Maternal AND CHILD HEALTH NURSING LECTURE

PRE- GESTATIONAL CONDITIONS  The left ventricle can not move the blood forward that
 Blood volume and cardiac output increases by 30% it receives from the left atrium.
at 28 weeks of pregnancy  Systemic blood pressure decreases and
 Functional or transient murmurs are normal pulmonary hypertension occurs and pulmonary
 Heart palpitations may occur edema
 As systemic blood pressure decreases,
pressoreceptors are stimulated that increases HR
and causes Vasoconstriction in an attempt to
elevate BP

Common cardiovascular problems during pregnancy

 Valvular damage
 Congenital heart anomalies: problems of the heart
since birth

CLASSIFICATION OF HEART DISEASE

CLASS DESCRIPTION
CLASS 1 Uncompromised. No limitations on physical
activity. No symptoms of cardiac
insufficiency, no angina pain
CLASS 2 Slightly compromised. Slight limitation on
physical activity. Ordinary activity causes
fatigue. Palpitation dyspnea and angina pain
CLASS 3 Markedly compromised. Moderate
limitation of activities. Excessive palpitation,
fatigue, dyspnea and angina pain ↓

CLASS 4 Severely compromised. Unable to carry out Decrease Systemic blood pressure

physical activity. Exercise cardiac pulmonary hypertension occurs

insufficiency even at rest pulmonary edema

CARDIOVASULAR CIRCULATION Left Sided heart failure

S/Sx
 Productive cough with blood speckled sputum
 Increases RR, Heart rate
 Fatigue, weakness , dizziness. ( lack of O2)
 Orthopnea (difficulty breathing when in supine
position)
 Paroxysmal nocturnal dyspnea( sudden awakening
at night due to dyspnea)
 Thrombus formation due to blood stagnation in
the LA Left Sided Heart Failure

LEFT SIDED HEART FAILURE

 Mitral stenosis, mitral insufficiency, coarctation MANAGEMENT:

of the aorta 1. Antihypertensive drugs

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2. Diuretics to reduce blood volume  The output of the right ventricle is less than the blood
3. Beta blockers to improve ventricular filling volume received by the right atrium
4. Anticoagulant – thrombus formation  Back pressure and congestion of the systemic
5. Low sodium diet venous circulation
 Decrease cardiac output to the lungs
EFFECT on the FETUS:  High vena cava pressure and jugular distention
 Poor placental perfusion  Liver(hepatomegaly) and spleen(splenomegaly)
 Intrauterine growth restriction becomes distended (enlargement)
 Fetal mortality  Ascites (fluid collects in spaces within your
abdomen)
TREATMENT/MANAGEMENT  Edema occurs
 UTZ  Hypoperfusion (a reduced amount of blood flow)
 NST
 Balloon Valve Angioplasty MANAGEMENT
 Diuretics for edema
 Correct the problem before pregnancy

PERIPARTAL CARDIOMYOPATHY
 Rare condition that occurs late in pregnancy
 Unknown cause: r/t stress of pregnancy on the
circulatory system
 Heart muscles makes it harder to pump blood during
RIGHT SIDED HEART FAILURE pregnancy
Causes:  Mortality rate: 50%
 Pulmonary valve stenosis
 a narrowing of the valve located between the S/Sx:
lower right heart chamber (right ventricle) and  SOB / Shortness of breath
the lung arteries (pulmonary arteries).  Chest pain
 valve flaps (cusps) may become thick or stiff.  Edema
This reduces blood flow through the valve  Cardiomegaly (enlargement of the heart)
 Atrial septal defects
 A hole in the wall between the heart's two upper MANAGEMENT:
chambers  Reduce physical activity
 Ventricular septal defects  Diuretics
 a hole in the wall between the two lower  Digitalis (medicine that is used to treat certain
chambers heart conditions; increases the contractility of
the heart)
 If problem persist after the postpartum period,
succeeding pregnancy is discouraged. Heart
transplant might be needed.

