NUR 410 Nursing Care in Maternity: Managing
Complications in Pregnancy
Leading cause of maternal death globally
During reproductive years, the endometrium has menstrual cycles, in which there is
tissue breakdown then repair, allowing embryo implantation. During ovulation, an ovum
is released from the ovary into the fallopian tubes, where it is ready to be fertilized. The
endometrium is thick at this time in preparation for the fertilized egg to implant. If there
is no implantation, the endometrium will shed during a menstrual cycle.
endometrium
Innermost layer of the uterus that thickens before ovulation to receive a fertilized egg
and support the placenta. If contraception does not occur, the buildup of the lining is
shed, and a menstrual period occurs.
During reproductive years, the endometrium has menstrual cycles, in which there is
tissue breakdown then repair, allowing embryo implantation. During ovulation, an ovum
is released from the ovary into the fallopian tubes, where it is ready to be fertilized. The
endometrium is thick at this time in preparation for the fertilized egg to implant. If there
is no implantation, the endometrium will shed during a menstrual cycle.
embryo
The term used for an egg fertilized by sperm when it implants in the uterus.
ovum
Egg released by female ovaries.
If the egg is fertilized by sperm, a zygote is formed, marking the beginning of pregnancy.
After fertilization, smooth muscle contraction and ciliary movement in the fallopian tubes
help transport the embryo to the uterus. The fertilized egg goes through many cellular
divisions, in which it becomes a blastocyst. In a healthy pregnancy, the blastocyst
implants into the endometrium. Once there is implantation, human chorionic
,gonadotropin (hCG) is secreted, which sustains the corpus luteum. The corpus luteum
produces estrogen and progesterone, allowing the pregnancy to continue and the
placenta to form. The cells divide and begin to form the embryo. In a healthy pregnancy,
genetic material creates 46 chromosomes in the embryo. blastocyst
A cluster of dividing cells made by a fertilized egg, which is the early stage of
an embryo. human chorionic gonadotropin (HCG) –
A hormone that is produced by the placenta during pregnancy and can be detected
in maternal serum. corpus luteum
A structure that develops in an ovary where ovulation took place that secretes estrogen
and progesterone until the placenta takes over.
There are approximately 38 weeks from implantation to delivery of the full-term fetus.
The fetus develops in the uterus and then is delivered through the vagina. The cervix
connects the uterus to the vagina, a canal made of connective tissue, smooth muscle
fibers, blood vessels, and elastic fibers. The cervix is usually slightly over 2 cm long and
has an internal cervical os, where the uterus attaches to the cervix, and an external
cervical os, where the cervix connects to the vagina. The cervix should remain firm,
closed, and greater than 25 mm in length throughout pregnancy until the client is close
to delivering the baby. During labor, the cervix becomes shorter and thinner, and dilates
to deliver the fetus.
internal cervical os
Opening of the cervix at the uterus.
external cervical os
Also known as endocervical canal, it is the passage that connects the vagina to the
uterus.
A nurse is teaching a group of students about pregnancy. Which of the following is
accurate and should be included in the teaching?
The corpus luteum produces estrogen and progesterone.
In addition to the reproductive system, a pregnant client's hemostatic system will also
undergo changes. The hemostatic system of the body is responsible for clot formation
,via complex interactions between coagulation factors (such as protein S and
antithrombin), platelets, and the vascular endothelium. The body's fibrinolytic system
helps prevent excessive coagulation by removing fibrin and causing clot dissolution.
Pregnant clients are complex because pregnancy is a prothrombotic state in which
there is a shift in the balance between hemostatic and fibrinolytic systems to help
prevent excessive hemorrhage during placental separation during delivery. The
prothrombotic state occurs because pregnant clients have an increase in some
coagulation factors, reduced fibrinolysis, and increased platelet reactivity.
prothrombotic state
A blood condition that increases the risk of clots to form in blood vessels.
fibrinolysis
A process that prevents clots from forming or breaks down clots that formed.
Pathophysiology
Spontaneous abortion—which is sometimes referred to as miscarriage, especially in
therapeutic communication with clients—is common. It may occur when there is
chromosomal instability in the embryo prior to implantation or due to the inability of the
endometrium to complete correct implantation. There are various types of spontaneous
abortions: threatened abortion, inevitable abortion, incomplete abortion, complete
abortion, septic abortion, and missed abortion. spontaneous abortion
Spontaneous pregnancy loss that occurs prior to 20 weeks gestation.
threatened abortion
The products of conception are threatened with expulsion through uterine cramping and
bleeding. The embryo continues to be viable, and the cervix remains closed. inevitable
abortion
The products of conception have not passed through the client’s dilated cervix;
abortion is unavoidable. incomplete abortion
, A partial passing of the products of conception from the cervical os. complete
abortion
All products of conception have been completely expelled.
septic abortion
Occurs when products of conception are retained and become infected. missed
abortion
Passage of some products of conception. The cervix is closed, but there is no fetal
cardiac activity.
Once the fetus is not viable, the cervix will dilate to dispel the products of conception, or
medical management may be necessary to dilate the cervix to remove the products of
conception. products of conception
Fetal or placental tissue.
Epidemiology
Estimates show that spontaneous abortions end as many as 26% of pregnancies.
Spontaneous abortion may occur prior to the client even knowing they were pregnant,
but of known pregnancies, up to 10% end in spontaneous abortion.
A nurse is caring for a client who has had a spontaneous abortion. Which of the
following is a possible cause of spontaneous abortions?
