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Complications of pregnancy (Abortion (nursing management (provide…
Complications of pregnancy
Abortion
risk factors
age, hormonal disorders, incompetent cervix, emotional instability, uterine fibroids, uterine trauma,
pathophysiology
for an abortion to accur the uterus must contract, the contractions may follow a stimulus
patient may describe these as menstrual cramps, blood may gush out depending on the stage of the condition
through all this the cervix may remain closed and the abortion is said to be threatening.
when the uterine contractions strengthens, vaginal bleeding increases, and the cervix becomes soft and progressively dilate abortion becomes inevitable
the expulsion of the uterine contents follow. should the foetus, membranes and placenta be expelled completely the abortion is said to be complete. incomplete abortion is when some of the products are still retained
causes
causes of spontaneous abortion are unknown but they are associated with foetal as well as maternal conditions
foetal cause
foetal abnormalities
a foetal with an ABO blood incompatibility
multiple pregnancy
maternal cause
uterine structure abnormalities
an incompetent cervix
hormonal imbalances
acute maternal infection
trauma to the abdomen and pelvis
Definition
abortion is also referred to as termination of pregnancy or miscarriage. it is a concept to describe involuntary or voluntary termination of pregnancy before the twentieth week of gestation
types of abortion
induced abortion
sponteneous abortion
inevitable abortion
missed abortion
threatened abortion
habitual abortion
Assessments and common findings
patient may report
dull back pain that has been lingering for some time
vaginal bleeding
having missed one or two consecutive periods
on examination
positive pregnancy test
height of the fundus may be above symphysis pubis
pyrexia
medical management
the doctor may order an oxytocin drip to be put up to assist the process
nursing management
provide emotional support
provide mechanism and prescribed medication to relieve pain
provide privacy
maintain intravenous therapy to counteract blood and fluid loss
monitor progress and vital signs
check the pad every 15 minutes and examine, record and report expelled product of conception
Ectopic pregnancy
risk factors
use of intrauterine contraceptive devices
previous ectopic pregnancies
adhesions from previous pelvic infection and tubal surgey
undiagnosed structural deformaties of the uterus or fallopian tubes
pathophysiology
the trube quickly gets distended and ruptures, realising the fertilised ovum and blood into the pelvic cavity
when the tube ruptures oestrogen and progesterone levels decrease and the endometrium start to shread off as in menstruation
the blastocyst quickly erodes the epithelium and becomes attached to the muscular layer
bleding from the ruptured tube may collect in the pouch of Douglas causing pelvic haematocele.
for unknown reasons the fertilised ovu fails to reach the uterine cavity and becomes implanted in the fallopian tube, pelvic cavity
vaginal bleeding may be scanty and dark brown in colour and pain may be moderate
causes
causes are unknown
assessment and common findings
pain quickly intensifies to become sharp and stabbing
pulse id fast and thready
lower abdominal pain
blood pressure suddenly drops
history of missed periods with spotting
ski is cold and clammy and temperature is subnormal
abdomen may be distended and tender with guarding
woman may complain of dizziness and nausea accompanied by frequency of micturition.
Definition
it is the condition where the implantation of the fertilised ovum occurs outside the uterine cavity either in the fallopian tube, the ovary or pelvic cavity.
medical and surgical management
a laparotomy will be done to remove blood that may be free in the peritoneal cavity
a hysterectomy may be perfomed, the operation should be done within 12 hours of diagnosis
nursing management
health education
encourage the woman and the family to mourn the loss of their child.
how to maximise the chances of a normal pregnancy
doing a vaginal pack and sanitary pad check and monitoring intake and output
monitoring vital signs to identify untoward internal bleeding
support the family during grieving time by listening to their concerns and give advice