NURSING MANAGEMENT OF PATIENTS WITH

CARDIOVASCULAR DISEASE
1. Closely asses maternal V/S and cardiopulmonary
status

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2. Question about increasing DOB, dyspnea, palpitation,

edema EFFECT:
3. Monitor FHR  Poor heart, kidney and/or placental perfusion
4. Monitor weight throughout pregnancy →miscarriage :<
5. Reinforce the use of medications
6. Alert patients of dangers signs MANAGEMENT:
7. Assess patients nutritional needs  Beta blockers and ACE inhibitors: causes
8. Encourage the need for frequent rest period peripheral dilation
9. Lateral recumbent or semi fowlers position  Methyldopa: antihypertensive (no effect to fetus;
10. Use of stool softener (valsalva maneuver= injury to drug of choice!!)
the heart) NOTE!!!
11. Prepare patient for labor. Use the low forcep delivery Constant ↑ BP → Constant hyperperfusion → Constant
12. During labor strictly assess maternal and fetal vital oxygen deprivation for the baby
signs
VENOUS THROMBOEMBOLYTIC DISEASE
NURSING INTERVENTION DURING LABOR AND  caused by stasis of blood in the lower extremities
BIRTH and hypercoagulation (effect of estrogen)
 Monitor FHT RESULTS TO:
 Monitor Vital signs, 100bpm HR indicates that heart  Blood stasis (stagnant blood)
is pumping ineffectively (normal range: 70-90 bpm)  Vessel damage
 Semi fowlers position for patient with pulmonary  Hypercoagulation (clotting)
edema  Deep Vein Thrombosis (DVT): formation of blood
 Patient should not push with contraction- clots in the veins of the lower extremities.
 Epidural anaesthesia is preferred  Do not massage pregnant women due to
 Low forceps or vacuum maybe used hypercoagulation!!
 Pain in the calf of the leg
POSTPARTUM NURSING INTERVENTION  Can result to pulmonary emboli
 Most critical time for the woman with heart disease  Do not use constrictive knee-high stockings
 Another 20-40% increase in the blood volume the  Not sitting with legs crossed
blood that should be supplied to the placenta is Diagnostic Exam:
released to the systemic circulation  Doppler Ultrasonography
 This rapid reaction takes place with 5 minutes
afterbirth MANAGEMENT:
 Use oxytocin with caution because they tend to  Bed rest
increase blood pressure  Heparin Subcutaneous injection (increases
 Breast feeding is not contraindicated, Kegel’s hemorrhage)
exercises can be done

A WOMAN WITH CHRONIC HYPERTENSIVE PULMONARY EMBOLISM

VASCULAR DISEASE  Chest pain
 With BP of 140/90mmHg  Sudden dyspnea
 HPN is associated with  Tachycardia
arteriosclerosis(development of fatty deposits  Hemoptysis
causing vasoconstriction→ hypertensive disease)  Dizziness and fainting
or renal disease (causes hypertension)
 Common in older women

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ANEMIA  prevention of neural tube defects

 Pseudoanemia (anemia during pregnancy)  seen in 1-5% of pregnancies
TRUE ANEMIA if:
Hgb: < 11 g/dL ( Hct: < 33% ) in the 1st trimester CAUSES:
Hgb: < 10.5 g/dl ( Hct: < 32% ) in the 2nd trimester  Multiple pregnancies
 Pregnant with secondary hemolytic problem
HEMATOLOGIC DISORDER AND PREGNANCY  Patient who are taking Hydantoin (anticonvulsant)
interferes with folic absorption
Types of anemias
1. Iron Defficiency Anemia EFFECT TO PREGNANCY:
 Most common:15-25 %  Premature separation of the placenta
 early miscarriage
CAUSES:
 Deficiency in iron (diet low in iron) MANAGEMENT:
 Heavy menstruation  400ug folic acid daily before pregnancy
 Unwise weight reduction program  600ug daily during pregancy
 Short period between pregnancies  folacin rich foods( green leafy vegetables, oranges,
 Low socio economic problem dried beans)
 low serum level < 30 ug/dl and an increase in iron  Lessens NEURAL TUBE & abdominal wall
binding capacity over 400 ug/dl DEFECTS
 IDA- Microcytic (small red blood cell)
 Hypochromic (less Hemoglobin) SICKLE CELL ANEMIA
 RBC are irregular and sickle- shaped
S/Sx:  RBC cannot carry needed oxygen
 Extreme fatigue  Recessively inherited hemolytic anemia (for
 Pallor homozygous)
 Poor exercise tolerance  Blood becomes viscous, clumping results causing
 PICA (eating disorder in which a person eats blood vessels blockage and decrease perfusion
things not usually considered food) toorgans
 hemolysis occurs thereby causing severe anemia
EFFECT TO THE FETUS: Incidence:
 Preterm and low birth weight  1 in every 10 African American has the recessive
genes
MANAGEMENT:
 Iron supplement - 27mg / day– take with vit C/
orange juice) (helps to absorb iron)
 Or 120-200 mg /day- anemia ( increase Hgb of3-4%
in 2 weeks) – ferrous sulfate/gluconate
 IM/IV dextran EFFECT TO PREGNANCY:
 Take foods high in iron- leafy vegetables, meat,  Prematurity / SGA due to IUGR
fruit, legumes (high fiber diet)  Miscarriage
 Iron causes constipation and makes the stool black  perinatal mortality

