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Samenvatting urgenties in de verloskunde
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Samenvatting van college urgenties in de verloskunde
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URGENTIES IN DE VERLOSKUNDE1 INHOUD
2 De fysiologische zwangerschap ....................................................................................................... 3
2.1 Anatomische aanpassingen in de zwangerschap .................................................................... 3
2.2 Maternale fysiologie in zwangerschap .................................................................................... 5
2.3 Diagnose zwangerschap .......................................................................................................... 7
3 Prenatale zorg ................................................................................................................................. 8
3.1.1 Eerste antenatale raadpleging ........................................................................................ 9
3.1.2 Contactmoment na 20 weken ....................................................................................... 10
4 Abdominaal onderzoek bij zwangeren .......................................................................................... 14
4.1 Palpatie van het abdomen: Handgrepen van leopold........................................................... 14
4.1.1 Eerste handgreep van Leopold ...................................................................................... 14
4.1.2 Tweede Handreep van Leopold..................................................................................... 15
4.1.3 Derde Handgreep van Leopold...................................................................................... 16
4.1.4 Vierde Handgreep van Leopold ..................................................................................... 17
4.2 Auscultatie foetale harttonen ............................................................................................... 18
5 Pathologische zwangerschap ........................................................................................................ 20
5.1 Vroege zwangerschap ........................................................................................................... 20
5.1.1 Bloedingen of pijn in de vroege zwangerschap ............................................................. 20
5.1.2 Miskraam ....................................................................................................................... 21
5.1.3 Buitenbaarmoederlijke – ectopische zwangerschap..................................................... 22
5.2 verder verloop van de zwangerschap ................................................................................... 24
5.2.1 Preëclampsie ................................................................................................................. 24
5.2.2 Bloeding in de tweede en derde trimesters .................................................................. 26
5.2.3 Antepartum en intrapartum bloedingen....................................................................... 26
5.2.4 Postpartum bloedingen ................................................................................................. 28
5.3 Zwangerschapsdiabetes ........................................................................................................ 30
6 Geboorte van het kind................................................................................................................... 32
6.1 Vroeggeboorte ...................................................................................................................... 32
6.2 Evaluatie van de pasgeborene .............................................................................................. 34
7 Casussen ........................................................................................................................................ 36
1
,2
,2 DE FYSIOLOGISCHE ZWANGERSCHAP
2.1 ANATOMISCHE AANPASSINGEN IN DE ZWANGERSCHAP
• Vrouwelijke inwendige genitalia + pelviene MRI
• Basis van embryologie: Op 6 weken na bevruchting van de eicel zal de blastocyst zich
innestelen in de baarmoeder. Op dit moment kan er wat bloedverlies optreden (deze lichte
bloeding is onschuldig) MAAR men dient er toch bedacht op te zijn dat op dit moment ook de
meeste miskramen gebeuren, hetgeen eveneens gepaard gaat met bloedverlies.
• Ontwikkeling van de embryo wordt ingedeeld in de CARNEGIE STAGES:
3
, • Orgaan ontwikkeling van embryo: Vanaf week 9 na de bevruchting zal er voornamelijk een
verdere groei van het embryo plaatvinden.
• Bekken: anatomie
4
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