HIGH RISK

PREGANANCY
PREPARED BY:
RUBY KATRINA WENDEE JOSON.RN
ROLE OF THE NURS
1. IDENTIFY RISK FACTORS
E:
2. ESTIMATE THE POTENTIAL EFFECT OF THE PREGNANCY OUTCOME
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QUICK
Definition of terms:
REVIEW!!!
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2 stages of complication
I. Antepartum II. Intrapartum
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I. ANTEPARTUM
COMPLICATION
◦ A. Firt Trimester (1-3mos)
◦ B. Second Trimester (4- 6)
◦ C. Third Trimester (7-9)

A. First Trimester
ABORTION – <20weeks
❑ Spontaneous Abortion
❑ Induced Abortion
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❑ SPONTANOUS ABORTION or MISCARRIAGE
❑ 1. Threatened Abortion
❑ 2. Inevitable Abortion
❑ 3. Complete Abortion
❑ 4. Incomplete Abortion
❑ 5. Missed Abortion
❑ 6. Habitual Abortion

❑ INDUCED ABORTION
❑ Therapeutic Abortion
❑ Illegal Abortion
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❑ SPONTANOUS ABORTION or MISCARRIAGE
❑ 1. Threatened Abortion
(+) bleeding; (+) cramping; NO dilation/ closed cervix
❑ 2. Inevitable Abortion
(+) bleeding; (+) cramping; (+) cervix dilation/ opened cervix BUT NO product of conception
❑ 3. Complete Abortion
(+) bleeding; (+) cramping; (+) cervix dilation/ opened cervix; all expelled
❑ 4. Incomplete Abortion
(+) bleeding; (+) cramping; (+) cervix dilation/ opened cervix; incomplete product
❑ 5. Missed Abortion
(+) Retained product but dead fetus, (+) coagulopathy
❑ 6. Habitual Abortion
3 or more preganancy
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UNRUPTURED RUPTURED
❑ INDUCED ABORTION
Therapeutic Abortion PERIOD missed missed
Illegal Abortion
PAIN Abdominal pain, Shoulder Pain sudden
sudden sharp, knife sharp, knife like,
Therapeutic Abortion like, unilateral, severe unilateral, severe pain
A. Fetal demises ( >20 weeks)
pain
a. Antenatal demise
b. Intranatal demines COLOR Vaginal discharge, dark (+) cullens sign,
B. Ectopic Pregnancy brown, bleeding Blue tinged

FEELIN Vague Discomfort Syncope

G
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Illegal Abortion
THE FAMILY CODE OF THE
PHILIPPINES : Executive Order No.
209

NOH: Modern Contraceptive prevalence

rate (all women)

RATE: 2017 - 24.9%

Target: 30% (2022)

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B. Second Trimester
a. Hydatiform mole

Gestational Trophoblastic disease

Molar Prganancy

Sperm produce multiple chromosomes ------ Loss of fertilized egg (nucleus) ------ neoplasm get
swell ------ it grows enlarges the uterus very rapidly ------- (+) clear vesicle (bunch of grapes)
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C. Third Trimester

1. Placenta Previa – 3 types

2. Abruptio Placenta – 3 types
3. Placenta Succenturiata
4. Placenta Bipartita
5. Placenta Tripartita
6. Velamentous Insertion of the cord
7. Vasa Previa
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❑ HYPERTENSIVE DISORDER
A. Pregnancy Induced Hypertension (PIH)
a. Gestational
b. Pre eclampsia
c. HELLP Syndrome
B. Transitional Hypertension
C. Chronic or Pre- existing Hypertension
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A. Pregnancy Induced Hypertension (PIH)
a. Gestational – (-) edema, (-) proteinuria
b. Pre eclampsia – “TRIAD SIGN and SYMPTOMS”

3 TYPES
a. MILD – weight gain (+)Protienuria
b. SEVERE – Visual disturbances, Epigastric Pain
c. ECLAMPSIA – Grand Mal Seizures

c. HELLP Syndrome
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❑ GESTATIONAL DIABETIS MELLITUS
❑ MULTIPLE PREGANANCY
TYPES:
1. Dizygotic (fraternal) multiple pregnancy
2. Monozyhotic (Identical) multiple pregnancy
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❑ HEART DISEASE
ACTIVITIES RECOMMENDATION
CLASS I No limitations of physical activities 10 hrs sleep/day
30 minutes rest after meal
A slight limitation of physical activities; for 10 hrs sleep/day
CLASS II
ordinary activities causes fatigue and 30 minutes rest after meal
discomfort
CLASS III A moderate limitation of physical activities for Early hospitalization 7-6mos.
less than ordinary activity causes fatigue and Of pregnancy
discomfort
CLASS IV
Marked limitation of physical activities, for Therapeutic Abortion
even at rest there is fatique and discomfort
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❑ SUBSTANCE ABUSE
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II. INTRAPARTUM COMPLICATION
◦ A. Cesarean Section
◦ B. Vaginal Birth After C- Section
◦ C. Internal Cephalic Version