Podcast
Questions and Answers
When does postpartum preeclampsia typically occur?
When does postpartum preeclampsia typically occur?
What can ultrasound reveal early in pregnancy in some cases?
What can ultrasound reveal early in pregnancy in some cases?
What does HELLP Syndrome stand for?
What does HELLP Syndrome stand for?
What is a potential consequence of polyhydramnios during pregnancy?
What is a potential consequence of polyhydramnios during pregnancy?
Signup and view all the answers
What is a common sign of HELLP Syndrome?
What is a common sign of HELLP Syndrome?
Signup and view all the answers
What does accumulation of amniotic fluid suggest during pregnancy assessment?
What does accumulation of amniotic fluid suggest during pregnancy assessment?
Signup and view all the answers
What is the result of the fertilization of two separate ova by two separate spermatozoa?
What is the result of the fertilization of two separate ova by two separate spermatozoa?
Signup and view all the answers
What effect can oligohydramnios have on the fetus?
What effect can oligohydramnios have on the fetus?
Signup and view all the answers
In a multiple pregnancy with identical twins, how many umbilical cords are typically present?
In a multiple pregnancy with identical twins, how many umbilical cords are typically present?
Signup and view all the answers
In what scenario can intrauterine transfusion be performed?
In what scenario can intrauterine transfusion be performed?
Signup and view all the answers
What is a common laboratory finding in patients with HELLP Syndrome?
What is a common laboratory finding in patients with HELLP Syndrome?
Signup and view all the answers
Study Notes
Postpartum Care
- Postpartum preeclampsia can occur up to 10-14 days after birth, usually within 48 hours.
- HELLP Syndrome is a variation of the gestational hypertensive process characterized by:
- Hemolysis leading to anemia
- Elevated liver enzymes leading to epigastric pain
- Low platelets leading to abnormal bleeding/clotting
- Associated with Antiphospholipid Syndrome (APS) or the presence of antiphospholipid antibodies.
Signs and Symptoms
- Proteinuria, edema
- Increased blood pressure
- Nausea
- Epigastric pain
- General malaise
- Right upper quadrant tenderness from liver inflammation
Laboratory Studies
- Hemolysis of red blood cells
- Thrombocytopenia
- Elevated liver enzyme levels (ALT and AST)
Therapy
- Transfusion of fresh frozen plasma or platelets to improve platelet count
- Intravenous glucose infusion
- Epidural anesthesia
Multiple Pregnancy
- Identical (monozygotic) twins:
- One placenta, one chorion, two amnions, and two umbilical cords
- Always of the same sex
- Fraternal (dizygotic, nonidentical) twins:
- Two placentas, two chorions, two amnions, and two umbilical cords
- May be of the same or a different sex
Assessment
- Uterus increases in size at a rapid rate
- AFP levels are elevated
- Quickening feels like flurries of action in different portions of the abdomen
- Auscultation of the abdomen reveals multiple sets of fetal heart sounds
- Ultrasound can reveal multiple gestation sacs early in pregnancy
- Vanishing twin syndrome occurs in 30% of cases
Therapeutic Management
- Multiple pregnancy complications include gestational hypertension, polyhydramnios, placenta previa, preterm labor, and anemia
- Closer prenatal supervision is necessary
Polyhydramnios
- Occurs when there is excess fluid of more than 2,000 ml or an amniotic fluid index above 24 cm
- Causes fetal malpresentation and premature rupture of the membranes
- Leads to additional risks of infection, prolapsed cord, and preterm birth
Assessment
- Accumulation of amniotic fluid suggests difficulty with the fetus’s ability to swallow or absorb, or excessive urine production
- Rapid enlargement of the uterus
- Auscultating the FHR can be difficult due to the increased amount of fluid surrounding the fetus
- Notice extreme shortness of breath due to the overly distended uterus pushing up against her diaphragm
Therapeutic Management
- Admit to hospital for bed rest and further evaluation or care at home
- Report any sign of ruptured membranes or uterine contractions
- Encourage a high-fiber diet and suggest a stool softener to avoid constipation
- Monitor vital signs and lower extremity edema frequently
Oligohydramnios
- Pregnancy with less than the average amount of amniotic fluid
- Effects on the fetus include:
- Severe growth restriction
- Weak muscles at birth
- Lungs can fail to develop (hypoplastic lungs)
- Distorted features of the face occur (Potter syndrome)
Post-term Pregnancy
- Causes include faulty computation and high doses of salicylates
- Complications include meconium aspiration, macrosomia, calcium deposits, and isoimmunization (Rh incompatibility)
Intrauterine Transfusion
- Restores fetal red blood cells through blood transfusion in utero
Fetal Death
- According to the time of quickening, fetal death can occur before or after the time of quickening
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Learn about nursing interventions for postpartum preeclampsia and HELLP Syndrome, which may manifest within days after birth. Understand the key symptoms and associations with antiphospholipid antibodies.
