Nursing 209

N209: Reproductive Health Study Guide learning complications o Tend to seek prenatal care later in pregnancy • Gestational diabetes o Affects 9.2% of all pregnancies according to the CDC o Cause is unknown; may be hormone related o Testing is done at first prenatal visit with one hour GTT if preexisting risk factors are present (history of GDM with previous pregnancy, BMI over 30, first degree relative, glycosuria); average risk done at 24-28 weeks gestation; 1 hour GTT: 50 gm load with BS <130 (if 130 or greater, will do three hr GTT) o Treatment depends upon severity of condition, usually is diet and exercise with blood glucose monitoring  Preprandial: 95 mg/dl or less  1 hour postprandial: 140 mg/dl or less  2 hour postprandial: 120 mg/dl or less o Multiple fetal andmaternal risks related tomacrosomia and circulatory changes (RDS, fetal death, jaundice, and hypoglycemia after birth) • Gestational trophoblastic disease (GTD) o Group of rare tumors than involve abnormal growth of cells outside of the uterus (begin in the cells that would normally become the placenta) o Most are benign but some can be malignant o All forms can be treated o Hydatiform mole: Molar pregnancy  In rare cases a normal fetus can develop, but in most cases, it is impossible for a fetus to form  Can be complete or partial o Invasive mole: Hydatiform mole that grows into the uterine muscle o Choriocarcinoma: Malignant form of GTD  Half start as molar pregnancies  One quarter develop in those who have had a spontaneous abortion, elective abortion, or ectopic pregnancy  Can develop after normal pregnancy and delivery o Placental-site trophoblastic tumor: A rare form of GTD that develops where the placenta attaches to the uterus  Develops after normal pregnancy or abortion, or after removal of hydatiform mole  Treated with surgery (most other GTDs respond to chemo drugs) o Epitheliod trophoblastic tumor: Rare form, hard to diagnose  Can often be confused with cervical cancer  Main treatment is surgery

©2018

Achieve

Page 31

of 109