Download High Risk Pregnancy revised 15

Identifying the High Risk
Pregnancy
A concurrent disorder, pregnancy-related
complication, or external factor
jeopardizes the health of the mother, fetus
or both
Objectives
When dealing with a High risk pregnant
woman, what factors must be considered
for a healthy outcome?
Describe three bleeding disorders that
place a woman at high risk.
Explain why and how a woman with
Diabetes is monitored during pregnancy.
Compare and contrast the importance of
Blood Pressures with PIH and HELLP.
Why is the RH factor an issue?
Diabetes Mellitus
n
n
n
n
Classification of diabetes mellitus
Assessment
Monitoring
Education
1st Trimester Bleeding
Spontaneous miscarriage
Threatened
Imminent
Complete
Incomplete
Missed
1st Trimester Bleeding
n
n
Ectopic pregnancy
Abdominal pregnancy
2nd Trimester Bleeding
Gestational trophoblastic disease
(Hydatidform mole)
Premature cervical dilatation
Cervical Cerclage
3rd Trimester Bleeding
Placenta Previa
Low implantation of placenta
Placenta Abruptio
Premature Rupture of
Membranes (PROM)
Before 37 weeks gestation
Associated with chorioamnionitis
Complications
Assessment
Management
Preterm Labor
Labor that occurs before the end of the
37th week of gestation
9-11% of all pregnancies
2/3 of all infant deaths
Management
Preterm Labor Drug
Administration
Antibiotics
Tocolytics
Steroids
Magnesium sulfate
Pregnancy-Induced Hypertension
(PIH)
n
Vasospasm occurs during pregnancy
General Symptoms
Hypertension
Proteinuria
Edema
n
Causes
n
n
n
n
PIH (Pregnancy Induced
Hypertension)
Gestational hypertension
Old term “Toxemia”)
Mild preeclampsia
Severe preeclampsia
Eclampsia
Gestational Hypertension
No Proteinuria
BP returns to normal after delivery
Chronic HTN may develop later in life
Mild Preeclampsia
BP elevated
Protein in urine
Mild edema
Severe PRE Eclampsia
Increase BP
Proteinuria
Oliguria
Cerebral Involvement
Extensive Edema
Double vision
Epigastric pain
Eclampsia
Seizures
Thrombocytopenia
Nursing Interventions
Rest
Good Nutrition
Emotional Support
HELLP Syndrome
rare complication
Hemolysis
Elevated
Liver Enzymes
Low
Platelets
Isoimmunization
(Rh Incompatibility)
Rh-negative mother is carrying a fetus
with Rh-positive blood
Hemolytic disease of the newborn
Assessment
Management
Medications
n
n
n
n
n
n
Terbutaline
Mag Sulfate
Apresoline
Valium
Methotrexate
Misoprostol