension and proteinuria, with or without edema, occurring mostly in the second half of pregnancy?

    <p>Preeclampsia</p> Signup and view all the answers

    What is a form of hypertension that is unique to pregnancy?

    <p>Preeclampsia</p> Signup and view all the answers

    What is the primary objective of monitoring vital signs for 24 hours in a patient with preeclampsia?

    <p>To prevent the progression of mild to severe preeclampsia</p> Signup and view all the answers

    What is the primary benefit of performing passive ROM exercises in a patient with preeclampsia?

    <p>To reduce uterine irritability</p> Signup and view all the answers

    What is the primary indication for supplementation of vitamin C and E in a patient with preeclampsia?

    <p>To improve maternal nutrition</p> Signup and view all the answers

    What is the primary reason for restricting salt intake in a patient with preeclampsia?

    <p>To reduce blood pressure</p> Signup and view all the answers

    What is the primary diagnostic criterion for gestational diabetes?

    <p>Hyperglycemia</p> Signup and view all the answers

    What is the primary indication for stopping exercises in a patient with preeclampsia?

    <p>Any one or more of the warning signs</p> Signup and view all the answers

    What is the primary benefit of diaphragmatic breathing exercises in a patient with preeclampsia?

    <p>To reduce anxiety and stress</p> Signup and view all the answers

    What is the primary classification of diabetes that occurs for the first time during pregnancy?

    <p>Gestational Diabetes</p> Signup and view all the answers

    What is the normal range for post prandial blood glucose?

    <p>&gt; 200 mg/dl</p> Signup and view all the answers

    Which of the following is a consequence of maternal diabetes on the fetus?

    <p>Neonatal morbidities</p> Signup and view all the answers

    What is the primary mechanism by which exercise decreases blood glucose levels?

    <p>Increased muscle glucose uptake</p> Signup and view all the answers

    What is a critical consideration for women who are new to exercise and are pregnant with diabetes?

    <p>Pregnancy is not the time to initiate a new exercise program</p> Signup and view all the answers

    What is a recommended type of exercise for women with diabetes during pregnancy?

    <p>Moderate exercise in the form of walking</p> Signup and view all the answers

    What is a key precaution to take when exercising with diabetes during pregnancy?

    <p>Measuring blood glucose levels before and after exercise</p> Signup and view all the answers

    What is a potential consequence of maternal diabetes on the mother?

    <p>Increased risk of post-partum hemorrhage</p> Signup and view all the answers

    What is a benefit of combining exercise with insulin therapy for women with diabetes during pregnancy?

    <p>Greater reduction in blood glucose levels</p> Signup and view all the answers

    What is a contraindication for exercise in pregnant women with diabetes?

    <p>Proliferative retinopathy</p> Signup and view all the answers

    What is the recommended dietary change for pregnant women with diabetes?

    <p>Decrease fat and carbohydrate intake to 40% to 50%</p> Signup and view all the answers

    What is the safest treatment for diabetes in pregnancy?

    <p>Insulin</p> Signup and view all the answers

    What is the recommended mode of delivery for pregnant women with diabetes?

    <p>Elective C-section</p> Signup and view all the answers

    What is a category of heart disease in pregnancy?

    <p>Rheumatic heart disease</p> Signup and view all the answers

    Why is a low-sodium diet recommended for cardiac patients during pregnancy?

    <p>To prevent excessive weight gain and edema</p> Signup and view all the answers

    What is encouraged during labor to minimize the increase in cardiac output?

    <p>Sedation and epidural anesthesia</p> Signup and view all the answers

    Why is oxygen therapy recommended during labor for cardiac patients?

    <p>To reduce the risk of supine hypotension</p> Signup and view all the answers

    What is the most common obstructive pulmonary disease of pregnancy?

    <p>Asthma</p> Signup and view all the answers

    What is a common characteristic of allergic or extrinsic asthma?

    <p>It is triggered by allergens</p> Signup and view all the answers

    When is exacerbation of asthma likely to occur during pregnancy?

    <p>At the end of the 2nd trimester</p> Signup and view all the answers

    What is a post-partum complication associated with asthma?

    <p>Prematurity</p> Signup and view all the answers

    Why is drug therapy not typically needed for most asthmatics during pregnancy?

    <p>Because most medications cross the uteroplacental barrier</p> Signup and view all the answers

    What is a recommended way to prevent exercise-induced asthma?

    <p>Exercising in a moist, humid environment</p> Signup and view all the answers

    What is a clinical manifestation of asthma?

    <p>Cough</p> Signup and view all the answers

    What is a trigger for asthma exacerbation?

    <p>Infections such as bronchitis and influenza</p> Signup and view all the answers

    Study Notes

    High-Risk Pregnancy

    • High-risk pregnancy includes hypertension, diabetes, cardiac disease, and asthma.

