REPRODUCTIVE FAMILY PLANNING ● The couple’s relationship

● It includes all decision an ○ Long term

individual and couple make about: ○ Short term
○ whether and when to ● Prior experiences with
have children contraception
○ How many children to OTHER CONSIDERATION
have ● It is necessary to understand
○ And how they are spaced various methods of contraception.
IMPORTANCE OF REPRODUCTIVE ○ Work and compare benefits
FAMILY PLANNING and disadvantages
● Some couples you will meet ● In assessing which best option a
○ Wants counseling and couple may choose.
how to avoid conception ○ Safe sex practices must be
○ Want information on advised
increasing fertility and ● Although there are many
about their ability to contraceptive methods reliable to
conceive avoid contraception. Condoms
○ Others need counseling provide protection against STD.
because contraceptives ○ This is a special
have failed. consideration if the
PURPOSES OF relationship is a
REPRODUCTIVE FAMILY PLANNING monogamous one.
● Because the method of
● Raising a child child requires
contraception offers 100%
significant amounts of resources
protection against pregnancy, it is
such as:
important to answer questions
○ Time
carefully.
○ Social
○ Financial WHAT TO ASSESS BEFORE BEGINNING
○ Environmental OF A NEW METHOD
● Planning can assure that ● VITAL SIGNS such as:
resources are available. ○ PAP smear
● To the health of the mother and ○ Pregnancy Test
child ○ Gonococcal and
● Helping to prevent HIV/AIDS Chlamydial Screening
○ HGB detection for anemia
IMPORTANT CONSIDERATION ● OBSTETRICS HISTORY for STDs
● Personal Value ● SUBJECTIVE ASSESSMENT OF
● Ability to use method correctly THE PATIENT
● If the method will affect the sexual ○ Desires
enjoyment ○ Needs
● Financial factors ○ Feelings
 ○ Understanding of NATURAL FAMILY PLANNING
contraception ● Also known as PERIODIC
● Sexual practices ABSTINENCE
CRITERIA IDEAL FOR CONTRACEPTIVE ● Involves to introduce or use
● It should be safe to use chemical or foreign materials into
○ Means free from any side the body of the female and the
effects male.
● It should be reliable and effective ● Its effectiveness varies from 2%
● It should be easy to administer ideal failure rate to 25% failure
and convenient rate depending mainly on the
● It should be cost effective couple from having coitus on fertile
● It should be culturally feasible and days.
acceptable ABSTINENCE
● Free of bothersome side effects ● This involves completely refraining
● Free of effects on future from coitus and 0% failure.
pregnancies ● However, due to natural human
TYPES OF desire, couples may find it difficult
REPRODUCTIVE FAMILY PLANNING to adhere to abstain.
● NATURAL FAMILY PLANNING ● It has very high failure rate
○ ABSTINENCE ADVANTAGES
○ COITUS INTERRUPTUS ● Acceptable to all religious group
○ LACTATION DISADVANTAGES
AMENORRHEA METHOD ● Requires high motivation and also
(LAM) self discipline
○ CALENDAR METHOD COITUS INTERRUPTUS
○ BASAL BODY ● One of the oldest methods of
TEMPERATURE contraception.
○ CERVICAL MUCUS ● The penis is withdrawn from the
METHOD vagina before ejaculation.
○ SYMPTOTHERMAL ● Coitus Interruptus is only about
METHOD 82% effective and should be used
● BARRIER METHOD with caution.
○ PHYSICAL BARRIERS ADVANTAGE
○ CHEMICAL BARRIERS ● No cost
● HORMONAL METHODS ● Does not require any device
● INTRAUTERINE DEVICES ● With self control and discipline, it
● SURGICAL METHODS can be fairly effective.
○ VASECTOMY DISADVANTAGES
○ TABH-SO
● Requires a great deal of self
control
● Failure rate is very high
 ● Slightest delay in withdrawal can DISADVANTAGE
lead to pregnancy. ● Many factors affect basal body
LACTATION AMENORRHEA METHOD temperature.
