Bleeding During Pregnancy ATI CH 7

Bleeding During Pregnancy ATI CH 7 Is vaginal bleeding during pregnancy normal? - No, it is always abnormal and must be investigated to determine the cause. It can impair both the outcome of the pregnancy and the mother's life. What are the causes of vaginal bleeding in the FIRST TRIMESTER? - Spontaneous Abortion Ectopic Pregnancy What are the causes of vaginal bleeding in the SECOND TRIMESTER? - Gestational trophoblastic disease - Molar Pregnancy HYDATIFORM MOLE CHORIOCARCINOMA What are the causes of vaginal bleeding in the THIRD TRIMESTER? - Placenta Previa Abruptio Placentae What are the signs and symptoms of, and assessment data related to, a spontaneous abortion (miscarriage)? - Vaginal bleeding, uterine cramping, and partial or complete expulsion of products of conception ◯ Backache and abdominal tenderness ◯ Rupture of membranes, dilation of the cervix ◯ Fever ◯ Signs and symptoms of hemorrhage such as hypotension and tachycardia What are the signs and symptoms of an ectopic pregnancy? - Abrupt unilateral lower-quadrant abdominal pain with or without vaginal bleeding What are the signs and symptoms of a Hydatiform Mole or Molar Pregnancy? - Uterine size increasing abnormally fast, abnormally high levels of hCG, nausea and increased emesis, no fetus present on ultrasound, and scant or profuse dark brown or red vaginal bleeding What are the signs and symptoms of Placenta previa? - Painless vaginal bleeding in the 3rd trimester What are the signs/symptoms of Abruptio placentae? - Vaginal bleeding, sharp abdominal pain, and tender rigid uterus What are the s/s with recurrent premature dilation of the cervix? - Painless bleeding with cervical dilation leading to fetal expulsion What are the s/s with preterm labor? - Pink-stained vaginal discharge, uterine contractions becoming regular, cervical dilation and effacement Spontaneous abortion (miscarriage) - When a pregnancy is terminated before 20 weeks of gestation (the point of fetal viability) or a fetal weight less than 500 g. Types of Spontaneous abortion (miscarriage) - threatened, inevitable, incomplete, complete, and missed. What are the risk factors for Spontaneous abortion (miscarriage) ? - ● Chromosomal abnormalities (account for 50%) ● Maternal illness, such as type 1 diabetes mellitus ● Advancing maternal age ● Premature cervical dilation ● Chronic maternal infections ● Maternal malnutrition ● Trauma or injury ● Anomalies in the fetus or placenta ● Substance use ● Antiphospholipid syndrome What are the assessment data for a THREATENED spontaneous abortion? - With or without slight cramps Spotting to moderate bleeding No tissue is passed Cervical opening is closed What are the assessment data for an INEVITABLE spontaneous abortion? - Moderate cramps Mild to severe bleeding No tissue is passed Cervical opening is dilated with membranes or tissue bulging at cervix What are the assessment data for an INCOMPLETE spontaneous abortion? - Severe cramps Bleeding is severe and continuous Partial fetal tissue or placenta is passed Cervical opening is dilated with tissue in cervical canal or passage of tissue What are the assessment data for a MISSED spontaneous abortion? - No cramps Bleeding consists of brownish discharge No tissue is passed and there is prolonged retention of tissue Cervical opening is closed What are the assessment data for a spontaneous abortion that is SEPTIC? - Intensity of cramps varies ...................