Term
|
Definition
|
|
Term
|
Definition
| loss of a fetus before it is viable |
|
|
Term
|
Definition
miscariage
denotes termination of pregnancy without action taken by woman or any other person |
|
|
Term
| Incidence of miscarriages/spontaneous abortion |
|
Definition
| unknown because of unrecognized losses |
|
|
Term
| When do most losses occur |
|
Definition
| during first 12 weeks of pregnancy |
|
|
Term
| When does the fetal death occur? |
|
Definition
| before signs and symptoms appear |
|
|
Term
| Age influences of maternal and paternal |
|
Definition
12% women under 20
26% women older 40
12% fathers under 20
20% fathers older 40 |
|
|
Term
|
Definition
most common: severe cogenital abnormalities incompatible with life
Maternal infections: syphilis, toxoplasmosis, rubella
maternal endocrine disorders (hypothyroidism)
teratogenic drugs
abnormalities of reproductive organs |
|
|
Term
| What are the different types of spontaneous abortions? |
|
Definition
Threatened abortion
Inevitable or Imminent abortion
incomplete abortion
complete abortion
missed abortion
recurrent or habitiual abortion
elective or induced abortion |
|
|
Term
| S/sx of a threatened abortion |
|
Definition
vaginal bleeding or spotting
possible uterine cramping, persistent backache, or pelvic pressure
cervix is closed |
|
|
Term
| Management of a threatened abortion |
|
Definition
Pelvic speculum exam
ultrasound
Labs: CBC, B-hCG, blood type and rh
bedrest
no sexual activity
peripad count |
|
|
Term
| S/sx of an inevitable or imminent abortion |
|
Definition
heavy vaginal bleeding
ruptured membranes
open cervix,
mild to severe cramping |
|
|
Term
| Management of an inevitable or imminent abortion |
|
Definition
natural explusion is common
dilation and cutterage (D&C) may be required if tissue remaines or bleeding is excessive |
|
|
Term
| S/sx of incomplete abortion |
|
Definition
heavy vaginal bleeding
open cervix
fetal and placental tissue has been passed
not all products of conception (POC) are expelled |
|
|
Term
| Management of incomplete abortion |
|
Definition
D&C
IV oxytocin (Picocin) or IM methylergonovine to contract uterus and control bleeding
large bore IV
blood type and screen |
|
|
Term
|
Definition
all products of conception are expelled
cervix closes
vaginal bleeding and uterine contractions abate |
|
|
Term
| Management of complete abortion |
|
Definition
no additional intervention necessary unless complications
teach warning signs like bleeding pain and fever
no intercourse until follow up visit with HCP |
|
|
Term
|
Definition
fetus dies but retained in uterus
Early sx of pregnancy disappear |
|
|
Term
| Management of Missed abortion |
|
Definition
D&C
Prostaglandin compounds |
|
|
Term
| Complications of Missed abortion |
|
Definition
Infection
Disseminated Intravascular Coagulation |
|
|
Term
| Define Recurrent or Habitual Abortion |
|
Definition
| three or more consecutive spontaneous abortions |
|
|
Term
| Causes of Habitual Abortion |
|
Definition
genetic or chromosomal abnormalities
abnormalities of a womans reproductive tract
infections |
|
|
Term
| Management of Recurrent Abortion |
|
Definition
PE
antiibiotics or hormones
cerclage |
|
|
Term
| Elective or induced abortion |
|
Definition
| Voluntary termination of a pregnancy |
|
|
Term
| Method types of elective abortion and time frame |
|
Definition
Medications: within 7 weeks of LMP
Dilation and vaccum aspiration with curettage: 12 weeks or less
Dilation and curettage D&C): second trimester |
|
|
Term
| Medications to induce abortion |
|
Definition
Mifepristone and misoprostol
antiprogesterone 600mg
prostaglandin 400mcg |
|
|
Term
| Procedure for Dilation and vacuum aspiration with curettage |
|
Definition
cerved dilated after local anesthesia
contents aspirated with negative pressure
possible scraping with a curet to ensure complete removal. |
|
|
Term
| when a pregnant patient experiences bleeding, what should they do? |
|
Definition
|
|
Term
| When a patient comes in for spotting/bleeding while pregnant, what test is run? |
|
Definition
|
|
Term
| In an incomplete abortion, why do some of the POC stay in the uterus? |
|
Definition
| They are often no larger than a ping pong ball if the gestation is very early |
|
|
Term
| What can the uterus do in relation to size when a missed abortion occurs? |
|
Definition
|
|
Term
| S/sx of uterine infection |
|
Definition
elevated temperature,
vaginal discharge with a foul odor
obdominal pain |
|
|
Term
| If a patient has a misssed abortion, but has an infection, what will the physisican do/ |
|
Definition
| Hold the evacuation of the uterus until antibiotic therapy has been initated |
|
|
Term
| What is diseminated intravascular coagulation? |
|
Definition
| defect in coagulation that may occur if fetus is retained for prolonged period. leads to decrease in clotting factors and leaves blood unable to clot. pt may bleed from gums, iv line, etc. |
|
|
Term
|
Definition
delivery of the fetus and placenta
possibly blood replacement products |
|
|
Term
| Possible tx of an incompetent cervix? |
|
Definition
| sutures. may be removed near term |
|
|
Term
| Nursing considerations for bleeding |
|
Definition
prevention and treatment of hypovolemic shock.
observe for tachycardia
falling bp
pale skin and mucous membranes
confusion
restlessness
and cool clammy skin
FLUID AND BLOOD REPLACEMENT |
|
|
Term
| Nursing considerations for emotional support |
|
Definition
may feel guilty, anger disapointment and sadness
emphasize with the patient
listen carefull to what they say
convey unconditional acceptance of the feelings
allow the couple to remain together as much as possible
simple, brief explanations |
|
|
