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is a severe form of morning sickness, with "unrelenting, excessive pregnancy-related nausea and/or vomiting
that prevents adequate intake of food and fluids."

TREATMENT

First-line treatment often involves rest and avoidance of sensory stimuli that may act as triggers. Frequent
small meals with avoidance of spicy or fatty foods and increasing high-protein snacks are recommended.

Ä Replace fluids and administer antiemetics, if required. Normal saline or Lactated Ringer solution is
recommended.
Ä Consider the addition of glucose, multivitamins, magnesium, pyridoxine, and/or thiamine. For any
patient in whom vitamin deficiency is a concern, thiamine 100 mg should be given before initiating
dextrose-containing fluids.
Ä Dextrose solutions may stop fat breakdown.
Ä Continue treatment until the patient can tolerate oral fluids and until test results show little or no
ketones in the urine.

SOME ANTI EMETIC First-line treatment often involves rest and avoidance of sensory stimuli that may act as
triggers. Frequent small meals with avoidance of spicy or fatty foods and increasing high-protein snacks are
recommended.

Ä Replace fluids and administer antiemetics, if required. Normal saline or Lactated Ringer solution is
recommended.
Ä Consider the addition of glucose, multivitamins, magnesium, pyridoxine, and/or thiamine. For any
patient in whom vitamin deficiency is a concern, thiamine 100 mg should be given before initiating
Ä Continue treatment until the patient can tolerate oral fluids and until test results show little or no
ketones in the urine.

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- is a complication of pregnancy in which the pregnancy implants outside the uterine cavity.[1] With rare
exceptions, ectopic pregnancies are not viable. Furthermore, they are dangerous for the mother,
internal bleeding being a common complication. Most ectopic pregnancies occur in the Fallopian tube
(tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. An ectopic
pregnancy is a potential medical emergency, and, if not treated properly, can lead to death.

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Early treatment of an ectopic pregnancy with methotrexate is a viable alternative to surgical treatment since at
least 1993.] If administered early in the pregnancy, methotrexate terminates the growth of the developing
embryo; this may cause an abortion, or the tissue may then be either resorbed by the woman's body or pass
with a menstrual period.


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If hemorrhage has already occurred, surgical intervention may be necessary. However, whether to pursue
surgical intervention is an often difficult decision in a stable patient with minimal evidence of blood clot on
ultrasound.


- Molar pregnancy is an abnormal form of pregnancy, wherein a non-viable, fertilized egg implants in the
uterus, and thereby converts normal pregnancy processes into pathological ones. It is characterized by
the presence of a hydatidiform mole (or hydatid mole, mola hydatidosa). Molar pregnancies are
categorized into partial and complete moles.

TREATMENT

- Hydatidiform moles should be treated by evacuating the uterus by uterine suction or by surgical
curettage as soon as possible after diagnosis, in order to avoid the risks of choriocarcinoma. Patients
are followed up until their serum human chorionic gonadotrophin (hCG) level has fallen to an
undetectable level. Invasive or metastatic moles (cancer) may require chemotherapy and often
respond well to methotrexate. The response to treatment is nearly 100%. Patients are advised not to
conceive for one year after a molar pregnancy. The chances of having another molar pregnancy are
approximately 1%.

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- It is a medical condition in which a pregnant woman's cervix begins to dilate (widen) and efface (thin)
before her pregnancy has reached term. Cervical incompetence may cause miscarriage or preterm
birth during the second and third trimesters.
- In a woman with cervical incompetence, dilation and effacement of the cervix may occur without pain
or uterine contractions. In a normal pregnancy, dilation and effacement occurs in response to uterine
contractions. Cervical incompetence occurs because of weakness of the cervix, which is made to open
by the growing pressure in the uterus as pregnancy progresses. If the responses are not halted,
rupture of the membranes and birth of a premature baby can result.
Risk factors for premature birth or stillbirth due to cervical incompetence include

- diagnosis of cervical incompetence in a previous pregnancy,

- previous preterm premature rupture of membranes,
- history of conization (cervical biopsy),
- diethylstilbestrol exposure, which can cause anatomical defects, and
- uterine anomalies.

Treatment

- Cervical incompetence is not generally treated except when it appears to threaten a pregnancy.
Cervical incompetence can be treated using cervical cerclage, a surgical technique that reinforces the
cervical muscle by placing sutures above the opening of the cervix to narrow the cervical canal.
- Cerclage procedures usually entail closing the cervix through the vagina with the aid of a speculum.
Another approach involves performing the cerclage through an abdominal incision. Transabdominal
cerclage of the cervix makes it possible to place the stitch exactly at the level that is needed. It can be
carried out when the cervix is very short, effaced or totally distorted. Cerclages are usually performed
between weeks 14 and 16 of the pregnancy. The sutures are removed between weeks 36 and 38 to
avoid problems during labor. The complications described in the literature have been rare: hemorrhage
from damage to the veins at the time of the procedure; and fetal death due to uterine vessels
occlusion.

