Transcript PP Pregnancy

From last time
Bag of water at term between 800 to 1200 cc of fluid
Amnion = inner layer secretes fluid
Chorion = outer layer
Functions of amniotic fluid:
cushions fetus from injury
Separates fetus from membranes
Allows freedom of movement; thus allows musculosketetal develop
Maintains constant fetal body temperature
Provides oral fluids - acts as excretion collection system
Remember the first 12 weeks of PG are critical – Organogenisis - Many women
don”t even kn ow they are pregnant EDUCATION IS VITAL
From last time:
Placenta functions as
Organ of excretion;
Respiration;
Elimination
Digestion
Endocrine
Does act as barrier to
large molecules &
blood cells
Organ shared by mom
& baby
When talking about teratogens - Cannot forget about medications –
Prescribed & over the counter
Rational use of any medication requires a risk vs. benefit assessment.
The FDA has established 5 categories to indicate the potential of a systemically
absorbed drug for causing birth defects. The key differentiation among the
categories rests upon the degree (reliability ) of documentation & the risk: benefit
Risk. Pregnancy Category X is particularly notable in that if any data exist that may
implicate a drug as a teratogen; therefore these drugs are contraindicated in PG
Class A: adequate studies have not demonstrated a risk to fetus in first trimester
Cass B: animal studies have not demonstrated a risk to fetus BUT are no adequate
studies in PG humans
Class C: animal studies have shown an adverse effect on fetus, But no adequate
studies in PG humans
Class D: is evidence of human fetal risk, BUT potential benefits form the use of the
drug in PG women maybe acceptable despite the risks
Class X: risk outweighs benefit
REGARDLESS OF PRESUMED SAFETY, NO DRUGS SHOULD BE ADMINISTERED DURING PG
UNLESS IT CLEARLY IS NEEDED & POTENTIAL BENEFITS OUTWEIGH POTENTIAL RISKS
When add to other criteria; perfect score for biophysical = 12
Does amniotic
Fluid give us
EDD?
Why & when
Do you preform
Amniocentesis?
Fetal
assessment
Cholsma
PUPPP’s - Pruritic Uriticarial Papules and Plaques of Pregnancy
unkown cause, occurs 3rd trimester, intense itching,
initially 1-2mm papules on abdomen, coalesce into larger plaques,
spreads to breasts, back and extremities,
Treated with topical steroids, antihistamines
See next slide
Decrease in IGG
Increase in WBC
Also increase stress in PG may have
something to do with increase
glucocorticosteriods to decrease
immune system so don’t attack fetus
Vaginal exam
Diagonal conjugate = measurement with finger between sacral
Promontory & lower border of symphasis pubis
Obstetrical conjugate or TRUE conjugate = cannot be measured
Directly. Is shortest diameter (anterposterior) between sacral
Promontory & symphasis pubis
Father’s
RH factor
given
delivery
Days after
implantatio
le
7 days
da
What are possible
Complaints, why &
What can we suggest?
Pelvic exercises
More reasons for
Some common
problems
thrombophelbitis
What does the woman experience ? What can we teach ?
Checking for clonus
Checking for
Deep tendon
reflex
Sea bands
Edema
Full term
pregnancy