FOLIC ACID DEFICIENCY ANEMIA MANAGEMENT:

Folic Acid/ Folacin  Exchange transfusion throughout pregnancy
 a B vitamin needed for the formation of RBC  To replace sickled cells, Restore Hgb level

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 Administer O2 S/Sx OF INFLUENZA:

 Increase fluid volume to lower viscosity (hypotonic)  high fever
 extreme prostration
RENAL AND URINARY DISORDERS AND  aching pains in the back and extremities
PREGNANCY  sore throat

Urinary Tract Infection MANAGEMENT:

 In a pregnant woman, ureters dilate from the effect of  Antipyretic ( Tylenol)
progesterone that causes stasis of urine.  Antiviral drug ( Tamiflu)
 Causative agent: Escherichia coli
NOTE!!! PNEUMONIA
 If the infectious agent is determined to be  Bacterial or viral invasion of lung tissue by pathogens
Streptococcus B- vaginal culture should be obtained such as S. pneomoniae, haemophilus influenzae,
since this is associated with pneumonia in newborns and Mycoplasma Pneumoniae

ASSESSMENT:
 Frequency and pain on urination
 (+) pyelonephritis: (+) lumbar pain usually on the
right side that radiates downward
 Nausea and vomiting
 Malaise
 Pain
 Elevated temperature (39 – 40 degree Celsius)
 Urine culture result: over 100,000 organisms/ml of
urine – a level diagnostic of infection S/Sx:
 DOB
THERAPEUTIC MANAGEMENT:  Productive cough
 Amoxicillin, Ampicillin, Cephalosporins (DRUG OF  fever
CHOICE)
 Sulfonamides MANAGEMENT:
 can be used early in pregnancy but not near  Administer prescribed antibiotics
term because they can interfere with CHON  Oxygen administration
binding of bilirubin, which then leads to
hyperbilirubinemia in the newborn EFFECT ON PREGNANCY:
 Tetracyclines  Fetal growth restriction
→ Oxygen deficit
 Are contraindicated as they cause bone growth  Preterm delivery
retardation and staining of the deciduous teeth
EXAM!!!
RESPIRATORY DISORDERS AND PREGNANCY 1. A pregnant women is diagnosed with pneumonia
INFLUENZA bacterial in form. Which among the following would
 Causative Agent: Influenza virus A,B,C you expect the doctor include in order.
 Antibiotic for 7 days
Common colds: 2. A pregnant woman diagnosed with CF asked what
Nasopharyngitis: nasal congestion (elevated estrogen) body system is affected by this disorder, the nurse
Management: the same with unpregnant women includes in her teaching that CF affects this?
 Pancreas and Lungs

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3. Which clinical manifestation would cause the nurse  Extreme fatigue

to suspect that a pregnant client is diagnosed with  Night sweats
systematic lupus erymatosus?
 (+) butterfly-shaped rash on the face Diagnostic Exam:
4. Oral aspirin therapy is given to a pregnant women  PPD (Mantoux) test
with rheumatoid arthritis. The nurse knows of the  (+) result: they have been exposed to someonewho
effect of this drug to the mother therefore she has to has the disease
monitor for?  Chest x-ray and sputum exam – confirmatory test
 Bleeding at birth once a woman has a positive reaction for PPD

ASTHMA MANAGEMENT:
 A disorder marked by reversible airflow obstruction,  Isoniazid ( INH), Rifampin (RIF), Ethambutol
airway hyperactivity, and airway inflammation hydrochloride (Myambutol) (DRUG OF CHOICE)

CAUSES: SIDE EFFECTS:

 inhaled allergen ( pollen, cigarette smoke, dust, furs
etc..)
PATHOPHYSIOLOGY:
Inhalation of allergen →release of bioactive mediators (
histamine, leukotrienes) → constriction of bronchial
smooth muscle → marked mucosal inflammation and
swelling → production of thick bronchial secretions
S/Sx:
 DOB
 (+) wheezing sound
Isoniazid- peripheral neuritis
Ethambutol – optic atrophy, loss of green color
recognition
NOTE!!
 A woman who had tuberculosis earlier in life
must be especially careful to maintain an
adequate level of calcium during pregnancy to
ensure the calcium tuberculosis pockets in her
lungs are not broken down and the disease is
not reactivated.