  
 
 
- Also known as Miscarriage, that it may be due to chromosomal or uterine abnormalities.
- It is a pregnancy that ends spontaneously prior to age of viability because of natural causes.
- Usually ends within the first 20wks of gestation.

This is r/t abnormal fetal development secondary to:

- Teratogenic factor or chromosomal aberations (eg. Trisomy 21)

- Implantation abnormalities
- Inadequate progesterone
- Infection (rubella, rubeola, syphilis)
- Teratogenic drugs ( tetracycline, isotretinoin)

Manifestations

- Mild to severe back pain

- Vaginal spotting
- Weight loss
- True contractions every 5-20 minutes
- Sudden decrease is signs of pregnancy

Complications

- Hemorrhage
- Infection
- Septic Abortion
- Isoimmunization
- Powerlessness
- Recurrent pregnancy loss
Management

- Transvaginal Ultrasound to determine severity of condition

- Use Misoprostol to encourage completeness of miscarriage
- Dilatation and Curettage (D&C)


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- it is the premature separation of the placenta on the endometrial lining.
- Unknown Cause

It is related to the following:

- Hypertension
- Placental separation from uterus.

Sign and symptoms:

- Sharp abdominal pain followed by uterine tenderliness

- Vaginal bleeding
- Signs of maternal shock
- Fetal distress

Interventions

- Treatment depends on the amount of blood loss and the status of the fetus. If the fetus is less
than 36 weeks and neither mother or fetus are in any distress, then they may simply be
monitored in hospital until a change in condition or fetal maturity whichever comes first.
- Immediate delivery of the fetus may be indicated if the fetus is mature or if the fetus or mother
are in distress.

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- is an obstetric complication in which the placenta is attached to the uterine wall close to or
covering the cervix. It can sometimes occur in the later part of the first trimester, but usually
during the second or third. It is a leading cause of antepartum haemorrhage (vaginal
bleeding). It affects approximately 0.5% of all labours.

Causes:

- Low implantation of the placenta possibly due to uterine abnormalities

- Placenta is covering the cervix

Signs and Symptoms:

- Painless
- Bleeding at the beginning of cervical dilatation
Interventions:

- No Vaginal exams to minimize trauma

- Blood replacement if blood loss is at large.
- Complete bed rest


 






- Rupture of fetal membranes with loss of amniotic fluid that occurs earlier than the expected
date of delivery.

Manifestations:

- Sudden gush of clear white fluid

- Positive for nitrezine test (Blue reaction)
- Positive ferning test
- Possible infection ( Positive culture test)

Complications:

- Infection
- Increase pressure on the umbilical cord from loss of amniotic fluid inhibiting fetal nutrition
supply
- Cord prolapse
- Pre-term labor

Management:

- Complete bed rest

- Administer antibiotics as prescribed
- Corticosteroid to accelerate fetal lung maturity after preterm 
- Monitor for infection
- Provide support and reassurance
- Provide adequate information and answer questions accordingly.


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- Acute hypertensive state that develops afeter 20th week of gestation.

Manifestations:

Ä Preeclampsia (Mild)
O BP of 140/90 mmHg or increase of 30/15 mmHg 2+ to 3+ proteinuria.
O Begins past 20th week
O Slight generalized edema, weight gain may be present
Ä Preeclampsia (Severe)
O BP of 150-160 / 100-110 mmHg on at least 2 occasion 6 hours apart at bed rest
O 4+ proteinuria
O Headache, epigastric pain
 Ä Eclampsia
O Hypertension
O Proteinuria
O Convulsions
O Unconsciousness

Complications:

Ä Abruptio Placenta
Ä Disseminated intravascular coagulation
Ä Thrombocytopenia
Ä Placental Insufficiency
Ä Intrauterine fetal death

Management:

Ä Promote Bed rest

Ä Good nutrition
Ä Provide emotional support
Ä Monitor maternal well being
Ä And fetal well being
Ä Administer medications (magnesium sulfate, Hydralazine)
Ä Provide care during seizures
Ä Monitor for postpartal hypertension for Eclampsia


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In Partial Fulfillment of the Requirements

In the Subject

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Janssen Vernis P. Guzman

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Miss Blezy Ann Corbillon

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November 17,2010