High-Risk Pregnancy Considerations Flashcards

A client with a clotting disorder (thrombophilia) such as Factor V Leiden mutation is at elevated risk for which complication during pregnancy?

Answer: Deep vein thrombosis and pulmonary embolism

Thrombophilias like Factor V Leiden increase the risk of venous thromboembolism (DVT and pulmonary embolism) during pregnancy, a period already hypercoagulable.

When a high-risk prenatal client is on anticoagulant therapy (e.g., heparin), the massage therapist should modify treatment by:

Answer: Using gentle pressure and avoiding deep tissue or vigorous techniques that could cause bruising or hematoma

Anticoagulation increases bleeding and bruising risk, so deep tissue and vigorous techniques are avoided in favor of light-to-moderate pressure.

Maternal hypotension during a massage session is most commonly caused by:

Answer: Aortocaval compression when the client is supine in late pregnancy

In late pregnancy, the gravid uterus can compress the aorta and inferior vena cava when the client is supine, reducing venous return and causing supine hypotensive syndrome.

A client with a high-risk pregnancy due to advanced maternal age (AMA, 35+) has a higher incidence of:

Answer: Chromosomal abnormalities, gestational hypertension, and placenta previa

AMA pregnancies carry increased rates of chromosomal anomalies (e.g., Down syndrome), gestational hypertension, preeclampsia, and placenta previa compared to younger mothers.

What is the primary reason massage is avoided over the abdomen during a threatened miscarriage (vaginal bleeding before 20 weeks)?

Answer: Any direct abdominal stimulation risks increasing uterine tone and worsening pregnancy loss

During a threatened miscarriage, stimulating the uterus through abdominal massage may increase uterine contractility and contribute to pregnancy loss.

A client on bed rest due to preterm labor at 32 weeks receives physician clearance for gentle massage. The therapist should prioritize:

Answer: Gentle circulatory massage to reduce edema and DVT risk, avoiding contraction-stimulating techniques

Bed rest increases DVT risk, so gentle circulatory work is beneficial, while contraction-triggering techniques and deep pressure must be avoided to prevent preterm delivery.

Which of the following is the most appropriate documentation practice after treating a high-risk prenatal client?

Answer: Document presenting conditions, physician clearance status, modifications made, client response, and any symptoms reported

Comprehensive documentation for high-risk prenatal clients must include all risk factors, medical clearance, technique modifications, and any changes in client status to ensure continuity and legal protection.