EFFECT ON PREGNANCY: CYSTIC FIBROSIS

 Fetal growth restriction  is a recessively inherited disease in which there is
 Preterm birth generalized dysfunction of the exocrine glands.
 Leads to mucous secretions particularly in the
MANAGEMENT: pancreas and lungs which become so viscid that
 Beta adrenergic agonists (terbutaline, albuterol) normal lung and pancreatic functions become
compromised
TUBERCULOSIS  MEN: causes subfertility due to a thick semen
 A contagious infection caused by bacteria that mainly  FEMALE: causes viscid cervical mucous that
affects the lungs but also can affect any other organ affects fertility
S/Sx:
CAUSATIVE AGENT:  Chronic respiratory infection
 Mycobacterium Tuberculosis  Overinflation of the lungs
 Difficulty digesting fat and protein
S/Sx:
 Chronic cough EFFECT ON PREGNANCY:
 Substantial weight loss  Fetal growth restriction
 Hemoptysis  Preterm labor
 Low grade fever  Perinatal death

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 Fibrin deposits in the kidneys plugging and blocking

MANAGEMENT: the glomeruli leasing to necrosis and scarring
 Administration of pancrelipase
 Bronchodilator MANAGEMENT:
 Antibiotic  NSAID
 Daily chest physiotherapy  Low molecular weight heparin
 Iron supplementation  Salicylates
 Hydroxychloroquine
RHEUMATIC DIORDERS AND PREGNANCY  Low dose prednisone
1. Rheumatoid Arthritis  Azothioprine ( immunosuppressant)
 A disease of connective tissue marked by joint
inflammation and contractures. GASTROINTESTINAL DISORDERS AND PREGNANCY
 This is a result of an autoimmune response that 1. Appendicitis
involves destruction of synovial membrane  Inflammation of appendix which occurs 1 in 1,500 to
2,000 pregnancies
S/Sx: Appendix: found in cecum
 Swelling Purpose: health of the gut, filters dirt
 Erythema
 Painful motion of the joints ASSESSMENT:
NOTE!!!  N/V / nausea and vomiting
 Untreated, formation of granulation tissue fills  Sharp, peristaltic RLQ pain (Mc Burneys point)
the joint space, resulting in permanent  Elevated temperature
disfigurement and loss of joint motion  Urine sample reveals ketones
 Leukocytosis (elevated due to inflammation)
MANAGEMENT: NOTE!!!
 Corticosteroid  Advise a woman that while she is waiting to be
 Hydroxychloroquine evaluated for possible appendicitis not to eat
 NSAID any food, drink any liquid, or consume any
 Some may take oral aspirin therapy laxatives because increasing peristalsis
could cause an inflamed appendix to
EFFECTS OF MEDICATION: rupture.
 Increased bleeding at birth
 Prolonged pregnancy MANAGEMENT:
 Infant may be born with bleeding defect  If AOG is 37 weeks and above – CS birth
 Premature closure of the ductus arteriosus (normal  If early in pregnancy: laparoscopic removal of the
blood vessel that connects two major arteries inflamed appendix
from pulmonary artery to aorta)
2. Hepatitis
2. SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)  Is a liver disease that occurs from the invasion of the
 A multisystem chronic disease of connective tissue Hepatitis A, B, C,D or E virus.
that occurs most frequently in women 20 to 40 years
of age MODE OF TRANSMISSION:
 widespread degeneration of connective tissue (heart, Hepa A (fecal/oral)
kidneys, blood vessels, spleen, skin and  fecal-oral contact
retroperitoneal tissue) occurs with onset of illnes  Treatable
 (+) butterfly-shaped rash on the face

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Hepa B and C (body fluids) Effects of Dilantin :

 exposure to contaminated blood or blood  Chronic hypertension
products or by contact with contaminated  Fetal syndrome: cognitive impairment, Vit K
semen or vaginal secretions deficiency

