Pregnancy Related Concerns
Pregnancy Related Concerns
Pregnancy Related Concerns
and
Pre-natal Care
Ovulation
Hormones rises
Progesterone
Fertilization
Cells continue to divide
implantation
Pregnancy
Fetal Development
Fetal Development
1. Pre-embryonic stage
zygote – fertilized ovum
Fetal Development
2. Embryonic (3rd to 8th week)
Germ layers:
a. Ectoderm
b. Mesoderm
c. Endoderm
Fetal Development
3. Fetal stage - fetus
Biopsychosoci
al
aspect of
pregnancy
3 signs of pregnancy
Presumptive
signs
Probable
signs
Positive
signs
First trimester
Presumptive signs
Breast changes
Urinary frequency
Fatigue and discomfort
Amenorrhea
Morning sickness
Enlarged uterus
First trimester
Probable signs
Goodells sign – softening of the cervix
Chadwick sign – bluish discoloration of
vagina
Hegar sign – softening of isthmus
Elevated body temperature
First trimester
Positive sign
Ultrasound
Second trimester
Presumptive sign
Chloasma
Linea nigra
Striae
gravidarum
Quickening
Second trimester
Probable signs
Enlarged abdomen
Braxton-Hicks contraction
Second trimester
Positive sign
Fetal heart tone
Reproductive System
Changes
Chadwick - vagina
Goodells - cervix
Hegar - isthmus
Piskacek - uterus
Gastrointestinal System changes
Morning
sickness
Heart burn and
flatulence
Bloating and
constipation
Musculoskeletal System changes
Lordotic position
Waddling gait
Leg cramps
Health Teachings
Sexual activity
Privacy
Moderation
Comfortable position
No air during cunnilingus
Contraindicated:
Vaginal spotting
Preterm labor
Premature rupture of membrane
Health Teachings
Exercises
Squatting
Walking
Kegel’s exercise
Shoulder circling
Pelvic rocking
Complications
during
pregnancy
Abortion
Induced
Therapeutic
Illegal
Spontaneous
Complete
Incomplete
Threatened
Missed
Inevitable
Habitual
Abortion
Causes:
Certain viruses
Chromosomal abnormalities, luteal phase defects
Immunologic abnormalities
Major trauma
Uterine abnormalities (eg, fibroids)
Most often, the cause is unknown.
Risk factors include
Age > 35
History of spontaneous abortion
Cigarette smoking
Use of certain drugs (eg, cocaine, alcohol, high doses of caffeine)
A poorly controlled chronic disorder (eg, diabetes, hypertension) in
the mother
Ectopic pregnancy
Implantation outside the uterine cavity
CAUSES - unknown
Damaged fallopian tube
Risk Factors:
Current use of an intrauterine device(IUD)
History of pelvic inflammatory disease (PID)
Sexually-transmitted diseases such
as chlamydia and gonorrhea
Congenital abnormality (problem present at
birth) of the fallopian tube
Ectopic pregnancy
History of pelvic surgery (because
scarring may block the fertilized egg from
leaving the fallopian tube)
History of ectopic pregnancy
Unsuccessful tubal ligation (surgical
sterilization)
Use of fertility drugs
Ectopic pregnancy
Symptoms
Light vaginal bleeding
Nausea and vomiting with pain
Lower abdominal pain
Sharp abdominal cramps
Pain on one side of your body
Dizziness or weakness
Pain in your shoulder, neck, or rectum
If the fallopian tube ruptures, the pain and bleeding
could be severe enough to cause fainting
Hydatidiform mole
Hydatidiform mole, or molar
pregnancy, results from too much
production of the tissue that is
supposed to develop into the
placenta.
Signs and symptoms:
Hypertension
Swelling in the feet, ankles and legs in the first
trimester
Abnormal growth of the uterus, either bigger or
smaller than usual
Nausea and vomiting that may be severe enough to
require a hospital stay
Vaginal bleeding during the first 3 months of
pregnancy
Placenta previa
Placenta previa occurs
when a baby's placenta
partially or totally covers
the opening in the
mother's cervix
Placenta previa
Placenta previa is also
more common among
women who:
Have delivered at least
one baby
Had placenta previa with
a previous pregnancy
Are carrying more than
one fetus
Smoke
Use cocaine
Placenta previa
Signs and
symptoms:
Painless bright
red vaginal
bleeding
Effects
Bleeding. Severe, possibly
life-threatening vaginal
bleeding (hemorrhage) can
occur during labor, delivery or
the first few hours after
delivery.
Preterm birth. Severe
bleeding may prompt an
emergency C-section before
your baby is full term.
Gestational DM
Affects how your cells use sugar
(glucose)
Causes high blood sugar that can affect
your pregnancy and your baby's health.
san
Risk factors:
Diet
Overweight or obesity
Age greater than 25
Effects
Excessive birth weight.
Early (preterm) birth and respiratory
distress syndrome.
Low blood sugar (hypoglycemia)
Type 2 diabetes later in life.
Untreated gestational diabetes can
result in a baby's death either before or
shortly after birth.
Effects
Gestational diabetes may also
increase the mother's risk of:
High blood pressure and
preeclampsia
Future diabetes
s
during
labor and
delivery
Premature labor
20 weeks to 36 weeks
Signs and symptoms:
Regular or frequent contractions — a tightening
sensation in the abdomen
Constant low, dull backache
A sensation of pelvic or lower abdominal pressure
Mild abdominal cramps
Diarrhea
Vaginal spotting or bleeding
Watery vaginal discharge (water breaking) — in a gush
or a trickle
A change in vaginal discharge
Risk factors
Previous preterm labor or premature birth
Pregnancy with twins, triplets or other multiples
Certain problems with the uterus, cervix or
placenta
Smoking cigarettes or using illicit drugs
Certain infections, particularly of the genital tract
Some chronic conditions, such as high blood
pressure and diabetes
Being underweight or overweight before
pregnancy, or gaining too little or too much weight
during pregnancy
Risk factors
Stressful life events
Red blood cell deficiency (anemia), particularly
during early pregnancy
Too much amniotic fluid (polyhydramnios)
Pregnancy complications, such as preeclampsia
Vaginal bleeding during pregnancy
Presence of a fetal birth defect
Little or no prenatal care
An interval of less than six months since the
last pregnancy
Fetal effects
Low birth weight
Breathing difficulties
Underdeveloped organs
Vision problems
Premature rupture of membrane
water breaks before the 37th week of
pregnancy
Risk factors:
A history of preterm premature rupture
of membranes in a prior pregnancy
A genital tract infection
Vaginal bleeding during pregnancy
Smoking during pregnancy
A low body mass index
Effect
Potential complications
include:
maternal or fetal infection,
placental abruption
at risk of complications due to
premature birth
Prolapsed umbilical cord
The most common cause of an umbilical cord
prolapse is a premature rupture of the membranes
that contain the amniotic fluid.
Other causes include:
Premature delivery of the baby
Delivering more than one baby per pregnancy
(twins, triplets, etc.)
Excessive amniotic fluid
Breech delivery (the baby comes through the
birth canal feet first)
An umbilical cord that is longer than usual
Prolapsed umbilical cord
An umbilical cord prolapsed
presents a great danger to the
fetus. During the delivery, the
fetus can put stress on the cord.
This can result in a loss of oxygen
to the fetus, and may even result
in a stillbirth.
Cephalocaudal disproportion
occurs when a baby’s head or body is too large to fit
through the mother’s pelvis
Causes:
Large baby due to:
Hereditary factors
Diabetes