    Hypertension in Pregnancy

    • Classification of hypertensive disorders:
    • Gestational hypertension: hypertension without proteinuria, occurring for the first time during pregnancy, usually in the second half.
    • Preeclampsia: hypertension and proteinuria, with or without edema, occurring mostly in the second half of pregnancy.
    • Eclampsia: seizures, convulsions, or fits in addition to preeclampsia.
    • Chronic hypertension: hypertension that is present prior to pregnancy or is diagnosed before the 20th week of gestation.

    Preeclampsia

    • Diagnosis:
    • Mild preeclampsia: blood pressure > 140/90 mmHg and protein in urine > 0.3 gm/Liter.
    • Severe preeclampsia: diastolic blood pressure > 110 mmHg and protein excretion > 3gm/day.

    Diagnosis and Management of Preeclampsia

    • Signs:
    • Diaphratic breathing exercise: inhale slowly through the nose, raise the abdomen, and exhale slowly through the mouth.
    • C. Exercises: upper and lower limb exercises (passive ROM) to avoid increasing intrabdominal pressure and uterine irritability.
    • Vital signs should be monitored for 24 hours to avoid changing the case from mild to severe preeclampsia.
    • Warning signs: headache, chest pain, dyspnea, vaginal bleeding, decreased fetal movement, and leakage of amniotic fluid.

    Nutritional Management of Preeclampsia

    • Salt restriction
    • Supplementation of vitamin C & E
    • Supplementation of calcium
    • Supplementation of magnesium
    • Omega 3

    Diabetes and Pregnancy

    • Definition: Rise in blood glucose level, usually detected at 24-28 weeks of gestation.
    • Classification:
    • Gestational diabetes
    • Type I Diabetes
    • Type II Diabetes
    • Diagnosis: characterized by hyperglycemia (fasting blood glucose > 120 mg/dl, postprandial blood glucose > 200 mg/dl)
    • Pathophysiology: placental levels increase during the late 2nd and 3rd trimesters of pregnancy.

    Impact of Maternal Diabetes on Fetus and Mother

    • Fetus: spontaneous abortion, congenital anomalies, macrosomia, neonatal morbidities, and intrauterine fetal death
    • Mother: post-partum hemorrhage, C.S., infections, and persistence of diabetes type II later in life

    Physical Therapy Management of Diabetes

    • Exercises:
    • Moderate exercise (walking on a treadmill for 30 minutes, 3 times a week) to decrease blood glucose levels
    • Precautions: measure blood glucose levels before and after exercise, and monitor fetal movement and uterine contraction after exercise
    • Contraindications for Exercise:
    • Myocardial ischemia or arrhythmias
    • Proliferative retinopathy
    • Twins and multiple births
    • Severe emotional stress
    • Hydramnios and macrosomia

    Medical Treatment of Diabetes

    • If diet and exercise fail to maintain blood glucose levels within normal limits, medical treatment is necessary
    • Insulin is the safest treatment

    Cardiac Disease in Pregnancy

    • Heart disease in pregnancy can be divided into two categories:
    • Rheumatic heart disease
    • Congenital heart disease
    • Guidelines during the prenatal period:
    • Avoid excessive weight gain and edema
    • Encourage rest
    • Avoid strenuous activity
    • Avoid anemia
    • Management of labor:
    • Minimize the increase in cardiac output
    • Sedation and epidural anesthesia are encouraged early in labor
    • Monitor cardiovascular status during delivery

    Asthma and Pregnancy

    • Definition: shortness of breath, characterized by increased response of the tracheobronchial tree to various stimuli
    • Clinical manifestations:
    • Cough
    • Dyspnea
    • Wheezing
    • Etiology:
    • Allergens
    • Exercise (especially in cold, dry atmosphere)
    • Infections (respiratory tract)
    • Occupational stress
    • Environmental stress
    • Emotional stress
    • Pharmacological stress

    Types of Asthma

    • Allergic (extrinsic) asthma: begins in childhood, triggered by allergens
    • Non-allergic (intrinsic) asthma: begins after the age of 35, more severe in nature

    Effect of Pregnancy on Asthma

    • Course of asthma during pregnancy is variable: may improve, stabilize, or worsen
    • Women with severe asthma tend to have exacerbation with pregnancy, while those with mild asthma improve

    Effect of Asthma on Pregnancy

    • Toxemia
    • Post-partum complications (prematurity, low birth weight, spontaneous abortion)

    Obstetric Management of Asthma

    • No drug therapy is needed for most asthmatics
    • Women should have plenty of fresh air, avoid people with infections, and avoid smoking
    • Adequate bed rest, treatment of respiratory infections, and minimizing stress or anxiety are recommended.

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    High Risk Pregnancy PDF

    Description

    This lecture covers classification, definition, and physical therapy management of high-risk pregnancy, hypertension, and diabetes during pregnancy. Learn about precautions and management techniques.

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