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Pregnancy Potential Problems (younger than age 18) - SOLUTION-Late to prenatal
care
-Late to prenatal care
-2 Xs rate of Low Birth Weight & SGA infants
-3 Xs infant mortality
-Preterm labor
-Preeclampsia
-Anemia
-STDs, especially Chlamydias
-Substance abuse (binge drinking)
,Psychosocial Potential Problems due to Teen Pregnancy - SOLUTION--Limited education
-Persistence of poverty
-Unstable family structure
-Poor parenting
-Repeated pregnancy
Causes of benign abdominal pain - SOLUTION-1. Round ligament pain
2. Constipation
3. Bloating
4. Braxton-hicks contractions
5. Heartburn
6. Corpus luteum cyst
Round Ligament Pain - SOLUTION-• D/t stretching of ligaments supporting uterus.
• They become thin and stretched like rubber bands
• Brief, sharp, or dull ache, unilateral or bilateral
• Occurs in 2nd trimester most commonly when sudden change of position, coughing, rolling over In bed
• RX = apply heat to area, bend knees to chest to shorten ligament, change position slowly, reassurance
of normalcy
Constipation - SOLUTION-• Caused by progesterone slowing GI motility
,• Occurs in 50% of pregnant women
• Can cause cramping
• RX = high fiber diet, exercise, increase fluids, prunes, eliminate iron supplements, OTC bulking agent
like Metamucil
• No laxatives
Bloating - SOLUTION-• Caused by increased gas formation d/t decreased GI motility
• Can be sharp, severe, one sided, short-lived, or lasting for awhile
• Check for lactose intolerance in African American Women
• RX = side lying to allow gas to pass, decrease gas forming foods, exercise to increase GI motility &
regularity
Braxton-Hicks Contractions - SOLUTION-• Most often 3rd trimester
• Abdomen tight, can be uncomfortable
• Occurs at regular intervals with rest between
• RX = hydration, rest, reassurance of normalcy
Heartburn (pyrosis) - SOLUTION-• GERD (gastroesophogeal reflux disease) or
"heartburn" in pregnancy is common
• Due to progesterone relaxation of esophageal sphincter & delayed gastric emptying (hence, not really a
disease)
• Pain after meals, located in the substernum epigastric area
• RX = watch food choices, antacids, reassurance of normalcy (Review NM617 & Varney for complete
picture)
Corpus luteum cyst - SOLUTION-• Corpus luteum makes progesterone to support pregnancy
• Usually resolve early 2nd trimester without problem
• May see this on early USN, can be 2cm-6cm
• Sometimes cyst will rupture causing several hours of pain
, • Usually resolves quickly, no residual problem
Causes of Abnormal Abdominal Pain - SOLUTION-• Miscarriage
• Ectopic pregnancy
• Preterm labor
• Placental abruption
• UTI
• Appendicitis
• Intestinal obstruction
• Cholecystitis
• HELLP syndrome
Miscarriage - SOLUTION-• Occurs primarily 1st trimester
• Sensation of intermittent uterine cramping, colicky, increasing in severity over time • Accompanied by
bleeding
Ectopic Pregnancy - SOLUTION-• Symptoms present primarily between 6-9 weeks gestation
• Unilateral sharp pain, can be intermittent or constant (rupture)
• Perceived higher than round ligament pain
• 50% of women with ectopic will also have bleeding
Preterm Labor - SOLUTION-• Most often 3rd trimester
• Pain most often above pubic bone (cervix) occurring at regular intervals (though can be perceived as
back pain)
• Increasing in severity over time
• May see increased vaginal discharge
• Accompanied by cervical change