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ProfuseOrphism

Uploaded by ProfuseOrphism

Mansoura National University

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high risk pregnancy obstetrics prenatal care

Summary

This document discusses various high-risk pregnancy conditions, including bleeding in early and late pregnancy, placenta previa, abruptio placenta, hypertension, gestational diabetes, hyperemesis gravidarum, anemia, chorioamnionitis, polyhydramnios, oligohydramnios, fetal growth restriction, and intrauterine fetal death. The information provides a summary of the different factors that can contribute to a high-risk pregnancy.

Full Transcript

High risk pregnancy Bleeding In Early Pregnancy It is bleeding from the genital tract during the 1st 20 weeks of gestation it is due to either to abortion, ectopic pregnancy and vesicular mole 1-Abortion It is loss of pregnancy before fetal viability (20-24 weeks)or fetal weight below 500 grams...

High risk pregnancy Bleeding In Early Pregnancy It is bleeding from the genital tract during the 1st 20 weeks of gestation it is due to either to abortion, ectopic pregnancy and vesicular mole 1-Abortion It is loss of pregnancy before fetal viability (20-24 weeks)or fetal weight below 500 grams 2-Ectopic pregnancy Ectopic pregnancy is defined as pregnancy occurring outside the normal uterine cavity It is an abnormal implantation of the fertilized ovum. It can be intrauterine, or extra uterine 3-Hydatidiform mole (Vesicular mole) Hydatidiform mole is a gross malformation of the trophoblast in which the chorionic villi proliferate and become avascular. The villi are filled with fluid forming vesicles, which look like a bunch of grapes. It is an abnormal development of the chorionic villi of conceptus. Bleeding in the late pregnancy It is bleeding from the genital tract after 20 weeks of gestation (Placenta previae - abruptio placenta) Placenta previae This is a condition in which the placenta is implanted over the lower uterine segment Types of placenta previae Placenta previa lateralis: The lower part of the placenta is implanted over the lower uterine segment, but does not reach the internal os Placenta previa marginalis: Part of the placenta is implanted over the lower uterine segment and its margin reaches the internal os, but does not cover it completely Incomplete central placenta previae The placenta covers the closed or incompletely dilated internal os , but with further dilatation. The placenta does not cover it completely when it is closed, but covers it incompletely when the os is dilated Complete central placenta previa: The whole placenta is implanted over the lower uterine segment, with the internal os located at the center of the placenta. Thus, the placenta covers the internal os completely even when it is fully dilated. Abruptio placenta ( accidental hemorrage) It is bleeding during the last three months of pregnancy, the first or second stage of labor, due to premature separation of a normally situated placenta Types Revealed: almost all the blood expelled through the cervix. Concealed: almost all the blood is retained inside the uterus. Combined: some blood is retained inside the uterus andsome is expelled through the cervix Hypertension during pregnancy Gestational hypertension : development of hypertension after 20 weeks of gestation in awoman with previous normal blood pressure Preeclampsia: development of hypertension , proteinuria and edema after 20 weeks of gestation Eclampsia: development of seizure or coma in woman with preeclampsia who has no history of preexisting causes Chronic hypertension disorder: hypertension that present before pregnancy premature rupture of membranes (PROM): Rupture of the membranes before the onset of labor at any stage Preterm premature rupture of membranes (PPROM): Rupture of membranes before (37 weeks) and in the absence of labor. Gestational diabetes Definition: carbohydrate intolerance that develop during pregnancy in the second or third trimester classification of diabetes in pregnancy gestational diabetes Pregesational diabetes Hyperemesis gravidarum Vomiting during pregnancy that is so severe it leads to dehydration, electrolyte and acid–base imbalance, and starvation ketosis Awoman experiencing hyperemesis need of hospitalization to manage profound and prolonged nausea and vomiting Anemia during pregnancy Anemia means the amount of functioning hemoglobin is reduced below normal. In female the Hb is 12-16g/100ml Anemia is diagnosed if Hb is below 12 mg/dl and in the pregnant women anemia is diagnosed if Hb is below 11 mg/ dl (physiological anemia) Chorioamnionitis Definition: It is a bacterial infection of amniotic fluid and fetal membranes. It typically complicates premature rupture of membranes and results from bacterial ascending into the uterus from the vagina Polyhydramnios :is defined as a state where liquor amnii exceeds 2000 cc Oligohydramnios: It is the opposite of polyhydramnios where liquor amnii below 500 cc. ( The normal range of liquor amini 800-1000 cc) Fetal growth restriction(FGR), also called intrauterine growth restriction( IUGR )or small for gestational age (SGA): is a fetal weight that is below the 10th percentile for gestational age as determined by ultrasoud. intra uterine fetal death : is typically defined as fetal death at or after 20 or 24weeks of pregnancy, It results in a baby born without signs of life.

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