Pregnancy in the acute care setting part i
Download
1 / 15

Pregnancy In the Acute Care Setting Part I - PowerPoint PPT Presentation


  • 135 Views
  • Uploaded on

Pregnancy In the Acute Care Setting Part I. Women’s Health Overview Implications for Physical Therapy Jane Frahm , PT, BCIA PFMD Rehab Institute of Michigan/WSU. SYSTEMIC CHANGES THAT OCCUR DURING PREGNANCY. EXCRETORY/RENAL SYSTEM.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Pregnancy In the Acute Care Setting Part I' - angelo


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Pregnancy in the acute care setting part i
Pregnancy In the Acute Care SettingPart I

Women’s Health Overview

Implications for Physical Therapy

Jane Frahm, PT, BCIA PFMD

Rehab Institute of Michigan/WSU



Excretory renal system
EXCRETORY/RENAL SYSTEM

  • Kidneys, Bladder, ureters, increase functional capacity

  • Increased urination (polyuria) common in 80-95%

  • Kidney expands 2º dilatation. of renal pelvis &  interstitial fluid

    • Glomerular Filtration Rate  50%


Excretory renal changes
Excretory/Renal Changes

COMMON URINARY DYSFUNCTIONS

  • Ureter Obstruction or Bladder Compression can occur with uterine growth

  • Urge Incontinence

  • Retention

  • Pyelonephritis or Kidney Infection


Cardiovascular changes
CARDIOVASCULAR CHANGES

  • Blood volume  40%

  • Cardiac Output  30-50%, Peak 28-32 wks

  • Arterial BP 

    • Most women see a drop in blood pressure during pregnancy. This is mainly due to a hormone called progesterone

  • Inferior Vena Cava 3-11% affected


Respiratory system
RESPIRATORY SYSTEM

  • Dyspnea (SOB) Common 60-70%

  • RR Unchanged, 02 consumption  14-20%

  • Tidal Vol. by 200 ml

  • Br/min  26%, (State of hyperventilation) secondary to  progesterone levels


Metabolic endocrine system
METABOLIC/ENDOCRINE SYSTEM

  • Estrogen

  • Progesterone

  • Human Placental Lactogen (HPG)

  • Human chorionic gonadotropin (HCG)

  • Relaxin: Produced in Corpus Luteum

    • Peaks early and late in pregnancy . Also in non pg., after ovulation & thru the menstrual cycle

    • Softens connective tissue!


Gi system
GI SYSTEM

  • Nausea and Vomiting

    • Mild to severe 50 – 60% Usually abates by wk 14-16

  •  Intestinal & gallbladder motility


Musculoskeletal system
MUSCULOSKELETAL SYSTEM

  • Postural Compensations

  • Compression Syndromes

  • Abdominal Wall/DiastasisRecti

  • Pelvic Girdle - Symphysis Pubis Symphysitis, Ligamentous laxity, or Separation

  • LBP

  • S-I Dysfunction


Typical postural changes
TYPICAL POSTURAL CHANGES

  • Forward head, Rounded shoulders, hyper- lordosis, Hyperextended knees, Pronated feet

  • COG shift 

  • Muscle shortening or elongation (promotes stretch weakness or adaptiveshortening)


NINE MONTH GESTATION

Both demonstrate increased lordosis

Black leotard-forward head

  • SHORTENED: Hip flexors, low back, pectorals

  • ELONGATED: Neck and upper back, abdominals

  • EXTRA WEIGHT on pelvic floor


High risk pregnancy
HIGH RISK PREGNANCY

25% of the OB Population has less than optimal outcome for mother or child


High risk pregnancy1
HIGH RISK PREGNANCY

  • PTL--Pre Term Labor

  • PPROM--Premature, Preterm Rupture of Membranes

  • IUGR--Intra Uterine Growth Retardation

  • GDM--Gestational Diabetes Mellitus

  • PIH-- Pregnancy Induced Hypertension

  • Placenta Previa, AbruptioPlacenta

  • Incompetent Cervix

  • Pre-eclampsia, Eclampsia, DIC - disseminating intravascular coagulation

  • Multiple Gestation


High risk pregnancy2
High Risk Pregnancy

  • Preeclampsia?Preeclampsia is a condition that typically starts after the 20th week of pregnancy and is related to increased blood pressure and protein in the mother's urine (as a result of kidney problems). Preeclampsia affects the placenta, and it can affect the mother's kidney, liver, and brain.

  • Eclampsia

    When preeclampsia causes seizures, the condition is known as eclampsia--the second leading cause of maternal death in the U.S. Preeclampsia is also a leading cause of fetal complications, which include low birth weight, premature birth, and stillbirth. There is no proven way to prevent preeclampsia. Most women who develop signs of preeclampsia, however, are closely monitored to lessen or avoid related problems. The only way to "cure" preeclampsia is to deliver the baby.


Pre existing conditions high risk status
PRE-EXISTING CONDITIONS – HIGH RISK STATUS

  • Diabetes

  • Cardiac Anomalies

  • Pulmonary Anomalies

  • Systemic Infection, Fever

  • HTN

  • Neoplasm

  • Chronic disability - neurological, spinal cord injury


ad