chapter 36 prenatal problems. © 2005 by thomson delmar learning,a part of the thomson corporation....
TRANSCRIPT
Chapter 36Prenatal Problems
© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
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Overview
Conception and Pregnancy Abdominal Pain in Women of
Childbearing Age Sexual Assault Complications of Pregnancy Blunt Abdominal Trauma
© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
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Conception and Pregnancy
Ovary releases an egg It travels through the fallopian tube where
it may be fertilized if sperm is present The fertilized egg travels into the uterus
where it implants in the uterine wall
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
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Conception and Pregnancy
Changes of pregnancy: First trimester– Implantation occurs– Organs begin to develop in fetus– Blood flow increases to uterus– Blood volume increases 30-35%– Heart rate increases– Blood pressure drops
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Conception and Pregnancy
Changes of pregnancy: Second trimester– Rapid growth and development of fetus– Uterus expands and presses on diaphragm– Breathing becomes more difficult
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Conception and Pregnancy
Changes of pregnancy: Third trimester– Fetus completes development
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Abdominal Pain in Women of Childbearing Age
Ectopic pregnancy– Ovum fails to descend into the uterus and it
implants in the fallopian tubes– Rupture of the fallopian tube can cause severe
bleeding, leading to shock
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Abdominal Pain in Women of Childbearing Age
Ectopic pregnancy – Lower abdominal pain, scant vaginal bleeding,
tachycardia, tachypnea, pallor– Treat for hypoperfusion
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
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Stop and Review
How does the body change with pregnancy? What can you do to care for a patient with
abdominal pain?
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Sexual Assault
Psychological as well as physical trauma Treat life threats during the initial assessment Maintain the patient’s privacy and the right to
refuse physical examination Never perform a genital exam unless
significant bleeding is present
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Complications of Pregnancy
Spontaneous abortion– Termination before 20 weeks is termed abortion– Usually due to a defect in the fetus or conditions
within the uterus– Usually occurs between the 6th and 12th weeks– Treat as you would an ectopic pregnancy
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Complications of Pregnancy
Placental abruption– Premature detachment of the placenta
from the uterine wall– Decreased blood flow to the fetus and
increased blood loss of mother
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Complications of Pregnancy
Placenta previa– Placenta grows over the opening of the uterus– Results in severe bleeding, which can rapidly
progress to hemorrhagic shock
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Complications of Pregnancy
Toxemia– Meaning “poisoned pregnancy”; known
as eclampsia today– Can lead to coma and death
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Complications of Pregnancy
Toxemia– Pre-eclampsia presents as hypertension
and edema– Eclampsia presents as seizure
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Blunt Abdominal Trauma
Amniotic fluid surrounds the fetus and acts as a shock absorber
In the third trimester, the abdomen protrudes outside the bony protective structures of the pelvis
Severe blunt force trauma can rupture the uterus
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Blunt Abdominal Trauma
Falls – Additional weight shifts the woman’s center of
gravity, making the pregnancy woman more prone to falling
Intentional trauma– Some pregnant women may become victims of
spousal abuse
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Blunt Abdominal Trauma
Motor vehicle collisions– The bulging abdomen can become the
area of first contact
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
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Stop and Review
How do you care for the pregnant patient with vaginal bleeding?
How do you care for the patient experiencing pre-eclampsia or eclampsia?
What protects the fetus from blunt abdominal trauma?
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