Complications of Pregnancy: Bleeding During 1st Trimester

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Questions and Answers

What is the medical term for any interruption of a pregnancy before a fetus is viable?

Spontaneous miscarriage (correct)

Incomplete miscarriage

Imminent miscarriage

Complete miscarriage

What is the main caution given to women experiencing bleeding during pregnancy?

Seek immediate medical attention (correct)

Use tampons to halt bleeding

Consume herbal supplements

Avoid lifting heavy objects

What is the most common cause of a threatened spontaneous miscarriage?

Lack of prenatal care

Chromosomal abnormalities (correct)

Poor placental attachment

Uterine abnormalities

Which sign is associated with an ectopic pregnancy?

Bluish umbilicus Signup and view all the answers

What is the main difference between a complete and incomplete spontaneous miscarriage?

Incomplete expulsion of uterine contents Signup and view all the answers

Which condition is characterized by implantation of a zygote outside the uterus?

Ectopic pregnancy Signup and view all the answers

What is the most common cause of painless bleeding in the third trimester of pregnancy?

Placenta Previa Signup and view all the answers

What type of placenta previa occludes a portion of the cervical os?

Partial Placenta previa Signup and view all the answers

Which nursing intervention is recommended for patients with placenta previa?

Monitor VS and FHR Signup and view all the answers

What is a common complication associated with placenta previa?

Infections Signup and view all the answers

Which degree of Placenta Previa totally obstructs the cervical os?

Total Placenta previa Signup and view all the answers

What nursing diagnosis may be appropriate for a patient experiencing fear related to the outcome of pregnancy due to placenta previa bleeding?

Fear related to outcome of pregnancy secondary to episode of placenta previa bleeding Signup and view all the answers

Which type of placental separation is characterized by painless vaginal bleeding attached at the edge?

Marginal Signup and view all the answers

What is a common sign of abruptio placentae?

Sharp stabbing pain at the fundus Signup and view all the answers

What is the recommended immediate management for abruptio placentae?

Lateral position or side lying Signup and view all the answers

What factor increases the risk of preterm labor?

Substance abuse Signup and view all the answers

What is a possible sign of preterm labor?

Show (pink-stained vaginal discharge) Signup and view all the answers

When may preterm labor be halted?

If the cervix is less than 4cm dilated and the membranes are intact Signup and view all the answers

Study Notes

Bleeding during Pregnancy

1st Trimester Bleeding
- Types of spontaneous miscarriages:
  - Threatened spontaneous miscarriage (early: under 16 weeks; late: 16 to 20 weeks)
  - Imminent (inevitable) miscarriage
  - Missed miscarriage
  - Incomplete spontaneous miscarriage
  - Complete spontaneous miscarriage
- Causes: unknown, possibly chromosomal or uterine abnormalities
- Signs and symptoms: vaginal spotting, cramping, cervical dilation

Ectopic Pregnancy

Definition: implantation of zygote at a site other than in the uterus, associated with tubal constrictures
Signs and Symptoms:
- Sudden unilateral lower abdominal quadrant pain
- Minimal vaginal bleeding, possible signs of hypovolemic shock or hemorrhage
- Cullin's Sign: bluish umbilicus
Most common site: tubal

Abruptio Placentae

Definition: premature separation of the placenta
Types of Separation:
- Marginal: attached at the edge, painless vaginal bleeding
- Central: most frequent, sharp stabbing pain at the fundus
Signs and Symptoms:
- Concealed bleeding: uterus becomes rigid, loses its ability to contract
- Couvelaire uterus: hard, board-like, and copper in color
Predisposing Factors:
- Maternal hypertension
- Increased maternal age
Management:
- Lateral position or side lying
- Immediate CS
- Oxygen administration by mask
- Take FHT and VS

Preterm Labor

Definition: many possible etiologic factors, increased chance in multiple gestation, mental illness
Signs and Symptoms:
- Show (pink-stained vaginal discharge) accompanied by uterine contractions becoming regular and effective
Cautions:
- Preterm labor may be halted if the cervix is less than 4cm dilated and the membranes are intact
- Corticosteroids are administered to aid fetal lung maturity
Management:
- Surgical operations (cervical cerclage)
- No coitus

3rd Trimester Bleeding

Placenta Previa
- Definition: abnormal implantation of the placenta in the lower part of the uterus, most common cause of painless bleeding in the third trimester
- Four degrees of Placenta Previa:
  - Low-lying placenta
  - Marginal placenta
  - Partial placenta previa
  - Total placenta previa
- Causes:
  - Rapid succession of pregnancy
  - Advanced maternal age
- Signs and Symptoms:
  - Painless bright red vaginal bleeding due to tearing of placental attachment
- Nursing Management:
  - Avoid coitus
  - Adequate rest
  - Monitor VS and FHR
  - Prepare oxygen and blood
  - In case of vaginal bleeding, prepare a double set up
- Complications:
  - Infections
  - Hemorrhage
  - Prematurity
- Nursing Diagnosis:
  - Fear related to outcome of pregnancy secondary to episode of placenta previa bleeding

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Description

Learn about the different types and causes of bleeding during the first trimester of pregnancy, including threatened and inevitable miscarriages. Understand the assessment and management of these complications.