obstetric emergencies/delivery
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why is pregnancy unique
deals with at least 2 patients’ concerns at one time
where does pregnancy begin
conception (egg & sperm together)
what happens after conception
gestation (fertilize)
when does placental formation develop
~2 weeks
how long is fetus development
~38 weeks
how long is a normal pregnancy
3 trimesters/ 39-42 weeks
when is a fetus considered viable
24 weeks
what type of PHx help determine problems with patient
pregnancies (gravida) and previous births (para)
what is the most common cause of bleeding in the first and second trimesters of pregnancy
spontaneous abortion
what happens during spontaneous abortion
body rejects developing fetus and miscarries prior to 20 week gestation period
S/S of spontaneous abortion
• abdominal cramping & backaches • vaginal bleeding w/ passage of clots and tissue • fetus passage • possible s/s of sepsis if incomplete abortion • s/s of shock
what happens during an ectopic pregnancy
embryo implants outside of uterus (fallopian tube) and prevents fetal development past ~8 weeks
risk factors of ectopic pregnancies
• PID • endometriosis • tubal surgery • IUD birth control
s/s of ectopic pregnancy
• severe abd pain in lower abd • short brown menstrual flow • intra-abd bleeding • rigid & distented abd • syncope • vaginal bleeding • s/s of shock
what is abruptio placenta
premature separation of the placenta from the wall of the uterus and most commonly occurs in the 3rd trimester
what are the common causes of abruptio placenta
• maternal hypertension • trauma • drug abuse
s/s of abruptio placenta
• !!painful vaginal bleeding during 3rd trimester!! • s/s of shock • positive orthostatic test • ridged tender uterus • Grey Turner Sign • Cullen Sign • no longer feels fetus movements • loss of FHT
what happens during placenta previa
placenta is implanted low in the uterus obstructing the cervical canal
what is the leading cause of bleeding in the 3rd trimester
placenta previa
what kind of patients are at risk of placenta previa
women over 30 and women expecting multiples
s/s of placenta previa
• !!painless vaginal bleeding during 3rd trimester!! • fetal movement continues • FHT remains • uterus is soft and un-rigid