Page 672 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 22

Risk Conditions Related to Pregnancy

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Priority Concepts
Reproduction, Safety

I. Bleeding During Pregnancy
A. Implantation bleeding: Bleeding that occurs 10 to 14 days after
conception. Usually lasts 1 to 2 days and is lighter than the typical
menstrual period. Often confused with a normal menstrual period.
No treatment is necessary.
B. Other causes include abortion, malignancy, polyps, trauma,
ectopic pregnancy, idiopathic, infection, molar pregnancy,
subchorionic hemorrhage, vaginitis, urinary tract infection,
cervicitis, cervical polyps, postcoital bleeding, placenta previa, and
abruptio placentae.
II. Abortion
A. Description: A pregnancy that ends before 20 weeks’ gestation,
spontaneously or electively
B. Types (Box 22-1)
C. Risk factors
1. Advanced maternal age
2. Those who have experienced a previous miscarriage
are at a higher risk
3. Previous elective abortion
4. Uterine abnormalities such as adhesions or fibroids
5. Prolonged time to achieve pregnancy
6. Low serum progesterone
7. Celiac disease
8. Polycystic ovarian syndrome
9. Thyroid dysfunction or Cushing’s syndrome
10. Systemic lupus erythematosus
11. Infection, fever, trauma
12. Low body mass index (BMI), less than 18.5
13. Smoking, alcohol, cocaine use, certain medications,
high caffeine intake
D. Assessment
1. Spontaneous vaginal bleeding
2. Low uterine cramping or contractions
3. Blood clots or tissue through the vagina

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