Complications of Pregnancy

Ectopic Pregnancy
-tubal pregnancy
-the fertilized ovum is implanted outside the uterus
-implantation occurs in fallopian tube
-spontaneous abortion may follow in early stages or embryo will continue to develop and cause the tube to rupture
-leads to severe hemorrhage or peritonitis (serious infection in peritoneal cavity) and loss of fallopian tube
Pregancy-Induced Hypertension (PIH)
-a state of persistently elevated blood pressure (more than 140/90) developing after 20 weeks of gestation and returns normal following delivery
-can lead to damaged blood vessels in kidneys and retina of eye or stroke to heart failure
Preeclamspia and Eclampsia
-blood pressure is higher than PIH
-kidney dysfunction is indicated by proteinuria, weight gain and generalized edema (face, hands, feet and legs)
-Preeclampsia: HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets), can progress to coagulation disorders
-Eclampsia: blood pressure is extremely high and generalized seizures (grand mal) or coma develops
Gestational Diabetes Mellitus
-2% to 5% of women during pregnancy
-increased glucose intolerance and increased glucose levels in the blood and urine
-higher risk of fetal abnormalities if blood glucose is increased in first trimester
-newborn is usually larger in size
Placental Problems
-Placenta Previa: when the placenta is implanted in the lower uterus or over the os (passage between uterus and cervix), the uterus will expand and contract near the end of pregnancy, the placenta is torn and bleeding occurs
-Abruptio Placentae: premature separation of the placenta from the uterine wall, resulting in bleeding usually occurs in last trimester
Thromboembolisms vs. Thromboplebitis
-thromboembolisms (blood clots) are common following childbirth and usually develop in the veins of the legs or pelvis
-thrombus can form spontaneously because of stasis of blood or increased coagulability
-clot forms over an inflamed area in the vein wall (thrombophlebitis), if a piece of thrombus breaks away (embolus) it will flow with the venous blood to the right side of the heart and into the lungs where it will lodge in a pulmonary artery or smaller branch obstructing blood flow to the lungs (pulmonary embolus)
-do not massage a leg if it is painful and red
Disseminated Intravascular Coagulation (DIC)
-a further serious complication of events such as abruptio placentae and preeclampsia
-increased activation of clotting mechanism occurs, resulting in diffuse blood clots and excessive consumption of all clotting factors
-formation of multiple thrombi causes organ damage but signs of DIC are usually related to hemorrhage
-bleeding may occur from the uterus, at injection sites, from the nose or mouth, under the skin (purpura), or internally
Rh Incompatibility
-can develop when the Rh factor antigens on fetal red blood cells differ from those on maternal red blood cells
-results when the mother is Rh negative and the fetus is Rh positive
-Hemolysis of red blood cells leads to severe anemia or low hemoglobin and possible heart failure and death in child
-Hemolysis also causes high serum bilirubin levels in child, resulting in jaundice and potential neuro damage
-Puerperal infection (childbed fever) is infection of the reproductive tract at any time during the 6 weeks following birth\
-Endometritis (inflammation of the uterine lining) may be caused by separation of the placenta, leaving raw tissue open to easy access of organisms from vagina
-Signs of Infection: fever, vomiting, lower abdominal pain, foul discharge from vagina
-Pelvic cellullitis (infection in the connective tissues or broad ligament of the pelvis)
-Peritonitis (infection of the peritoneal membranes), manifested by severe pain, high fever, tachycardia and abdominal distention
Adolescent Pregnancy
-risky due to teen not seeking prenatal care early in the pregnancy