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Questions and Answers
The leading complications related directly to the pregnancy are:
The leading complications related directly to the pregnancy are:
What might Rh-negative women need to prevent Rh isoimmunization?
What might Rh-negative women need to prevent Rh isoimmunization?
Rh immune globulin
HCG levels should double in a threatened abortion. If not, poor placental function may be suspected.
HCG levels should double in a threatened abortion. If not, poor placental function may be suspected.
True (A)
What causes septic abortion?
What causes septic abortion?
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What medications are used to provide high-dose, broad-spectrum antibiotic therapy?
What medications are used to provide high-dose, broad-spectrum antibiotic therapy?
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______________ and digitalis may be necessary to maintain sufficient cardiac output.
______________ and digitalis may be necessary to maintain sufficient cardiac output.
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A ruptured ectopic pregnancy is a nonserious condition, regardless of the site of implantation.
A ruptured ectopic pregnancy is a nonserious condition, regardless of the site of implantation.
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What percentage of ectopic pregnancies occur in the ampullar portion?
What percentage of ectopic pregnancies occur in the ampullar portion?
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Select the symptom for septic abortion.
Select the symptom for septic abortion.
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What is the medical term for any interruption of a pregnancy before a fetus is viable?
What is the medical term for any interruption of a pregnancy before a fetus is viable?
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A viable fetus is usually defined as a fetus of more than 20 to 24 weeks of gestation or one that weighs at least 700 g.
A viable fetus is usually defined as a fetus of more than 20 to 24 weeks of gestation or one that weighs at least 700 g.
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If interrupted spontaneously, the pregnancy is a:
If interrupted spontaneously, the pregnancy is a:
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Spontaneous miscarriage occurs in what percentage of all pregnancies:
Spontaneous miscarriage occurs in what percentage of all pregnancies:
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If a miscarriage happens before week 16 of pregnancy it's considered a late miscarriage.
If a miscarriage happens before week 16 of pregnancy it's considered a late miscarriage.
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What is the most frequent cause of spontaneous miscarriage?
What is the most frequent cause of spontaneous miscarriage?
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Rubella, syphilis, herpes simplex, cytomegalovirus, and toxoplasmosis infections may not cross the placenta and cause early miscarriage.
Rubella, syphilis, herpes simplex, cytomegalovirus, and toxoplasmosis infections may not cross the placenta and cause early miscarriage.
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Assessment for miscarriage includes:
Assessment for miscarriage includes:
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Which type of miscarriage includes part of the conceptus (usually the fetus) is expelled, but the membrane or placenta is retained in the uterus?
Which type of miscarriage includes part of the conceptus (usually the fetus) is expelled, but the membrane or placenta is retained in the uterus?
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What is another name for missed miscarriage?
What is another name for missed miscarriage?
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Possible causes for Recurrent Pregnancy Loss includes:
Possible causes for Recurrent Pregnancy Loss includes:
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What is the name of second most frequent cause of bleeding In the first trimester?
What is the name of second most frequent cause of bleeding In the first trimester?
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At 6-8 weeks, the zygote does not grow large enough to cause rupture of the FT.
At 6-8 weeks, the zygote does not grow large enough to cause rupture of the FT.
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Select the correct sign and symptom to Ectopic Pregnancy.
Select the correct sign and symptom to Ectopic Pregnancy.
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A tender mass is not usually palpable in Douglas’ cul-de-sac on vaginal examination for Ectopic Pregnancy.
A tender mass is not usually palpable in Douglas’ cul-de-sac on vaginal examination for Ectopic Pregnancy.
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Hydatidiform Mole is also know as?
Hydatidiform Mole is also know as?
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Risk Factors: tends to occur most oftenn women who always have an high protein intake, and in women older than age 45 years.
Risk Factors: tends to occur most oftenn women who always have an high protein intake, and in women older than age 45 years.
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The maternal mortality rate when giving patient with eclampsia is?
The maternal mortality rate when giving patient with eclampsia is?
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What is the extreme oedema called (pitting edema) for a patient with Severe Preeclampsia?
What is the extreme oedema called (pitting edema) for a patient with Severe Preeclampsia?
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Betamethasone is preferred as it leads to lower rates of _______ syndrome or bronchopulmonary dysplasia in newborns
Betamethasone is preferred as it leads to lower rates of _______ syndrome or bronchopulmonary dysplasia in newborns
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If labor can not be prevented or halted completely what can be used?
If labor can not be prevented or halted completely what can be used?
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What percentage of pregnancies are assocaited with the occurance Preterm Rupture of Membranes?
What percentage of pregnancies are assocaited with the occurance Preterm Rupture of Membranes?
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It's important to use Assess VS every 20 – 25 minutes to monitor hypovolemic?
It's important to use Assess VS every 20 – 25 minutes to monitor hypovolemic?
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What are three components of triad with the acronym HELLP?
What are three components of triad with the acronym HELLP?
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When does this case may result in maternal mortality rate for HELLP?
When does this case may result in maternal mortality rate for HELLP?
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Multiple gestations are more common as _____% to _______% with all births
Multiple gestations are more common as _____% to _______% with all births
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Hydramnios is defined by how many mL at term?
Hydramnios is defined by how many mL at term?
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What does ultrasound reveal on a patient with breast and abdominal enlargement, but presents with pseudocyesis?
What does ultrasound reveal on a patient with breast and abdominal enlargement, but presents with pseudocyesis?
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With RhoGAM injections what can't cross the placenta?
With RhoGAM injections what can't cross the placenta?
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Is RhoGAM injected to what type of baby?
Is RhoGAM injected to what type of baby?
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What are the indication used for for RhoGAM?
What are the indication used for for RhoGAM?
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Flashcards
Thromboembolism
Thromboembolism
A leading pregnancy complication involving blood clots.
Hypovolemic Shock
Hypovolemic Shock
Condition from losing 10% of blood volume; can lead to fetal distress.
Signs of Hypovolemic Shock
Signs of Hypovolemic Shock
Symptoms include increased pulse, decreased BP, and cold clammy skin.
Spontaneous Miscarriage
Spontaneous Miscarriage
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Threatened Abortion
Threatened Abortion
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Ectopic Pregnancy
Ectopic Pregnancy
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Pregnancy-Induced Hypertension (PIH)
Pregnancy-Induced Hypertension (PIH)
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Abruptio Placenta
Abruptio Placenta
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Gestational Trophoblastic Disease
Gestational Trophoblastic Disease
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HELPP Syndrome
HELPP Syndrome
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Placenta Previa
Placenta Previa
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Cervical Cerclage
Cervical Cerclage
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Fetal Heart Rate Monitoring
Fetal Heart Rate Monitoring
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Tocolytics
Tocolytics
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Isoimmunization
Isoimmunization
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Preterm Labor
Preterm Labor
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Oligohydramnios
Oligohydramnios
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Hydramnios
Hydramnios
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Multiple Gestation
Multiple Gestation
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Pseudocyesis
Pseudocyesis
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DIC (Disseminated Intravascular Coagulation)
DIC (Disseminated Intravascular Coagulation)
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Fetal Death Causes
Fetal Death Causes
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Tonic-Clonic Seizures
Tonic-Clonic Seizures
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Terbutaline
Terbutaline
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Amniocentesis
Amniocentesis
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Potter’s Syndrome
Potter’s Syndrome
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Maternal Care in Pregnancy
Maternal Care in Pregnancy
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Study Notes
Nursing Care of a Family Experiencing a Sudden Pregnancy Complication
- Leading pregnancy complications include thromboembolism, hemorrhage, infection, pregnancy-induced hypertension, and ectopic pregnancy.
Bleeding During Pregnancy
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Table 21.1 (Summary of Primary Causes of Bleeding During Pregnancy): Details bleeding types (threatened miscarriage, imminent miscarriage, missed miscarriage, incomplete miscarriage, complete miscarriage, ectopic pregnancy, hydatidiform mole, premature cervical dilatation), associated cause, assessment, and cautions.
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Ectopic pregnancy: Implantation outside the uterus, most commonly in the fallopian tube. Associated with lower abdominal pain and vaginal spotting.
