Complications of pregnancy Essay Example | Topics and Well Written Essays - 1250 words

Complications of pregnancy - Essay Example Delayed menstruation for 1-2 weeks followed by spotting or bleeding is a typical sign of ectopic pregnancy. Gastrointestinal problems may also occur along with lightheadedness and dizziness. Yet if tubal pregnancy remains undetected for 4-6 weeks after conception, the fallopian tube becomes more distended and can rupture leading to symptoms like excruciating abdominal pain, nausea, vomiting and faintness. In some cases, the patient may go into shock or rapid pulse, decreased blood pressure, restlessness, sweating may lead to hemorrhage (Smeltzer, 2009). Adnexal mass might be found upon pelvic examination along with tenderness (Doherty, 2010). Complications/risks: Failure to diagnose ectopic pregnancy especially in patients with few symptoms can increase the risk of internal bleeding which can result in hemorrhage or shock. Management: Treatment choices include surgical intervention either laparotomy or laparoscopy and medication. Surgical management may be salpingectomy (removing the concerned fallopian tube) or salpingostomy (preserving the affected tube) depending on patient’s wish. However, salpingostomy increases the risk of persistent trophoblast and ectopic pregnancy whereas salpingectomy avoids these risks but only one tube remains with reproductive ability. Non-surgical medication treatment includes the use of anti-cancer drug methotrexate (Tembhare, 2010) which can be administered intravenously or intramuscularly (Wolfson, 2009). Delivery before 37th week of pregnancy is classified as pre-term labor (WHO, 1994). Clinical presentations: Clinical signs of preterm labor include uterine contractions, menstrual like cramps, diarrhea, back-ache, pelvic pressure, increased vaginal discharge(Littleton, Engebretson, 2002)vaginal bleeding, ruptured membranes, initial cervical dilation greater than 3 cm and contraction frequency of 4 per hour or more (Creasy, Resnik and lams, 2004). Complications/risks: Risk factors to the mother are largely associated with tocolytic agents used in treatment. Respiratory depression/arrest, pulmonary edema, hypotension and cardiac arrest are complications associated with administration of magnesium; similarly, terbutaline may induce hyperglycemia, hypokalemia and myocardial ischemia. Other drugs (nifedipine and indomethacin) may produce side effects like gastrointestinal problems, renal failure and hepatitis (Littleton, Engebretson, 2002). Neonatal may suffer from renal dysfunctions, nec rotizing enterocolitis, patent ductus arteriosus, intracranial hemorrhage preterm deliveries. Management: Obstetric practices for averting preterm labor include bed rest, home uterine activity monitoring, sedation and hydration, however, little evidence is present about success rates of these methods (Goldenberg, 2002). Tocolytic therapy is used for the hindering uterine contractions which include calcium channel blockers (nicardipine, nifedipine), magnesium, ?-mimetics (terbutaline, fenoterol etc.), non-steroidal anti-inflammatory agents (indomethacin) and ethanol. Evidence suggests that tocolytic therapy is significant in preventing preterm labor (Berkman et al., 2003 ). In addition, cervical cerclage is employed where cervical incompetence is found, in which a suture (rescue cerclage) is placed to prevent further dilations. Management of preterm labor includes avoiding neonatal complications through use of corticosteroids and antibiotics to prevent traumatic delivery and streptoc occal neonatal sepsis (Goldenberg, 2002) Pre-eclampsia is a condition in which pregnant patient experiences a triad of