(精编)【高血压英文教学精品课件】 Complications in Pregnancy.pptVIP

Associated factors: Maternal hypertensive disorders (present in 50% of women with placental abruption) Advanced maternal age Advanced maternal parity Abdominal trauma Cocaine use Maternal smoking Chorioamnionitis Sudden uterine decompression (rupture of membranes in polyhdramnios or between deliveries of multiple gestations) External cephalic version Placental abruption in a previous pregnancy (10% recurrence rate) Signs Hallmark sign is painful vaginal bleeding Colicky abdominal/back pain Non-reassuring fetal heart rate tracing Intrauterine fetal death Uterine tenderness/uterine irritability Contractions Uterine enlargement Couvelaire uterus – in a major abruption blood extravasates into myometrium causing uterus to become “woody hard” and fetal parts will no longer be palpable” DIC Maternal shock Management Delivery (with preparations for massive postpartum hemorrhage) If mother symptomatic/deteriorating, urgent delivery irregardless of fetal maturity If fetus very immature and maternal and fetal vital signs are stable, tocolytics for uterine quiescence may be considered If fetus alive and viable urgent delivery by cesarean section unless vaginal delivery imminent (vaginal delivery preferred unless contraindications) Resuscitation/correction of hypovolemia Correction of coagulopathy * toComplications in PregnancyHugh E. Mighty, MD, FACOG, MBAAssociate Professor and Chair, Department of Obstetrics, Gynecology Reproductive Sciences Introduction Pregnancy is not in itself a disease. However many medical disorders, as well as surgical complications can occur during pregnancy, childbirth, and in the post delivery time. These events are generally unexpected in what is usually a young, healthy population. In the time allowed, this mini med school topic will be explored. The participants will gain an understanding of the multiple medical and surgical complications that surround pregnancy, and also learn about the basis for treatment, the likely outcomes and