● A breastfeeding woman has ○ Illness
natural suppression of both ○ Physical activity.
ovulation and menses CERVICAL MUCUS METHODS
● It could be considered safe if: ● Change in cervical mucus that
○ An infant is under 6 months naturally occurs with ovulation.
of age. ● A way to identify fertile times to
○ Being totally fed every 4 help you gauge the best days to
hours during the day and have or avoid unprotected days.
every 6 hours at night. HOW DOES IT WORK
○ No supplementary ● Before ovulation each month, the
○ Menses has not returned. cervical mucus is thick and does
FERTILITY AWARENESS METHOD OF not stretch.
NATURAL FAMILY PLANNING ● Just before ovulation , mucus
● CALENDAR METHOD secretion increases.
● BASAL BODY TEMPERATURE ● On the day of ovulation, cervical
METHOD mucus becomes thin, copious,
● CERVICAL MUCUS METHOD watery, and transparent.
● SYMPTOTHERMAL METHOD ○ SPINNBARKEIT
CYCLE BEADS ■ Cervical mucus
● Red bead first day of pregnancy stretches at least
● Dark brown beads, tells you if your 1 inch before the
cycle is shorter than 26 days. strand breaks.
● Brown beads, pregnancy is very ● All the days that the cervical
unlikely mucus is copious (3 to 4 days after
● White beads, pregnancy is most ovulation) are considered fertile
likely. days where a woman should
BASAL BODY TEMPERATURE abstain from coitus.
● This method is used by monitoring ADVANTAGES
or taking the woman’s body ● Inexpensive
temperature everyday upon ● Does not have side effects
waking up. DISADVANTAGE
● Before the day of ovulation: the ● The feel of vaginal secretion is
woman’s temperature is 0.5F. unreliable since the seminal fluid
● On the day of ovulation: the of the male has watery
woman’s temperature. consistency and can be confused
● To make sure it is effective, it with ovulatory consistency.
should be combined with a ● High failure rate because of
calendar method. difficulty interpreting mucus status.
 BARRIER METHODS ● No health visit of prescription
● Forms of birth control that place a needed
chemical or latex between the FEMALE CONDOM
cervix and entering sperm into the ● Made of latex polyurethane
uterine cavity. pre-lubricated with spermicide
SPERMICIDES ● The inner ring covers the cervix
● Agent that kills spermatozoa and the outer ring rests against the
before they can enter the cervix. vaginal opening.
● It changes the vaginal pH to a DIAPHRAGMS
strong acid level which is not ● A circular rubber disk that is
conducive to sperm survival. placed over the cervix before
ADVANTAGES intercourse to mechanically block
● May be purchased without the passage of the sperm.
prescription ● After coitus, diaphragm must
● When used together with other remain for 6 to 24 hours because
contraceptives they increase the sperm is still viable.
other methods of effectiveness. CONTRAINDICATION
● There are various forms to choose ● May not be effective if the uterus is
from such as: prolapsed, retroflexed, or
○ Gel anteflexed which displaces the
○ Creams cervix
○ Sponges ● Diaphragms may cause UTI’s
○ Films ● Should not be used in cases of
○ Foams ○ Acute Cervicitis,
○ Vaginal Films ○ Herpes Virus Infection
CONTRAINDICATION ○ Papillomavirus Infection
● Vaginallly inserted spermicides ○ Allergy to rubber or
are contraindicated with women spermicides
with acute cervicitis ● Do not leave diaphragm in place
● Bothersome for women because for more than 24 hours
they are sticky. ● Do not use it during menstruation
MALE CONDOM HORMONAL CONTRACEPTIVES
● A latex or rubber or synthetic ● Combined oral contraceptive pills
material placed over the erect ● PROGESTIN-ONLY ORAL
penis before coitus to trap the CONTRACEPTIVE PILLS
sperm. ● INJECTABLES
● It has a failure rate of 15% (DEPO-PROVERA/DMPA)
ADVANTAGES ● IMPLANTS
● Available in pharmacies and (NORPLANT,JADELLE)
convenience stores ● Hormonal contraceptives are, as
the name implies, hormones that
 cause such fluctuations in a ○ You are over 35 and
normal menstrual cycle that smokes
ovulation does not occur ○ You are overweight
COMBINED ORAL CONTRACEPTIVES ○ You have migraines
(COC’s) ○ You have some types of
● Composed of varying amounts of medication or herbal
synthetic estrogen combined with medicines.
a small amount of synthetic MONOPHASIC COC’s
progesterone (progestin). ● Provide fixed doses of both
● 92% effective, and 99% effective if estrogen and progestin throughout
taken correctly and continuously a 21-day cycle.
