Sig maternal weight loss associated w fetal intrauterine growth restriction

Sig maternal weight loss associated w fetal

This preview shows page 6 - 8 out of 53 pages.

Sig maternal weight loss associated w fetal intrauterine growth restriction (IUGR) o Management Hx of N&V in previous preg advised to take MVI before next conception Rest encouraged Avoid foods & sensory stimuli that provoke symptoms Eat small frequent meals of dry, bland foods, include high protein snacks Avoid spicy foods, eating crackers before arising in morning may be benefit, ginger capsules effective Hospitalization IV fluid w dextrose & vit given, pt placed on NPO, tx w antiemetics Parental or enteral feedings ordered if pt unable to take oral nourishment & if normal weight gain parameters not being achieved HEMORRHAGIC DISORDERS - Leading cause of maternal death in US - 3 rd trimester vaginal bleeding occurs in 3-4% of all preg & may be obstetric or nonobstetric in nature - ex of nonobstetric: severe cervicitis, benign and malignant neoplasms, lacerations, varices OBSTETRIC CAUSES OF VAGINAL BLEEDING - Placenta Previa o Is implantation of placenta in lower uterine segment, near or over internal cervical os o Accounts for 20% of all antepartal hemorrhages o 3 recognized variations complete (total) placenta previa placenta covers entire cervical os associated w greatest amnt of blood loss, so most serious risk Partial placenta previa placenta that partially occludes cervical os Marginal placenta previa encroachment of the placenta to the margin of the cervical os, & a low lying placenta is one that is implanted in lower uterine segment in close proximity to internal cervical os o Placenta accrete, placenta percreta, and placenta increta are placentas w abnormally firm attachments to the uterine wall o Unusual placental adherence may accompany placental previa o PP may be associated w conditions that cause scarring of uterus (prior c/s births or previous abortions w curettage) o PP may also occur w large placental mass (seen in multiple gestations, diabetes, erythroblastosis fetalis) o Other RF = smoking, cocaine use, hx placenta previa, closely spaced preg, AA, mom age >40 o Signs and Symptoms
Image of page 6
Common – painless vag bleed r/t small disruptions in placental attachment during normal development & subsequent stretching & thinning of lower uterine segment during 3 rd trimester Initial bleed small amnt & stops as uterus contracts – but, bleeding can reoccur at any time may be associated w profuse hemorrhage & shock that sig morbidity & mortality Blood bright red & Painful bleed may occur if placenta abrupts away from uterine tissue o Maternal and Fetal Morbidity and Mortality Preme delivery responsible for 60% of perinatal detahs associated w placenta previa Fetal risks = preterm premature rupture of membranes, IUGR, malpresentation, congenital anomalies, vasa previa Vasa pervia umbilical cord implanted into membranes rather than placenta Vessels traverse within membranes & cross cervical os before reaching placenta Umbilical bv are at risk for laceration Appearance of bright red blood @ time of rupture of membranes
Image of page 7
Image of page 8

You've reached the end of your free preview.

Want to read all 53 pages?

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture