ANTENATAL COMPLICATIONS

SHARE:

Abortion
  • Interruption of pregnancy before the age of VIABILITY (20 weeks)
Spontaneous Abortion
  • Causes
    • Abnormal fetal formation
    • Low progesterone levels
    • Implantation abnormalities
    • Infection
    • Teratogens
  • Signs and Symptoms
    • VAGINAL SPOTTING
Threatened Abortion
  • Unexplained scant bright red vaginal bleeding
  • No cervical dilatation
  • Most common cause of 1st trimester bleeding
  • Nursing Care
    • Avoid strenuous activity
    • No coitus for 2 weeks
Imminent/Inevitable Abortion
  • Bleeding with cervical dilation and uterine contractions
  • Treatment
    • Save any tissue fragments discharged for later examination
    • If no FHT is detected, D&C is performed to remove conceptus
Complete Abortion
  • All of conceptus is expelled without any assistance; profuse bleeding which stops after a few days
  • Treatment
    • Go directly to hospital for assistance
    • Fragments of conceptus may be checked to prevent further bleeding
    • Oxytocin or methergine to stop bleeding
Incomplete Abortion
  • Part of the conceptus is expelled, usually the fetus, and the placenta and membranes are left
  • Treatment
    • Dilatation and Curettage (D&C)
    • Make sure the woman knows that the pregnancy is already lost
Missed Abortion
  • The fetus dies but is not expelled
  • Treatment
    • Dilatation and Curettage (D&C)
    • Make sure the woman knows that the pregnancy is already lost
    • MISOPROSTOL (Cytotec) - to dilate cervix and stop bleeding
Habitual Abortion
  • Also known as Recurrent Pregnancy Loss; 3 spontaneous miscarriages at roughly the same gestational age
  • Causes
    • Defective sperm or ova
    • Endocrine disorders
    • Uterine defects
    • Infections
    • Autoimmune disorders
Induced Abortion
  • Artificial induction of abortion via mechanical or chemical means
[next]
Ectopic Pregnancy
  • Implantation of the zygote outside the uterine cavity; most commonly on the ampullar region of the Fallopian tube
  • Causes
    • Salpingitis - may cause scarring of Fallopian tube and subsequent blockage
    • PID
    • Use of IUD
    • Smokers
    • Uterine tumors
  • Signs and Symptoms
    • Bleeding during 6-12 weeks
    • SHARP STABBING PAIN
    • CULLEN’S SIGN – bluish tinge on the umbilicus
    • Falling hCG
    • Shock
  • Treatment
    • Ligation of bleeding vessels
    • Unilateral salpingectomy
    • METHOTREXATE FOLLOWED BY LEUCOVORIN - to destroy remaining tissue
    • Mifepristone - to induce labor
Abdominal Pregnancy (Ectopic)
  • Growth of the fetus outside of the uterus
  • Signs and Symptoms
    • Fetal outline easily palpable directly below the abdominal wall and not inside the uterus
[next]
Hydatidiform Mole / Gestational Trophoblastic Disease
  • the abnormal proliferation and degeneration of trophoblastic villi
  • Most common cause of 2nd trimester bleeding
    • Complete Mole - trophoblastic villi swell and become cystic, “empty ovum” was fertilized; usually lead to choriocarcinoma
    • Partial Mole - some of the trophoblastic villi form normally but is swollen and misshapen, has 69 chromosomes; usually doesn’t lead to choriocarcinoma
  • Causes
    • Asians
    • Low protein intake
    • Older than 35 years of age
  • Signs and Symptoms
    • Elevated hCG
    • High weight gain for gestational age
    • No FHT
    • Discharge of clear fluid filled vesicles
  • Treatment
    • No pregnancy for 12 months
    • Let mother express concerns, feelings and emotions
    • METHOTREXATE FOLLOWED BY LEUCOVORIN - to destroy remaining tissue
    • Dactinomycin - alternative to methotrexate
[next]
Hyperemesis Gravidarum
  • Projectile vomiting during pregnancy
  • Causes
    • Increased levels of hCG
  • Treatment
    • Monitor I&O
    • TPN
    • IV fluid replacement
    • Soft diet
    • Antiemetics – METOCLOPRAMIDE (Plasil, Reglan)




Hyperemesis Gravidarum
Morning Sickness
Skin Color
yellow, jaundiced
normal
Duration
Exceeds 1st trimester
1st-2nd trimester
Skin Turgor
dehydrated
hydrated
Electrolytes
abnormal
normal


[next]
Incompetent Cervix
  • Also known as Premature Cervical Dilation
  • Signs and Symptoms
    • Pink show
    • Painless dilation
  • Treatment
    • CERVICAL CERCLAGE – MCDONALD (taped) & SHIRODKAR (sutured) TECHNIQUE
    • Modified Trendelenburg position