PHYSIOLOGY BIPHASIC COC’s
● The estrogen acts to suppress ● Deliver a constant amount of
follicle stimulating hormone estrogen throughout the cycle but
(FSH) and LH, thereby an increased amount of progestin
suppressing ovulation. during the last 11 days.
● The progesterone action TRIPHASIC COC’s
complements that of estrogen by ● Triphasic preparations vary in both
causing a decrease in the estrogen and progestin content
permeability of cervical mucus, throughout the cycle.
thereby limiting sperm motility ● Types more closely mimic a
and access to ova. natural cycle, thereby reducing
● Progesterone also interferes breakthrough bleeding (bleeding
with tubal transport and outside the normal menstrual
endometrial proliferation to such flow).
degrees that the possibility of EXTENDED CYCLE PILLS
implantation is significantly ● These are typically used in a
decreased. 13-week cycle.
WHO CAN USE IT? ○ You take active pills for
● If you are healthy and do not 12 weeks, and during the
smoke, you can keep taking the last week of the cycle,
pill safely for many years. you take inactive pills
● You should not use this pill if you and have your period.
have: ■ As a result, you
○ Had Heart Attack, Stroke, have your period
or Blood Clot in you legs or only three to four
lungs times per year.
○ A family member has a NOTE
blood clot in their legs or ● Typical pills have 28-pill
lungs dispensers
 ○ Of which 21 active pills and fertilizing the egg released
7 placebo pills) each month.
BENEFITS OF COCs ○ This hormone also thins
● Oral contraceptives have the endometrial lining to
noncontraceptive benefits such as make it inhabitable for a
decreased incidences of: fertilizing egg, just in case
○ Dysmenorrhea, because the sperm penetrates the
of lack of ovulation egg’s barrier.
○ Premenstrual dysphoric ■ Thinning your
syndrome and acne, uterine directly
because of the increased reduces the
progesterone levels menstrual flow to
○ Iron deficiency anemia, provide you with
because of the reduced relief from heavy
amount of menstrual flow periods.
○ Acute pelvic ● To ensure the pill retains its
inflammatory disease effectiveness in preventing
(PID) and the resulting pregnancy, you must take it at
tubal scarring the same time every day.
○ Endometrial and ovarian SIDE EFFECTS/ CONTRAINDICATION OF
cancer, ovarian cysts, and ORAL CONTRACEPTIVE
ectopic pregnancies ● Nausea
○ Fibrocystic breast ● Weight gain
disease ● Headache
○ Possibly osteoporosis, ● Breast tenderness
endometriosis, uterine ● Breakthrough bleeding (spotting
myomata (fibroid uterine outside the menstrual period)
tumors), and progression ● Monilial vaginal infections
of rheumatoid arthritis ● Mild hypertension
○ Colon cancer ● Depression
(Stubblefield, Carr-Ellis, & ● Advise all women taking COCs to
Kapp, 2007) notify their health care provider if
PROGESTIN-ONLY PILLS symptoms of myocardial or
(MINI PILL) thromboembolic complications
● Also called the Mini Pill. occur. These are:
● The mini pill prevents pregnancy ○ Chest pain (pulmonary
using progestin alone, instead of embolism or myocardial
combining with estrogen. infarction)
○ Low dose of progestin ○ Shortness of breath
actively thickens mucus (pulmonary embolism)
to prevent sperm from ○ Severe headache
(cerebrovascular accident)
 ○ Severe leg pain INTRAMUSCULAR INJECTION
(thrombophlebitis) HORMONE (DEPO-PROVERA)
○ Eye problems such as ● A single intramuscular injection of
blurred vision depot medroxyprogesterone
(hypertension, acetate (DMPA) is a
cerebrovascular accident) progesterones given every 12
SUBDERMAL HORMONE IMPLANTS weeks or 3 months which also has
● This is a progestin-filled minature the same effects as hormonal pills.