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Hydatidiform mole (gestational trophoblastic disease): Abnormal proliferation of trophoblastic cells, resulting in grape-like vesicles. HCG levels are usually abnormally high.
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Premature cervical dilation: Cervix dilates and opens too early during pregnancy, causing the expulsion of the fetus.
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Placenta previa: The placenta implants abnormally low, covering the cervix. Results in painless vaginal bleeding in the third trimester.
Hypovolemic Shock
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Occurs when 10% of blood volume is lost or 2 units of blood.
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Fetal distress occurs with 25% blood volume loss.
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Symptoms include pallor, increased pulse, decreased blood pressure, decreased cardiac output, fetal bradycardia, and decreased urinary output.
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Peripheral vasoconstriction occurs, impacting oxygen supply to the placenta.
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Cold clammy skin, confusion, and tachypnea are possible symptoms.
Spontaneous Miscarriage
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Abortion is the medical term for pregnancy loss before viability.
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Viability is usually defined as a fetus over 20-24 weeks gestation or weighing at least 500 grams.
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Causes include abnormal fetal development (teratogenic/chromosomal), immune response rejection, implantation abnormalities, or progesterone deficiency from the corpus luteum.
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Certain medications (isotretinoin) and alcohol use are also risk factors.
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Assessment involves vaginal spotting and treatment depends on symptoms.
Assessment
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Confirmation of pregnancy (positive pregnancy test or physician confirmation).
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Duration of pregnancy in weeks.
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Duration of bleeding.
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Intensity and description of bleeding (bright red, dark, accompanied by tissue, etc.).
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Frequency of bleeding.
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Associated symptoms (cramping, pain).
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Type of blood (especially important for Rh-negative mothers).
Types of Abortion
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Threatened abortion: Vaginal bleeding with or without cramping, but the pregnancy may continue.
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Imminent abortion: Increasing vaginal bleeding, cramping, and contractions; loss of fetus is possible.
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Complete abortion: The fetus and pregnancy products are fully passed, and the bleeding is diminishing.
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Incomplete abortion: Part of the pregnancy products are passed, but some remain in the uterus.
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Missed abortion: The fetus dies but not passed, resulting in a delayed loss of pregnancy.
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Important to note: these are not the only types, and bleeding is a symptom, not diagnosis.
Complications of Miscarriage
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Hemorrhage: Spontaneous complete loss is rare, but incomplete loss can be significant if associated with disseminated intravascular coagulation (DIC). Unusual odors or large clots in the vaginal discharge are not normal, and indicate the need for medical intervention.
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Infection: Infections may develop after a miscarriage, especially with remaining pregnancy products. Infection can lead to sepsis.
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Septic abortion: A severe infection of the uterus following an abortion which can lead to toxic shock syndrome, septicemia, kidney failure, and death.
Septic Abortion Management
- Full blood count, serum electrolytes, and creatinine measurements should be taken. Urine cultures should also be performed.
- Resuscitation should be given immediately and patients may need fluid, high dose antibiotics (e.g. penicillin, gentamicin, and clindamycin), and/or tetanus immunoglobulin (TTIG).
- Infected tissue will have to be removed; this usually involves a D&C procedure.
- If infection is severe enough, the patient will need intensive care in the hospital
Ectopic Pregnancy
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Implantation outside of the uterus, usually in a fallopian tube.
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Risk factors include previous pelvic inflammatory disease (PID), smoking, and intrauterine devices (IUDs).
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Assessment using ultrasound or MRI to confirm.
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Symptoms include sudden pain in one lower abdominal quadrant, vaginal bleeding and uterine tenderness.
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Treatment depends on the specific location, and a decision on whether to do surgical removal or use medication, like methotrexate, to terminate.
Abdominal Pregnancy
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The fetus develops in the abdominal cavity rather than the uterus.
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Major risk associated with this condition is hemorrhage as the implanting placenta may damage nearby blood vessels.
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Risk factors include advanced maternal age, and previous uterine medical procedures.
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Survival rates are lower in this condition, and management is often a laparotomy.
Gestational Trophoblastic Disease
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Abnormal proliferation of trophoblast cells, which are part of the placenta structure.