[next]
Placenta Previa & Abruptio Placenta
  • Types of Placenta Previa
    • Low - placenta is in close proximity to the cervical os
    • Partial - placenta covers a portion of the cervical os
    • Total - placenta completely covers cervical os
  • Degrees of Separation (Abruptio Placenta)
    • - no separation
    • - minimal separation, no fetal distress, vaginal bleeding
    • - moderate separation, fetal distress, uterus is tense and painful
    • - extreme separation, no immediate intervention, shock, death
  • Treatment
    • NO VAGINAL EXAMS
    • Amniocentesis to assess fetal lung maturity
    • BETAMETHASONE – to improve lecithin:sphingomyelin ratio of lung surfactants



Abruptio Placenta
Placenta Previa
Skin Color
painful
painless
Blood Color
dark
bright red
Amount of Bleeding
profuse
scant
Palpation
board-like, rigid, tender
soft, boggy, not tender

[next]
Pregnancy-Induced Hypertension (PIH)
  • Signs and Symptoms
    • HYPERTENSION
    • EDEMA
    • PROTEINURIA
  • Treatment
    • Bed rest
    • Nutritious Diet
  • Care During Seizures
    • Place pillow under head
    • Raise side rails
    • Side-lying position
    • No sudden stimuli
    • NPO
    • MAINTAIN PATENT AIRWAY

[next]
Mild Preeclampsia (PIH)
  • Signs and Symptoms
    • BP 140/90
    • Proteinuria +1 to +2
    • Edema on face and upper extremities
Severe Preeclampsia (PIH)
  • Signs and Symptoms
    • BP 160/110
    • Proteinuria +3 to +4
    • Extreme edema on face and hands
    • Hyperreflexia and ankle clonus
Eclampsia (PIH)
  • Signs and Symptoms
    • Seizures
    • Signs and symptoms of preeclampsia
  • Stages of Tonic-Clonic Seizures
    • Tonus – muscles of the body contract and stiffen
    • Clonus – muscles contract and relax repeatedly and limbs flail wildly
    • Post-ictal state – in a semicomatose state
  • Drug of Choice
    • MAGNESIUM SULFATE

[next]
HELLP Syndrome
  • Hemolysis, Elevated Liver enzymes, Low Platelet
  • Signs and Symptoms
    • Nausea
    • Epigastric pain
    • General malaise
    • Right upper quadrant tenderness
    • Thrombocytopenia
  • Treatment
    • Platelet transfusion
    • IV Dextrose

[next]
Multiparity
  • Signs and Symptoms
    • Elevated alpha-fetoprotein
    • Faster rate of increase in size of uterus
    • Multiple FHT
  • Nursing Care
    • Bed rest
    • Cesarean section upon delivery
Fetal Death
  • No FHT
  • MISOPROSTOL w/ OXYTOCIN - to induce labor and stop bleeding

[next]
Hydramnios
  • Amniotic fluid more than 2000mL
  • Normal amount: 500-1000mL
  • Signs and Symptoms
    • Unusual rapid enlargement of uterus
    • Shortness of breath
    • Weight gain
    • Varicosities
  • Tx
    • Bed rest
    • Stool softeners
    • Amniocentesis

[next]
Post Term Pregnancy
  • Exceeds 42 weeks of gestation
  • Treatment
    • Cesarean section
    • Assessment of maturity
    • Labor induction
  • Treatment
    • MISOPROSTOL - induces labor
    • PROSTAGLANDIN E1 - induces labor
    • Oxytocin - induces labor

[next]
Preterm Labor
  • Labor before the 37th week of gestation
  • Causes
    • Chorioamnionitis
    • Other infections
    • Incompetent cervix
  • Signs and Symptoms
    • Early uterine contractions
  • Rx
    • Tocolytics - MAGNESIUM SULFATE - halts contractions
    • BETAMETHASONE IM q24h 12mg - improves lung surfactant ratio
    • DEXAMETHASONE IM q12h 6mg - improves lung surfactant ratio
    • β-sympathomimetic drugs - TERBUTALINE & RITODRINE - halts contractions
[next]
TORCH Complex
  • Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, Herpes Simplex
  • Vaccination, Antibiotics, and Cesarean Section
[next]
PROM (Premature Rupture of Membranes)
  • Rupture of fetal membranes with loss of amniotic fluid during pregnancy before 37 weeks
  • Signs and Symptoms
    • Blue Nitrazine test result
    • Sudden gush of clear fluid
  • Treatment
    • FIBRIN-BASED SEALANT - glues membranes
    • AMNIOINFUSION - infusion of fluid into amniotic sac
    • Bed rest - reduces fluid loss
    • Antibiotics - prophylactic measure for infection
[next]
Rh Incompatibility
  • Also known as Isoimmunization
  • Develops when Rh- mother with Rh+ baby
  • Baby may develop erythroblastosis fetalis - maternal antibodies destroy the Rh+ fetal RBC
  • The destruction of red blood cells from erythroblastosis fetalis releases large amounts of unconjugated bilirubin leading to a condition known as kernicterus, wherein the unconjugated bilirubin is deposited in the brain and damages it
  • Caused when the father is Rh+
  • Appears as Coombs’ Test Negative
  • Treated with RhoGam
[next]
DIC (Disseminated Intravascular Coagulation)

