RNSG 1412 (Ob/Pedi) - Exam 3, PPT & Learning Guide:
Complications of Pregnancy|Obstetric and Maternal-Fetal Health
Assessment: Hemorrhagic Conditions, Spontaneous and Recurrent
Abortions, Ectopic and Molar Pregnancy, Placenta Previa, Abruptio
Placentae, Hyperemesis Gravidarum, Gestational and Chronic
Hypertension, Preeclampsia, Eclampsia, HELLP Syndrome, Rh and ABO
Incompatibility, Gestational Diabetes Mellitus, Pre-existing Diabetes,
Fetal Growth Abnormalities, Macrosomia, Intrauterine Growth
Restriction, Cardiac Disease, Perinatal Loss, Adolescent and Delayed
Pregnancy, Substance Abuse, Maternal-Fetal Nursing Interventions,
Cerclage Management, DIC, Fetal Surveillance, Neonatal
Complications, Psychological Support, Nutritional Management, Labor
and Delivery Considerations Exam Questions Verified and Provided
with Complete A+ Graded Rationales Latest Updated 2026
Hemorrhagic Conditions of Early Pregnancy - ABORTIONS
Spontaneous abortion
ØThe leading cause of pregnancy loss
ØMost commonly due to chromosomal abnormalities incompatible with life
ØRate increases with age
ØTreatment
•Preventing complications such as hypovolemic shock and infection
•Providing emotional support for grieving
Types of Abortions
Threatened = vag. bleeding, may/may not happen
Inevitable
,Incomplete = need D&C
Complete
Missed (what is a major complication?) infection/ high risk for DIC, need D&C
Recurrent OR Habitual abortion (what is a potential treatment?) repeated miscarriages, tx = cerclage
Disseminated Intravascular Coagulation (DIC)
DIC (consumptive coagulopathy)
ØA life-threatening complication of missed abortion, abruptio placentae, and preeclampsia
ØPro-coagulation and anti-coagulation factors are simultaneously activated.
ØThe priority in treating DIC is delivery of the fetus and placenta.
ØBlood replacement products and cryoprecipitate are administered to maintain circulating volume.
DIC Assessment/Signs and Symptoms
Spontaneous bleeding – from gums and nose, all mucous membranes, brain bleed (epistaxis, injection
and IV sites, incisions)
Tachycardia, diaphoresis, restlessness, hypotension = hypovolemic shock
,Hematuria, oliguria, occult blood in stool
Altered LOC if cerebral circulation is decreased or cerebral bleed
Treatment: deliver fetus, blood replacement (whole blood, PRBCs, cryoprecipitate) and oxygen
Habitual abortion - incompetent cervix?
Cervical incompetence, an anatomic defect that results in painless dilation of the cervix in the second
trimester
Treatment for Incompetent Cervix: CERCLAGE
Cervix can be sutured to keep it from opening - Sutures are removed near term if vaginal delivery is
expected, or they may be left in place if a cesarean birth is planned
Nursing care after cerclage
►Bedrest in a slight Trendelenburg position
►Teach
►Assess for leakage
►Assess for contractions
, ►Assess fetal movement and report decrease movement
►Assess temperature for elevation
Hemorrhagic Conditions of Early Pregnancy - Ectopic Pregnancy
Implantation of the fertilized ovum in an area outside of the uterine cavity.
Ø95% occur in the fallopian tubes.
The incidence is increasing as a result of
risk factors for ectopic pregnancy
Øpelvic inflammation/infection/surgery,
Øanatomical defects,
Øcigarette smoking,
Øvaginal douching, and ? (what are more risk factors?) PID, IUD, maternal age >35, previous ectopic, any
assistive reproductive med/procedure, failed tubal ligation, multiple induced abortions, anything causing
pelvic area scar tissue
Manifestations of Ectopic Pregnancy
Early Signs:
Missed period = early pregnancy signs
Complications of Pregnancy|Obstetric and Maternal-Fetal Health
Assessment: Hemorrhagic Conditions, Spontaneous and Recurrent
Abortions, Ectopic and Molar Pregnancy, Placenta Previa, Abruptio
Placentae, Hyperemesis Gravidarum, Gestational and Chronic
Hypertension, Preeclampsia, Eclampsia, HELLP Syndrome, Rh and ABO
Incompatibility, Gestational Diabetes Mellitus, Pre-existing Diabetes,
Fetal Growth Abnormalities, Macrosomia, Intrauterine Growth
Restriction, Cardiac Disease, Perinatal Loss, Adolescent and Delayed
Pregnancy, Substance Abuse, Maternal-Fetal Nursing Interventions,
Cerclage Management, DIC, Fetal Surveillance, Neonatal
Complications, Psychological Support, Nutritional Management, Labor
and Delivery Considerations Exam Questions Verified and Provided
with Complete A+ Graded Rationales Latest Updated 2026
Hemorrhagic Conditions of Early Pregnancy - ABORTIONS
Spontaneous abortion
ØThe leading cause of pregnancy loss
ØMost commonly due to chromosomal abnormalities incompatible with life
ØRate increases with age
ØTreatment
•Preventing complications such as hypovolemic shock and infection
•Providing emotional support for grieving
Types of Abortions
Threatened = vag. bleeding, may/may not happen
Inevitable
,Incomplete = need D&C
Complete
Missed (what is a major complication?) infection/ high risk for DIC, need D&C
Recurrent OR Habitual abortion (what is a potential treatment?) repeated miscarriages, tx = cerclage
Disseminated Intravascular Coagulation (DIC)
DIC (consumptive coagulopathy)
ØA life-threatening complication of missed abortion, abruptio placentae, and preeclampsia
ØPro-coagulation and anti-coagulation factors are simultaneously activated.
ØThe priority in treating DIC is delivery of the fetus and placenta.
ØBlood replacement products and cryoprecipitate are administered to maintain circulating volume.
DIC Assessment/Signs and Symptoms
Spontaneous bleeding – from gums and nose, all mucous membranes, brain bleed (epistaxis, injection
and IV sites, incisions)
Tachycardia, diaphoresis, restlessness, hypotension = hypovolemic shock
,Hematuria, oliguria, occult blood in stool
Altered LOC if cerebral circulation is decreased or cerebral bleed
Treatment: deliver fetus, blood replacement (whole blood, PRBCs, cryoprecipitate) and oxygen
Habitual abortion - incompetent cervix?
Cervical incompetence, an anatomic defect that results in painless dilation of the cervix in the second
trimester
Treatment for Incompetent Cervix: CERCLAGE
Cervix can be sutured to keep it from opening - Sutures are removed near term if vaginal delivery is
expected, or they may be left in place if a cesarean birth is planned
Nursing care after cerclage
►Bedrest in a slight Trendelenburg position
►Teach
►Assess for leakage
►Assess for contractions
, ►Assess fetal movement and report decrease movement
►Assess temperature for elevation
Hemorrhagic Conditions of Early Pregnancy - Ectopic Pregnancy
Implantation of the fertilized ovum in an area outside of the uterine cavity.
Ø95% occur in the fallopian tubes.
The incidence is increasing as a result of
risk factors for ectopic pregnancy
Øpelvic inflammation/infection/surgery,
Øanatomical defects,
Øcigarette smoking,
Øvaginal douching, and ? (what are more risk factors?) PID, IUD, maternal age >35, previous ectopic, any
assistive reproductive med/procedure, failed tubal ligation, multiple induced abortions, anything causing
pelvic area scar tissue
Manifestations of Ectopic Pregnancy
Early Signs:
Missed period = early pregnancy signs