ASSESSMENT: NOTE!!
 n/v  Women may be prescribed Vit K during labor
 Liver area may feel tender on palpation or the last 4 weeks of gestation to prevent
 Dark yellow urine – excretion of bilirubin Vit K deficiency and hemorrhage in the
 Light-colored stool – lack of bilirubin newborn
 Jaundice – late symptom
 Hepatomegaly (enlarged liver) ENDOCRINE DISRODERS AND PREGNANCY
 Elevated serum bilirubin level 1. Diabetes Mellitus
 Increased liver enzymes  Is an endocrine disorder in which the pancreas
cannot produce adequate insulin to regulate body
MANAGEMENT: glucose levels.
 Bed rest  Characterized by hyperglycemia
 High-calorie diet  It affects 3% to 5% of all pregnancies and is the
 Planned CS: to reduce possibility of blood most frequently seen medical condition in pregnancy
exchange Macrosomic babies
 Hepatitis B immunoglobulin (HBIG) and the first  Difficulty during labor and delivery
dose of Hepa B vaccine should be administered  Possible CS
 Cause bleeding to the mother after delivery
NEUROLOGIC DISORDER AND PREGNANCY (postpartum)
1. Seizure Disorder TYPES
 Recurrent seizure are seen in about 3 to 5 women 1. Type 1 (insulin dependent)
per 1000 births  caused by destruction of the beta cells of the
CAUSES: pancreas.
 Head trauma  more than 90% of the beta cells are
 Meningitis destroyed

TYPES:
a. Absence seizure ( rapid fluttering of the eyelids)
 No effect on the fetus
b. Tonic-clonic seizure
Tonic: sudden muscle contractions; stop breathing;
mouth foaming (inability to swallow)
Clonic: fast stiffening and relaxation of muscles that
happens repeatedly
 sustained, full body involvement
 can lead to fetal hypoxia

MANAGEMENT:
 Administer antiseizure medications such as: 2. Type 2 (non insulin dependent)
trimethadione, valproic acid, phenytoin sodium  insulin resistance and deficiency in insulin
production

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3. Gestational Diabetes (during pregnancy) DURING PREGNANCY:

 Abnormal glucose metabolism that arises  Glomerular filtration of glucose ↑, causing slight
during pregnancy GLYCOSURIA
 Insensitive body with the action of insulin due to  Insulin secretion is ↑
different hormones (human placental  FBS level is ↓
lactogen)  All women appear to develop insulin resistance due
to the presence of HPL, increased cortisol, estrogen,
CLINICAL MANIFESTATIONS (3Ps of DM) progesterone, catecholamines
 Polyuria (frequent urination; >3L/day)
 Polydipsia (extreme thirst) EFFECT on PREGNANCY:
 Polyphagia (rise in appetite)  large for gestational age babies (>10lb)
 Hydramnios (excessive amniotic fluid)
 Macrosomic infant may lead to CPD during delivery
 All these conditions may necessitate a woman
to undergo CS delivery
 High incidence of congenital anomaly (caudal
regression)
 Spontaneous miscarriage
 Stillbirth
 At birth neonate are more prone to
HYPOGLYCEMIA, RDS, hypocalcemia,
hyperbilirubinimia

Risk factors for developing gestational diabetes

mellitus:
 Obesity
 Age over 25 years
 Hx of large babies (10 lb or more)
 Hx of unexplained fetal or perinatal loss
 Hx of congenital anomalies in previous
pregnancies
 Hx of PCOS