  • Fibrinogen levels fall below effective limits
  • Extreme bleeding at one site because most of the fibrin and platelets rush to another area; not enough is left for the rest of the body especially at the site of implantation
  • Signs and Symptoms
    • Easily bruised
  • Treatment
    • HEPARIN


Name

anaphysio,3,ASEPSIS AND INFECTION CONTROL,9,audio,1,biochemistry,2,blog,1,BSN Notes: Assessment in Psychiatry,6,BSN Notes: Burns,11,BSN Notes: Care of Terminally Ill Patients,6,BSN Notes: Childhood and Developmental Disorders,6,BSN Notes: Common Behavioural and Social Problems,4,BSN Notes: Common Childhood Diseases,7,BSN Notes: Common Signs And Symptoms,32,BSN Notes: Community Mental Health Nursing,12,BSN Notes: Critical Care,12,BSN Notes: Disaster and Emergency,15,BSN Notes: ENT,8,BSN Notes: Eye,25,BSN Notes: History and Assessment,24,BSN Notes: Introduction of Psychiatry,27,BSN Notes: Legal Issues In Psychiatry,4,BSN Notes: Medication Administration,24,BSN Notes: Neuritic_Stress related and Somatization Disorders,10,BSN Notes: Neurology,6,BSN Notes: Oncological Nursing,8,BSN Notes: Organic Brain Disorders,1,BSN Notes: Oxygenation,3,BSN Notes: Personality_Sexual and Eating Disorders,5,BSN Notes: Principles and Concepts of Psychiatry Nursing,2,BSN Notes: Psych-pharmacology and Other Treatment Modalities,30,BSN Notes: Psychiatry Emergencies and Crisis Intervention,4,BSN Notes: Psychosocial Needs,5,BSN Notes: Schizophrenia and othe Psychotic Disorders,4,BSN Notes: The healthy child,5,BSN Notes: TNPR,9,BSN Notes: Urinary Elimination,14,chn,41,clinicalkannada,4,clinicals1,35,clinicals2,10,clinicals3,26,clinicals4,11,Code of Ethics,3,community,7,Critical thinking,7,drugs,3,Equipment & Linen,9,Equipments & Linen,1,Etics and Legal,1,exa,1,exam,11,featured,19,fon,141,fon3,141,fun,1,geriatric,1,graphic,1,Growth and Development,5,he,93,hotspot,6,kannada,54,language,1,Machinery,10,Medications,1,Memory Tools,9,mhn,126,microbiology,3,misc,2,mnemonics,48,msn,137,NCLEX,13,ncp,27,news,4,obg,28,OBG Medications,1,Peri- operative Nursing,2,pharma,29,Physical Examination and Assessment,9,Psychology,2,Pulse,7,resources,1,Respiration,4,Transitional care,1,Ventilators,5,voice,2,
ltr
item
notes.nursium.com: ANTENATAL COMPLICATIONS
ANTENATAL COMPLICATIONS
notes.nursium.com
https://notes.nursium.com/2017/03/antenatal-complications.html
https://notes.nursium.com/
https://notes.nursium.com/
https://notes.nursium.com/2017/03/antenatal-complications.html
true
3454605208880343795
UTF-8
Loaded All Posts Not found any posts VIEW ALL Readmore Reply Cancel reply Delete By Home PAGES POSTS View All RECOMMENDED FOR YOU LABEL ARCHIVE SEARCH ALL POSTS Not found any post match with your request Back Home Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sun Mon Tue Wed Thu Fri Sat January February March April May June July August September October November December Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec just now 1 minute ago $$1$$ minutes ago 1 hour ago $$1$$ hours ago Yesterday $$1$$ days ago $$1$$ weeks ago more than 5 weeks ago Followers Follow THIS CONTENT IS PREMIUM Please share to unlock Copy All Code Select All Code All codes were copied to your clipboard Can not copy the codes / texts, please press [CTRL]+[C] (or CMD+C with Mac) to copy