PRESENTED

BY
MARIA
Introduction
 Many complication occurs
during pregnancy & affect health
of mother & fetus as well as
outcomes.
 Hemorrhage is the first ten cause
of maternal mortality &
morbidity affect about 32% of
all maternal death.
 Many women do not understand
the bleeding is abnormal &
dangerous sign & come late to
health care facilities.
OBJECTIVES

Students will be able to :-

Enumerates types of associated medical problem during
pregnancy.
Promote, protect & maintain the health of the mother during
pregnancy
Detect ‘High Risk’ cases & given them special attention.
Reduce maternal & infant mortality & morbidity rate.
Maximize self care ability of herself.
DEFINITION OF BLEEDING IN
EARLY PREGNANCY
Any vaginal bleeding
before 20 weeks period
of gestation is defined
as early pregnancy
bleeding.
 Ectopic
pregnancy

Hydatidiform Cervical
Mole(vesicular cancer
Mole)

Abortion
Local
lesions
Meaning & Definition of ectopic
pregnancy
Meaning:-”in the wrong place”

Definition:-Ectopic pregnancy is defined as implantation of

fertilized ovum in any site other than the endometrium of the
uterine cavity.
About 1% of all pregnancies are ectopic.
 Causes/Risk factors of ectopic
pregnancy
 Impaired tubal contractility.
 Impaired tubal ciliary action.
 Decreased sperm mobility
 The use of intrauterine contraceptive device.
 Smoking
 Congenital abnormality of fallopian tube
 Tubal ligation
 Infertility treatment such as IVF
 Condition such as endometriosis & fibroids
can narrow the fallopian tube.
 Conti…
 Pelvic inflammation disease.
 History of previous pelvic operation such as D &
C.
 Ovarian surgery.
Possible outcomes of tubal pregnancy

Tubal abortion
Tubal mole
Tubal rupture
Pathology of ectopic pregnancy
Management of ectopic pregnancy
 Evaluated immediately-salpingectomy is performed.
 Management of ectopic pregnancy
 Follow-up is needed.
 Family planning should be discussed.

 Provide emotional support.

 HYDATIDFORM MOLE
Hydatidiform mole is a gross malformation of the
trophoblastic in which the chorionic villi proliferate &
become avascular.
Types of hydatidform mole
 Causes of hydatidiform mole
The exact cause Is unknown.
 Sign & symptoms of hydatidform
mole
+ve pregnancy test

Vaginalbleeding
& nausea vomiting
Sign & symptoms of hydatidform
mole
Over distension of the uterus & larger
than expected for weeks of gestation.
No fetal movements ,no fetal parts
Overactive thyroid gland
Pelvic pain & discomfort
Anaemia
High blood pressure
Passing grape like cluster from vagina
Management of hydatidform mole
Admit the women to hospital.
Evacuation of the uterus under general
anesthesia.
Need for monitoring HCG levels for 2
years (
Complication of hydatidform mole
Hemorrhage
Shock
Perforation
Uterinesepsis
Choriocarcinoma
ABORTION
 DEFINITION OF ABORTION
It is the termination of
pregnancy before 24 weeks
or product of conception
weighing below 500
grams.
OR
The termination is either
spontaneous or induced
before the fetus develop
sufficiently to survive.
 INCIDENCE OF ABORTION
Spontaneous abortion occurs in 10-15% of
pregnancy, 80% of them occur in the first trimester.

CAUSES:-50-80% of abortion in the first 12 weeks

of pregnancy result from chromosomal anomalies
 MISSED
ABORTION

SEPTIC
ABORTION