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Major complications in pregnancy


Major complications in pregnancy Miscarriages Also known as spontaneus abortions Expulsion of fetus before it reaches viabilty pregnancy that ends on it's own, within ... – PowerPoint PPT presentation

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Title: Major complications in pregnancy

Major complications in pregnancy
  • Also known as spontaneus abortions
  • Expulsion of fetus before it reaches viabilty
  • pregnancy that ends on it's own, within the first
    22 weeks of gestation
  • Reasons
  • Hormonal problems, infections or maternal health
  • Lifestyle (i.e. smoking, drug use, malnutrition,
    excessive caffeine and exposure to radiation or
    toxic substances)
  • Implantation of the egg into the uterine lining
    does not occur properly
  • Maternal age
  • Maternal trauma

Types of abortions
  • Threatened abortions
  • early pregnancy uterine bleeding
  • The cervix remains closed
  • Inevitable (Incomplete) abortions
  • Abdominal or back pain accompanied by bleeding
    with an open cervix
  • Leads to complete incomplete abortions

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  • Complete abortions
  • embryo have emptied out of the uterus. Bleeding
    should subside quickly
  • Incomplete abortions
  • embryo have not emptied the uterus completely

  • Missed abortions
  • experience a miscarriage without knowing it.
  • embryonic death has occurred
  • there is no expulsion of the embryo.
  • Signs would be a loss of pregnancy symptoms and
    the absence of fetal heart sounds found on an
  • Recurrent abortions
  • Defined as 3 or more
  • consecutive first
  • trimester miscarriages

  • Therapeutic Abortion
  • Intentional termination of pregnancy before age
    of viability to preserve the health of the mother
  • Elective Abortion
  • Intentional termination of pregnancy for reasons
    unrelated to mothers health

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Ectopic pregnancy
  • in which the embryo implants outside the uterine
  • Occur mainly in the fallopian tube, also cervix,
    ovaries, and abdomen
  • An ectopic pregnancy is a potential medical
    emergency, and, if not treated properly, can lead
    to death

  • 95 occur in the fallopian tube
  • The zygote or embryo may die and be absorbed by
    the body, or the tube could rupture (ruptured
    tubal pregnancy) with bleeding into the abdominal
    cavity. This is a surgical emergency

  • Signs symptoms
  • Lower abdominal pain, may have light vaginal
  • If tube ruptures
  • May have sudden severe lower abdominal pain
  • Vaginal bleeding
  • Signs of hypovolemic shock
  • Shoulder pain may also be felt

  • Placenta previa
  • Abnormal implantation of the fetus in the lower
    uterine segment
  • The growing uterus completely/ partially covers
    the orifice
  • Prevent baby from delivering vaginally
  • Caesarian section is done
  • Bright bleeding occurs when cervix
  • dilates, resulting in painless bleeding

  • Abruptio placentae (accidental hemorrhage)
  • Normal implantation of placenta
  • Dark bleeding with pain and enlarging uterus
    suggest blood is accumulating within the cavity

  • Placenta previa
  • Infection, because of vaginal organisms
  • Postpartum hemorrhage, because if lower segment
    of uterus was site of attachment, then there are
    fewer muscle fibers so weaker contractions may
  • Abruptio placentae
  • Predisposing factors
  • Hypertension
  • Cocaine or alcohol use
  • Cigarette smoking and poor nutrition
  • Blows to the abdomen
  • Prior history of abruptio placentae
  • Folate deficiency

Cervical insufficiency (incompetent cervix)
  • In cervix secretions fill the canal and form a
    protective barrier called the mucous plug During
    a normal pregnancy,
  • the cervix remains firm, long, and closed until
    late in the third trimester.
  • At birth it usually starts to soften, efface
    (grow shorter), and dilate (open up) as your body
    prepares for labor

  • cervix is softer and weaker abnormally short
  • it may efface and dilate without contractions
    also called "incompetent cervix
  • can result in
  • Second,trimester miscarriage
  • preterm premature rupture of the membranes
    (PPROM), or preterm delivery (before 37 weeks).

Antepartum Hemorrhage
  • Bleeding from the birth canal after 22 weeks
  • Fetus is visible
  • Main two causes,
  • Accidental hemorrhage - Abruptio placentae
  • Placenta praevia

Excessive amniotic fluid (hydramnios or
  • medical condition describing an excess of
    amniotic fluid in the amniotic sac
  • Opposite to this is oligohydramnios,
  • a deficiency in amniotic fluid
  • Causes,
  • Maternal hyperglycemia
  • Fetal abnormalities such as esophageal atresia,
    duodenal atresia, facial cleft, renal disoeders,
    chromasome abnormalities

  • Indications
  • uterus growing more rapidly
  • unusual abdominal discomfort
  • increased back pain
  • shortness of breath
  • extreme swelling in feet and ankles.
  • Confirm by an ultrasound. amniotic fluid index
  • normal measure for the third trimester is
    between 5 and 25 cm
  • A total of more than 25 cm is considered high.

Placental Insufficiency
  • Placenta fails to transport adequate blood
    supply to the growing fetus
  • Lack of oxygen and nutrients to the fetus
  • Baby might be small to the date/ intrauterine
  • Serial screening is important
  • Ultra sound examination fetal growth
  • Cardiotachography fetal heart sound
  • Blood urine test

  • Increase of placental blood flow can be done
  • Rest
  • Maternal diet rich in protein
  • Correcting of anemia
  • Higher risk pregnancies such as multiple
    gestations should be monitored very carefully

False labour
  • When a mother reaches her due date painless/
    painful infrequent contractures
  • Mother feels that she is close to labour
  • Cervix dilation does not occur
  • Contractions don't grow consistently longer,
    stronger, and closer together.

Pregnancy induced hypertension
  • Also known as pre eclampsia
  • After 30th week
  • Signs for monitor
  • Oedema present in ankle after a night rest / in
    hands ad feet
  • Raised diastolic blood pressure (gt90Hgmm)
  • proteinuria

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