ensure optimal health of mother and newborn Dietary regulation Glucose monitoring Medication management Oral hypoglycemics Insulin therapy Evaluation of fetal status (ultrasounds, NSTs)
Risks Polyhydraminos Increases risk for PTL and PROM Preeclampsia- Eclampsia Hyperglycemia Retinopathy Vaginitis and UTIs Congenital abnormalities LGA/macrosomia Shoulder dystocia IUGR Due to vascular changes Respiratory distress syndrome Inhibition of fetal enzymes necessary for surfactant production Maternal Fetal/Neonatal
Rh Alloimmunization: Causes Rh-negative woman carries an Rh-positive fetus Fetal red blood cells cross into maternal circulation Response: Production of Rh antibodies Transfer or RBCs usually occurs at birth The first child is not affected Subsequent pregnancy Rh antibodies enter the fetal circulation Result: Hemolysis of fetal red blood cells and fetal anemia
Rh Alloimmunization: Fetal and neonatal risks Anemia Hemolytic Syndrome Erythroblastosis fetalis Marked fetal edema, called hydrops fetalis Congestive heart failure Marked jaundice
Rh Alloimmunization: Prevention Screen for Rh incompatibility and sensitization History Identify Rh-negative woman Antibody screen (indirect Coomb’s test) Identifies if woman is sensitized Give injection of 300 mcg Rh Immune globulin (Rhogam)
Rh Alloimmunization: Prevention Give Rh Immune Globulin in following cases of Rh Negative women: With no antibody titer At 28 weeks’ gestational age After each abortion and within 72 hours postpartum Amniocentesis and placenta previa invasive procedures that may cause bleeding After trauma/vaginal bleeding
ABO incompatibility Cause: Mother has type O blood and infant has A, B, or AB Anti-A and anti-B antibodies occur naturally During pregnancy maternal antibodies cross placenta Cause hemolysis of the fetal red blood cells Unlike Rh incompatibility, first infant is often involved, no evidence of repeated sensitization, no antepartal treatment
ABO incompatibility Creates hyperbilirubinemia in the infant Hyperbilirubinemia is treated with phototherapy Assess for potential for ABO incompatibility - type O mother and type A or B father Following birth Newborn assessed carefully Assess for development of hyperbilirubinemia Unlike Rh incompatibility, it cannot be prevented
Trauma During Pregnancy Types of Trauma Blunt trauma Penetrating Injuries Gun shot wounds Causes Motor vehical accidents Falls Direct Assaults Impact Maternal Shock Premature Labor or spontaneous abortion
Impact of Trauma During Pregnancy Maternal Mortality: From head trauma or hemorrhage Uterine rupture is rare Placental abruption Traumatic separation of the placenta High rate of fetal mortality Premature birth Premature rupture of membranes
You've reached the end of your free preview.
Want to read all 67 pages?
- Winter '20
- Obstetrics, vaginal bleeding, premature rupture, Fetal Red Blood