rod not bigger than a matchstick, ● The effectiveness rate of this
estrogenol implant. method is almost 100% making it
○ This can be inserted under a popular contraceptive method.
the skin on the inside of the ● Because it only contains
upper arm. progesterone, it can be used
○ This slowly release during breastfeeding, although
progestin over a period of 3 women should wait 6 weeks after
years which also birth before the first injection
suppresses ovulation, ● ADVANTAGE:
thicken cervical mucus, ○ Reduction of:
and change the ■ Ectopic Pregnancy
endometrium lining which ■ Endometrial Cancer
make implantation difficult. ■ Endometriosis
○ The rod is inserted by the SIDE EFFECTS
trained Physician under ● Irregular heavy menstrual bleeding
local anesthesia not later for the first year and no menstrual
than 7 days after menstrual bleeding after the first year.
period to be certain the ● It also impairs glucose tolerance in
woman is not pregnant. women at risk for diabetes so it
SIDE EFFECTS/ CONTRAINDICATIONS must be used cautiously for these
● Weight Gain women.
● Breakthrough Bleeding ● It increases the risk for
● Amenorrhea osteoporosis for loss of bone
● Scar on the insertion site mineral density.
● Contraindication is when the ○ Calcium supplements must
couple desire pregnancy within be advised.
one year and undiagnosed uterine ● It is not advisable for use for more
bleeding. than 2 years.
● Infection can also occur on the INTRAUTERINE DEVICE (IUD)
insertion site. ● A small plastic device that is
inserted into the uterus through
the vagina, IUD’s can either be
hormonal or non hormonal.
 ■ ParaGard last
longer than IUD’s
○ It is effective for 10 years.
● MIRENA/LILETTA IUD
○ LEVONORGESTREL
■ Releasing
intrauterine system
52 mg.
■ This contains a
● Although it has been used for drug reservoir of
contraceptive purposes thousands progesterone in the
of years back (used in camels) the stem which diffuses
mechanism is still not fully into the uterus
understood. which prevents
○ But it is used to prevent endometrial
fertilization and to increase proliferation and
sterile inflammatory thickens the
process to prevent cervical mucus.
implantation ■ It has also potential
● It is inserted by a trained to reduce
OB/Midwife/ or nurse. endometrial cancer
● The following must be considered: ○ It is effective for 5 years
○ Before insertion: ● SKYLA IUD
■ Pelvic examination ○ LEVONORGESTREL
■ Clearance must be ■ Releasing
performed intrauterine system
■ Contraindicated for 13.5 mg
women with high ○ It has a lower dose of
risk of STI’s progesterone.
■ It must be inserted ○ It is effective for 3 years.
after menstrual flow
and advised no
coitus before
insertion.
TYPES OF IUD
● COPPER T380
○ The copper triggers your
immune system to prevent
pregnancy.
○ It can cause your periods
to be heavier, especially at
first.
 CESAREAN BIRTH NURSING RESPONSIBILITIES FOR
● It is a procedure where birth is WOMAN ANTICIPATING A C/B
accomplished through abdominal ● All women talk about their fears
incision into the uterus. PRE OPERATIVE
● It is one of the oldest types of ● Obtain Health History before
surgery and one with few administration of anesthesias.
complications. ○ Previous Surgeries
● It is a latin word which means “to ○ Secondary illness
cut” ○ Allergic Reactions or
INDICATION FOR C/B Reaction to food and drugs
MATERNAL FACTORS ○ Reaction to anesthesia
● Genital Herpes ○ Bleeding Problems
● Cephalo-Pelvic Disproportion ○ Current Medications taken
(CPD) by the woman
● Disabling condition of the mother. ○ Women's knowledge about
○ Severe HPN the procedure
○ Heart Conditions ○ Length of hospitalization
● Previous C/S ○ Post-Surgical Equipment
PLACENTAL FACTORS (IC/IVF)
● Placenta Previa ○ Special Precautions
● Premature Separation of the necessary for her infant.
