Maternal Health Complications Quiz

Infection and Abortion

• Infection may occur from using unsterile materials during an abortion procedure
• Immediate attention is required to prevent patient death

Fertilization and Implantation

• Fertilization occurs in the distal third of the fallopian tube after the union of the ovum and spermatozoa
• The fertilized egg then moves down to the uterine cavity and implants on the uterine walls
• Miscarriage is defined as a spontaneous abortion of less than 12 weeks gestation

Maternal Health During Pregnancy

• The uterine walls develop into the decidua, allowing safe implantation of the embryo
• The cervix does not have this endometrial lining, causing early abortion of ectopic pregnancies located in the cervical region

Ectopic Pregnancy

• Ectopic pregnancy occurs when implantation occurs outside the uterine cavity
• Tubal pregnancies occur most in the ampullar area
• Rupture can cause severe peritoneal bleeding and signs of shock
• Ultrasound and Magnetic Resonance Imaging are effective in detecting ectopic pregnancies

Signs and Symptoms

• Severe abdominal pain
• Sharp Amenorrhea
• Vaginal bleeding
• Hypertrophy from hormones
• Nausea and vomiting
• Rapid pulse, lightheadedness, sweating, paleness (signs of shock)

Therapeutic Management

• Some ectopic pregnancies are reabsorbed before they rupture and require no treatment
• Rapid, thready pulse, rapid respiration, falling blood pressure, and normal temperature may be observed upon hospital assessment
• Falling HCG or serum progesterone level causes the pregnancy to end
• Leukocytosis due to internal trauma
• Unruptured ectopic pregnancies are treated with oral methotrexate
• Hysterosalpingogram/ultrasound is performed to assess tubal patency after treatment
• Laparoscopy or Culdoscopy are used to visualize the fallopian tube if symptoms are inadequate

Complications

• Heterotopic pregnancy: gestation occurs both extra-uterine and intrauterine
• Pseudocyesis: presence of all signs of pregnancy except for the confirmation of the presence of the fetus
• Ruptured ectopic pregnancy is serious regardless of the site it is implanted in
• Oophorectomy, salpingectomy, and hysterectomy may be required in some cases

Causes of Ectopic Pregnancies

• Congenital malformations or tubal surgeries
• Assisted pregnancies (e.g. in vitro fertilization)
• Pelvic Inflammatory Disease (PID)
• Uterine tumor
• Smoking
• Salpingitis scarring
• Oral contraceptives
• Intrauterine devices (IUD)