Chromosomal instability
Etiology and Risk Factors
The cause of spontaneous abortion varies and is not always known. Fetal chromosomal
anomalies cause approximately 50% of all spontaneous abortions, but many other
losses occur too early to determine a cause. The chance of having a spontaneous
Complications in Pregnancy
Leading cause of maternal death globally
During reproductive years, the endometrium has menstrual cycles, in which there is
tissue breakdown then repair, allowing embryo implantation. During ovulation, an ovum
is released from the ovary into the fallopian tubes, where it is ready to be fertilized. The
endometrium is thick at this time in preparation for the fertilized egg to implant. If there
is no implantation, the endometrium will shed during a menstrual cycle.
endometrium
Innermost layer of the uterus that thickens before ovulation to receive a fertilized egg
and support the placenta. If contraception does not occur, the buildup of the lining is
shed, and a menstrual period occurs.
During reproductive years, the endometrium has menstrual cycles, in which there is
tissue breakdown then repair, allowing embryo implantation. During ovulation, an ovum
is released from the ovary into the fallopian tubes, where it is ready to be fertilized. The
endometrium is thick at this time in preparation for the fertilized egg to implant. If there
is no implantation, the endometrium will shed during a menstrual cycle.
embryo
The term used for an egg fertilized by sperm when it implants in the uterus.
ovum
Egg released by female ovaries.
If the egg is fertilized by sperm, a zygote is formed, marking the beginning of pregnancy.
After fertilization, smooth muscle contraction and ciliary movement in the fallopian tubes
help transport the embryo to the uterus. The fertilized egg goes through many cellular
divisions, in which it becomes a blastocyst. In a healthy pregnancy, the blastocyst
implants into the endometrium. Once there is implantation, human chorionic
,gonadotropin (hCG) is secreted, which sustains the corpus luteum. The corpus luteum
produces estrogen and progesterone, allowing the pregnancy to continue and the
placenta to form. The cells divide and begin to form the embryo. In a healthy pregnancy,
genetic material creates 46 chromosomes in the embryo. blastocyst
A cluster of dividing cells made by a fertilized egg, which is the early stage of
an embryo. human chorionic gonadotropin (HCG) –
A hormone that is produced by the placenta during pregnancy and can be detected
in maternal serum. corpus luteum
A structure that develops in an ovary where ovulation took place that secretes estrogen
and progesterone until the placenta takes over.
There are approximately 38 weeks from implantation to delivery of the full-term fetus.
The fetus develops in the uterus and then is delivered through the vagina. The cervix
connects the uterus to the vagina, a canal made of connective tissue, smooth muscle
fibers, blood vessels, and elastic fibers. The cervix is usually slightly over 2 cm long and
has an internal cervical os, where the uterus attaches to the cervix, and an external
cervical os, where the cervix connects to the vagina. The cervix should remain firm,
closed, and greater than 25 mm in length throughout pregnancy until the client is close
to delivering the baby. During labor, the cervix becomes shorter and thinner, and dilates
to deliver the fetus.
internal cervical os
Opening of the cervix at the uterus.
external cervical os
Also known as endocervical canal, it is the passage that connects the vagina to the
uterus.
A nurse is teaching a group of students about pregnancy. Which of the following is
accurate and should be included in the teaching?
The corpus luteum produces estrogen and progesterone.
In addition to the reproductive system, a pregnant client's hemostatic system will also
undergo changes. The hemostatic system of the body is responsible for clot formation
,via complex interactions between coagulation factors (such as protein S and
antithrombin), platelets, and the vascular endothelium. The body's fibrinolytic system
helps prevent excessive coagulation by removing fibrin and causing clot dissolution.
Pregnant clients are complex because pregnancy is a prothrombotic state in which
there is a shift in the balance between hemostatic and fibrinolytic systems to help
prevent excessive hemorrhage during placental separation during delivery. The
prothrombotic state occurs because pregnant clients have an increase in some
coagulation factors, reduced fibrinolysis, and increased platelet reactivity.
prothrombotic state
A blood condition that increases the risk of clots to form in blood vessels.
fibrinolysis
A process that prevents clots from forming or breaks down clots that formed.
Pathophysiology
Spontaneous abortion—which is sometimes referred to as miscarriage, especially in
therapeutic communication with clients—is common. It may occur when there is
chromosomal instability in the embryo prior to implantation or due to the inability of the
endometrium to complete correct implantation. There are various types of spontaneous
abortions: threatened abortion, inevitable abortion, incomplete abortion, complete
abortion, septic abortion, and missed abortion. spontaneous abortion
Spontaneous pregnancy loss that occurs prior to 20 weeks gestation.
threatened abortion
The products of conception are threatened with expulsion through uterine cramping and
bleeding. The embryo continues to be viable, and the cervix remains closed. inevitable
abortion
The products of conception have not passed through the client’s dilated cervix;
abortion is unavoidable. incomplete abortion
, A partial passing of the products of conception from the cervical os. complete
abortion
All products of conception have been completely expelled.
septic abortion
Occurs when products of conception are retained and become infected. missed
abortion
Passage of some products of conception. The cervix is closed, but there is no fetal
cardiac activity.
Once the fetus is not viable, the cervix will dilate to dispel the products of conception, or
medical management may be necessary to dilate the cervix to remove the products of
conception. products of conception
Fetal or placental tissue.
Epidemiology
Estimates show that spontaneous abortions end as many as 26% of pregnancies.
Spontaneous abortion may occur prior to the client even knowing they were pregnant,
but of known pregnancies, up to 10% end in spontaneous abortion.
A nurse is caring for a client who has had a spontaneous abortion. Which of the
following is a possible cause of spontaneous abortions?
Chromosomal instability
Etiology and Risk Factors
The cause of spontaneous abortion varies and is not always known. Fetal chromosomal
anomalies cause approximately 50% of all spontaneous abortions, but many other
losses occur too early to determine a cause. The chance of having a spontaneous