Placenta EFFECTS OF SURGERY ON A WOMAN
● Umbilical Cord Prolapse STRESS RESPONSE
FETAL FACTORS ● Either physical or psychological
● Macrosomic Fetus in Fetal Lie ● The body responds to preserve
● Extreme Low Birth Weight functions of the major body.
● Fetal Distress ○ Increased Epinephrine and
● Fetal Anomalies Norepinephrine could
● Multigestation or Conjoined Twins cause:
● Transverse Fetal Lie ■ Increased Heart
TWO TYPES OF C/S Rate and Bronchial
SCHEDULED Dilation
● There is time for thorough ■ Increase Blood
preparation for the experience Sugar
throughout the antepartal period. ■ Peripheral
EMERGENT Vasoconstriction
● Emergent cesarean births are ■ Increased Blood
done for reasons such as placenta Pressure.
previa, premature separation of ● These stress related changes
the placenta, fetal distress, or minimize blood supply to lower
failure to progress in labor.
 extremities could lead to OPERATIVE RISKS FOR A WOMAN
thrombophlebitis. POOR NUTRITIONAL STATUS
INTERFERENCE IN BODY RESPONSES ● Obesity interferes with wound
● The skin as the first line of defense healing
is compromised. ○ Fatty tissue is difficult to
● Strict aseptic technique must be heal.
observed following the days after ● Prolonged healing may result to
the surgery to compensate for this infection or rupture of incision
defense (dehiscence)
● If Cb is done after the membranes ● Increased workload for the heart of
have ruptured, the increased risk the woman
of infection such as endometritis ● Pneumonia
may take place. ○ Lack of lung expansion
INTERFERENCE WITH CIRCULATORY causes Pneumonia.
FUNCTION ● Vitamin Deficiency
● Blood loss that occurs with surgery ○ Vitamin C and D
may result in hypovolemia and ○ Protein deficiency is also a
hypotension. risk for healing
● Ineffective tissue perfusion of all AGE VARIATION
body tissues ● Old aged women is high risk for
● Normal blood loss during CB is CB
500-1000 ml ALTERED GENERAL HEALTH
INTERFERENCE WITH BODY FUNCTION ● Persons that is high risk for
● Increased flow of fluid of the surgical procedures:
surgical wound also disrupts ○ Diabetes Mellitus
function ○ Heart Disease
● Displacement of the urinary ○ Anemia
bladder leads to loss of sense of ○ Kidney Disease
filling. FLUID AND ELECTROLYTE IMBALANCE
● Pressure on the intestine causes ● Lower than normal blood pressure
paralytic ileus/halting intestinal may be felt by a mother more than
function. one with normal blood volume.
● Thrombophlebitis FEAR
○ Impaired lower extremities ● Extreme worry or anxiety about
blood flow. the surgery may need a detailed
INTERFERENCE WITH SELF-MAGE OR explanation before the operative
SELF-ESTEEM procedure
● Presence of incision scar CB PUTS NEWBORN AT RISK THAN
● CB also marks her as a woman VAGINAL BIRTH
less than others because she was ● Inadequate respiration
not able to give vaginal birth. ● Infection
 PREOPERATIVE DISCHARGE PLAN
DIAGNOSTIC PROCEDURES ● Mother must be aware of the
● Assess the heart, kidney, restrictions in exercise or activity
circulatory and fetal heart rate. such as:
○ Vital Signs determination ○ Do not lift heavy objects
○ Urinalysis more than 10lbs
○ CBC ○ Do not walk upstairs more
○ Coagulation Time and than once a day for the first
Partial PT 2 weeks
○ Electrolyte and pH Balance ● Report or recognize possible
○ Blood Typing and Cross complications
Matching ○ Redness or discharge the
○ Ultrasound to determine incision line
Fetal presentation and ○ Lochia with heavier than
maturity menstrual flow
PREOPERATIONAL TEACHING ○ Abdominal pain other than
● Assess how much a woman the suture line or after pain
already knows about the surgery discomfort.