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 Family history of DM
 Member of a population with a high risk for DM
(Native American, Hispanic, Asian)
ASSESSMENT:
 Fasting plasma glucose: >126mg/dl or nonfasting
plasma glucose >200mg/dl – Dx of DM
 75-g oral glucose tolerance test – confirmatory
test
MONITORING A WOMAN WITH DM:
 Measurement of glycosylated hemoglobin: it
reflects the average blood glucose level over the
past 4 to 6 weeks
 HbA1c result of 6% or higher confirms the presence
of GDM
THERAPEUTIC MANAGEMENT:
Insulin administration
 Combination of short-acting insulin with
intermediate type (2/3 in the morning and 1/3 in the
evening)
 Self-administered before breakfast in a ration of 2:1
(intermediate to regular) and again just before dinner
in a ration of 1:1
 When using short-acting insulin (peaks in 1 hour),
instruct a woman to eat immediately after injecting
insulin
 Oral hypoglycemia agents are not recommended
since it crosses the placenta
Blood Glucose Monitoring
 If Hypoglycemia is present – drink fluid with
sustained carbohydrate (glass of milk and crackers)
 For elevated blood glucose – check the urine for
ketones
INSULIN PUMP THERAPY ( Continuous Subcutaneous
Insulin infusion)
 A syringe of regular insulin is placed in the pump
chamber and a small gauge needle is attached to a
length of thin polyethylene tubing, which is then
implanted into the subcutaneous tissue of a woman’s
abdomen or thigh
 this is an effective method to keep serum glucose
constant
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Tests for Placental Function and Fetal Well-being
 Due to increase birth anomalies- level of serum
alpha-fetoprotein should be obtained at 15-17 weeks
to check for neural tube defects and UTZ at 18-20
weeks to check for gross anomalies
 Creatinine clearance per trimester
 NST
TIMING FOR BIRTH
 Previously CS birth may be done at 37 weeks
gestation to prevent fetal loss from placental
insufficiency but this can lead to RDS once the fetus
an is still immature
 Now, when an accurate assessment of fetal age is
available by amniocentesis and the pregnancy can
be maintained within safe limits by the use of
nonstress testing, the last weeks of pregnancy are
not as hazardous as before.
 If all possible, vaginal birth is preferred. Labor may
be induced by rupture of the membranes and
oxytocin infusion after measures to induce cervical
ripening
POSTPARTUM ADJUSTMENT
 1 or 2-hour postprandial blood glucose determination
to help regulate how much insulin she needs during
this adjustment period
 Monitor for bleeding because hydramnios during
pregnancy may lead to poor uterine contraction after
birth
 Breastfeeding is not contraindicated
 Inform them that they are at risk to develop type 2
DM later in life
ISOIMMUNIZATION (Rh INCOMPATIBILITY/ Rh
Sensetization/Hemolytic disease of the fetus)
 Occurs when an Rh negative mother carries an Rh
positive fetus
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 Maternal AND CHILD HEALTH NURSING LECTURE

 If the mother is Rh-negative and the father is

Rh-positive, the baby has at least a 50% chance of
being Rh-positive.
 Rhesus (Rh) factor is an inherited protein found on
the surface of red blood cells.
 If your blood has the protein, you're Rh positive. If
your blood lacks the protein, you’re
Rh-negative.
 Anti D antibody is formed when the blood of an
Rh-negative mother is exposed to Rh positive
blood of a baby.
How a mother is exposed:
 Delivery (NSD/CS)
 Miscarriage
 Amniocentesis
 Abruptio placenta ISOIMMUNIZATION ( Rh INCOMPATIBILITY)
 Blood transfusion ASSESSMENT:
 All Rh negative mothers should undergo ANTI-D

ANTIBODY TITER
 Determine paternal blood type if Rh positive
 Normal – 0
 Minimal: below 1:8
 If the result is still normal on the 28th week no
THERAPY is needed
 If the result is elevated: 1:16 fetal well being should
be monitored every 2 weeks or more often with a
Doppler velocity to determine the presence of
anemia or the destruction of fetal RBC. Can result to
fetal hydrops

ASSESSMENT:
Mother does not show signs
Future FETUS:
 Hemolytic disease
 Hyper bilirubenemia
 Fetal anemia, immature RBC
 Splenomegaly, hepatic failure
 Fetal heart failure
 Fetal hydrops

MANAGEMENT:
 Administration of RhIg (RhoGam) – 28 weeks then
within 72 hours after delivery
 prevents maternal formation of antibodies
 Need to check blood factor of babies after delivery

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 Determination of the infant’s blood type

 Coomb’s Test NEGATIVE – RhIg will not be given
to the mother
 Coomb’s test POSITIVE – RhIg will be given
 Intrauterine transfusion – through amniocentesis
technique

MENTAL ILLNESS AND PREGNANCY

Schizophrenia
 have its highest incidence among adolescents and
young adults and so may occur in young pregnant
women. Depression occur 4 times more in women
than in men, and often in young adults, making it the
most common mental illness seen in pregnant young
adults

MANAGEMENT:
 TEAM APPROACH: psychiatric care team and
prenatal care group – to ensure stress of pregnancy
is not exacerbating the mental illness
 Psychotropic medication may be given after proper
evaluation of its teratogenic effect

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