Pregnancy Complications

Description

Abortion, Premature birth, Hemorrhagic conditions of pregnancy
Allie Winningham
Flashcards by Allie Winningham, updated more than 1 year ago
Allie Winningham
Created by Allie Winningham over 7 years ago
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Resource summary

Question Answer
Abortion A spontaneous or elective termination of pregnancy before the 20th week of gestation, based on the date of the last menstrual period. Spontaneous abortion is frequently called miscarriage. Induced abortion is also referred to as "elective" abortion.
Spontaneous abortion: Occurence Occurs in 12% women < 20 years 26% women> 40 years Usually within first 12 weeks of pregnancy
Causes of Spontaneous Abortion Severe congenital abnormalities (most common-such as chromosomal abnormalities), infection, endocrine disorders (hypothyroidism, insulin dependent diabetes mellitus)
4 Types of Spontaneous Abortion 1) Threatened abortion 2) Inevitable abortion 3) Incomplete abortion 4) Complete abortion
1)Threatened abortion Vaginal bleeding and period-like symptoms (uterine cramping, lower back pain, feelings of pelvic pressure). Women should notify healthcare providers if they experience these symptoms. Labs show decreased B-hCG. Cervix appears closed.
Management of Threatened abortion Thorough health history (LNMP, amount, frequency, onset of bleeding). Description of symptoms. Treatment of infection if present. Vaginal ultrasound and B-hCG levels. Bed rest and sexual abstinence during bleeding can decrease likelihood of abortion.
2) Inevitable abortion Membranes rupture, cervix dilates, and active bleeding occur. Natural expulsion of uterine contents commonly occurs.
Management if Inevitable abortion D&C may be necessary to remove un-expelled uterine contents if bleeding persists after expulsion of contents.
3) Incomplete abortion MOST products are expelled. Active uterine bleeding and severe abdominal cramping with cervical opening.
Management of Incomplete abortion Assess hemodynamic stability. Stop bleeding. Type and screen blood for transfusion if necessary. Insert IV line for fluid replacement. D&E (dilation and evacuation) may be necessary for later term incomplete abortions.
4) Complete Abortion Everything is expelled from uterus. Bleeding and contractions cease and the cervix closes after products are passed.
Management of Complete abortion no intervention is required unless excessive bleeding or infection develops. Advise woman to rest and watch for bleeding, pain, or fever. Abstain from intercourse until after follow-up with HCP.
Preterm Infants 34 to 36 and 6/7 Weeks
Complications of Preterm Infants -Cold Stress (reduced brown fat) -respiratory distress (lung immaturity) -jaundice -hypoglycemia -trouble feeding (decreased suck reflex) -risk infection (lack of antibodies from breast milk)
Women at increased risk for Premature Delivery -Short cervix -Fetal fibronectin (fFN): present 16 to 20 weeks and near labor, but earlier may suggest PTL -Infection: increased risk premature ROM or birth
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