○ Refresh the mother if she ○ Elevated body temperature
already had post-CS ○ Frequency on urination
● NPO ○ Burning sensation
● DBE after the operation BLEEDING
● Indwelling Catheter and IVF PRIMARY CAUSES OF BLEEDING IN
● Early Ambulation PREGNANCY
PREOPERATIONAL MEASURES FIRST TRIMESTER
● Informed Consent ● Uterine Abnormalities
● Overall Hygiene ● Chromosomal Problems
● Gastric emptying to decrease ● Unknown Causes
gastric secretions ● Infection
● Baseline I&O ● Deficient Progesterone
● Hydration ● Metabolic Disorder
● Preoperative medication ANATOMIC DEFECTS OF THE UTERUS
● Patient Chart
○ Documentation must be
completed
PREVENTION OF COMPLICATION
● Deep Breathing Exercises
● Turning side to side
● Early ambulation after 4-6 hours
for lower extremities circulation
BLEEDING DURING FIRST TRIMESTER conception or the fetus and
CLASSIFICATION placenta from the uterus
● Threatened Miscarriage ● Miscarriage is when an embryo or
● Imminent fetus dies before the 20th week of
● Missed Miscarriage pregnancy
● Incomplete Miscarriage ● Miscarriage usually happens early
● Complete Miscarriage in your pregnancy.
● Ectopic Pregnancy ○ 8 out of 10 miscarriages
SECOND TRIMESTER happens in the first 3
● Hydatidiform Mole months
● Premature Cervical Dilatation. PATHOPHYSIOLOGY OF MISCARRIAGE
THIRD TRIMESTER 1. DUE TO ETIOLOGIC FACTOR
● Placenta Previa LIKE GENETIC
● Abruptio Placenta 2. TRISOMY CHROMOSOMES ARE
● Preterm Labor THE MOST COMMON
ABORTION CHROMOSOMAL ANOMALIES
3. INSUFFICIENT HORMONAL
● The National Center for Health
LEVEL
Statistics, the Center for Disease
4. RESULT IS SPONTANEOUS
Control and Prevention (CDC),
MISCARRIAGE BEFORE 10
and the World Health Organization
WEEKS OF GESTATION
(WHO) define abortion as
pregnancy termination prior to 20 PATHOLOGY OF ABORTION
weeks gestation or a fetus FIRST 8 WEEKS GESTATION
weighing less than 500g ● Separation of decidua basalis and
○ Despite this, definitions expulsion of the ovum
vary widely according to ○ If retained within the
state laws uterus, the ovum becomes
○ Fetus weighing less than surrounded by decidua and
500 grams blood clot
○ Before the 20th completed 8 TO 12 WEEKS OF GESTATION
week of gestation ● Rupture of the decidua capsularis
○ Early abortion and late and expulsion of the product of
abortion conception
○ 15% of clinically evident AFTER 12 WEEKS
pregnancies ● Rupture of the membranes
○ 80% of abortions prior to followed by expulsion of the
12 weeks gestation product of fetus and the placenta
MISCARRIAGE in the uterus.
● Abortion is the removal of PATHOLOGY
pregnancy tissue, products of ● Hemorrhage into the decidua
basalis
● Necrosis and inflammation IMMINENT MISCARRIAGE/ INEVITABLE
● Uterine contraction and cervical ● A threatened miscarriage
dilatation becomes imminent or inevitable if
● Expulsion of most or all the uterine contraction and cervical
products of conception dilatation occur.
ETIOLOGY ● Loss of products of conception
● Abnormal karyotype:50% cannot be halted
● Maternal Factors MANAGEMENT
○ TORCH ● Mother must visit OB for FHB
○ Infection assessment and ultrasound.
○ Immunologic factors ● Save any tissue or fragments from
○ Maternal Systemic bleeding and bring to OB
Diseases ● Tissue must be examined for H.