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Types include complete mole(no father's genetic material) and partial mole(some fetal material and some abnormal growth).
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The villi become swollen and cystic.
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Needs close medical follow-up and testing afterward, as it has the potential to become malignant(cancerous).
Placenta Previa
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Implantation of the placenta abnormally low in the uterus, potentially overlying the cervix.
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The risk factors associated with the condition are previous cesarean birth, uterine curettage, and multiple pregnancy.
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Assessment includes painless vaginal bleeding and determining if the placenta is covering the cervix.
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Management includes bed rest, and avoiding vaginal checks until the pregnancy reaches term or has been assessed early by ultrasound.
Preterm Labor/ Premature Rupture of Membranes
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Labor that occurs before 37 weeks of gestation.
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Risk factors include dehydration, urinary tract infections, periodontal disease and certain chronic medical disorders.
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Assessment includes signs like vaginal spotting, pelvic pressure, consistent uterine contractions and/or loss of amniotic fluid.
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Potential complications include compromised fetal health, increased risk of infection and cord prolapse (potential difficulty with childbirth, and/or respiratory problems when baby is born prematurely).
Preterm Separation of Placenta
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Premature separation of the placenta from the uterus.
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Risk factors include chronic high blood pressure, trauma to the abdomen, and smoking.
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Management priorities include cessation of bleeding, stabilization of mother and fetus, and delivery of the baby.
Pregnancy Induced Hypertension
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A condition of high blood pressure that begins in pregnancy and generally causes some degree of proteinuria and edema.
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Previously referred to as toxemia.
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Most frequent form of high risk pregnancy.
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Risk factors include multiple gestations, primiparas between the ages of 20 - 40, women from low socioeconomic backgrounds and those with previously high parities (many past pregnancies).
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Symptoms include hypertension, weight gain, edema, and proteinuria.
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Complications include cerebral hemorrhage, kidney failure, and eclampsia.
HELLP Syndrome
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Hemolysis, elevated liver enzymes, and low platelet count.
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Closely related to PIH and often requires aggressive management.
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Complications include subcapsular liver hematoma, hyponatremia, renal failure, hypoglycemia, and cerebral hemorrhages, and maternal and fetal death.
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Management includes identifying the condition early, and aggressive efforts to maintain maternal stability and to deliver the baby safely.
Multiple Gestation
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A pregnancy with two or more babies.
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Identical twins develop from the same fertilized egg; two placentas can be found in fraternal twins(from two fertilized eggs)
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Greater risk of complications during pregnancy including hypertension, hydramnios, preterm rupture of membranes and bleeding.
Hydramnios/ Oligohydramnios
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Hydramnios: Excessive amniotic fluid. This can cause the uterus to become enlarged and lead to a compromised ability for the baby to either grow or breath, and may increase the risk for premature birth by creating pressure on the mother's diaphragm. A high fluid volume also contributes to labor abnormalities, making it harder for the baby to move properly.
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Oligohydramnios: Insufficient amniotic fluid. Insufficient amniotic fluid can cause compression of extremities, and reduce the baby's overall chance for survival. It is most commonly caused by fetal renal issues.
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Both conditions require careful observation and may require interventions like amniocentesis to adjust fluid levels.
Post-Term Pregnancy
- Pregnancy lasting longer than 42 weeks.
- Risk factors linked to a prolonged gestation include increased maternal age and high-dose salicylates use .
- Potential Fetal complications include meconium aspiration and macrosomia.
- Treatment options may include inducing labor to try and prevent further complications.
Pseudo-Cyesis
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A condition where a woman experiences pregnancy symptoms though she is not pregnant.
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Potential causes may be wish-fulfillment, or depression-related issues.
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Management often involves medical reassurances, and counseling to help the woman cope, which is important for emotional health as well as physical.
Isoimmunization/Rh Incompatibility
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Involves antibodies formed by a negative Rh Mother against the positive Rh of a fetus. This can cause hemolysis of Red Blood Cells and can lead to extremely serious complications in the newborn/fetus including miscarriage.
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Proper assessments and intervention to avoid the negative outcomes associated with the antibody formation/exposure is important.
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Explore the primary causes complications in pregnancy.