○ Anatomic Defects Mole
○ Trauma ● FHB and ultrasound absence may
● Toxic Factors indicate D&E to extract remaining
CHARACTERISTICS products of conceptus
THREATENED ABORTION ● Observe for saturation of sanitary
● Usually bright red spotting pads for heavy bleeding.
● Without cervical dilation TREATMENT
● Without expulsion of products of ● Pathologic examination
conception ● Dilation and curettage
MANAGEMENT ● Oxytocin
● Mother must visit the OB for FHB ● Ultrasound
assessment and ultrasound ● antibiotics
● Blood is drawn for Hcg testing CLINICAL FINDINGS
repeated again after 48 hours ● Severe Bleeding
○ If placenta is still intact ● INCOMPLETE ABORTION
● CBR is not necessary, ○ Expulsion of some but not
○ It may cause pooling of all of the products from the
blood and bleeding again conception
when the mother ● THREATENED ABORTION
ambulates ○ Expulsion of all the
○ Bleeding must stop within products of conception
24 hours COMPLETE ABORTION
○ Restrict coitus for 2 weeks ● The entire product of conception
after the bleeding episode are expelled spontaneously
to prevent infections and without any assistance of D&E
avoid further bleeding. ○ FETUS
○ MEMBRANES
○ PLACENTA
● Bleeding slows within 2 hours and ● Infection
then stops within a few days after ○ Tends to develop when
the passage of the product of pregnancy occur over a
conception. short time
CLINICAL FINDINGS ○ It tends to develop when
● Products of conception pregnancy occurs over a
● Ultrasound short time.
● Bleeding ○ It tends to occur with
MISSED MISCARRIAGE women who have lost a
● Also known as early pregnancy great deal of blood.
failure ○ Advise mothers to look for
● The fetus dies in the utero but is signs of:
not expelled. ■ Fever
● It is usually discovered during ■ Abdominal Pain
prenatal examination when no ■ Tenderness
increase in fundal height and there ■ Foul smelling
is no FHB heard discharge from
● A woman may have had vagina
symptoms of threatened HABITUAL ABORTION
miscarriage and may have no ● Three or more successive
clinical symptoms spontaneous pregnancy loss
● If pregnancy is over 14 weeks ○ If not successive it is called
labor may be induced by repeated abortion.
administration of Cytotec to dilate ● Causes
the cervix followed by oxytocin ○ Cervical incompetence
stimulation ○ Poor nutritional status
TREATMENT ○ Hormonal disturbance
● DIC ○ Defective ova or
● ESTROGEN spermatozoa
● D&C ○ Rh incompatibility
● OXYTOCIN ○ Chronic Nephritis
COMPLICATION OF MISCARRIAGE ● Treatment may cause such as
● Hemorrhage cervical incompetence or
○ For complete abortion treatment of causative disease as
■ Hemorrhage is rare syphilis, DM, etc.
○ For incomplete abortion or LABORATORY FINDINGS
accompanying DIC ● Ultrasonography
■ Major hemorrhage ● PT
is a possibility ● Blood Count
○ Complication may include ● Gestational Sac and Viable
hypovolemic shock Embryo with heart motin
● Hcg
● Anemic
COMPLICATION
● Severe hemorrhage
● Intrauterine Synechiae
○ Adhesion
● Perforation
SEPTIC ABORTION
● An infection of the placenta and
the fetus of a previable pregnancy.
● Infection is centered in the
placenta and there is risk of
spreading to the uterus causing
pelvic infection or becoming
systemic to cause sepsis and
potential damage of distant vital
organs
SIGNS AND SYMPTOMS
● Tender uterus
● Offensive vaginal bleeding
● High temperature
● Rapid pulse
● Unstable BP
● Shock
TREATMENT
● Isolation
● Clinical bacteriological to identify
the infectious organisms
● Administrations of antibiotics as
doctor orders
● Intake and output chart should be
kept
● Soiled pads should be properly
collected and burned.
HEMATOLOGIC DISORDERS