Care of the Mother and Child Risk

• High risk pregnancy threatens the health or life of the mother or her fetus.
• Concurrent disorder, pregnancy-related complication, or external factor that jeopardizes the health of the mother, the fetus, or both.
• High risk pregnancy requires specialized care from specially trained providers.
• High risk pregnancy doesn’t only mean physical, it can be psychological, and financial, social factors that can categorize the pregnant women as high risk.
• The physician will refer you to different health services depending on the health condition.
• Management: If PROM occurs at 36 weeks of gestation or later, labor is induced within 24 hours to deliver the baby.
• Risk Factor: Vaginal or cervical infection
• Less than 10 kicks, go to the hospital immediately.
• Avoid sexual intercourse or insertion of anything in the vagina.
• Note any uterine contractions, reduced fetal activity, or other signs of infection.
• Diagnosis: In diagnosing, health practitioners are confused if it’s a urine or amniotic fluid coming out from the mother, therefore, they use the following tests: Nitrazine Test – swab vaginal canal, Fern Test.
• PROM can cause infection to the mother.
• Nursing Management: Report a temperature that is above 38 º C (100.4 º C)
• Record fetal kick counts daily, and report fewer than 10 kicks in a 12-hour period.
• Some women enter pregnancy with chronic illness, even before they got pregnant.
• Some women have healthy condition but develop complications during pregnancy.
• Psychological factors that can categorize pregnancy as high risk include not going for check-ups or asking for help, delays in seeking medical attention, and pregnancy-related stress.
• Social factors that can categorize pregnancy as high risk include trouble finding support people, poverty, trouble transporting, and isolation.
• Physical factors that can categorize pregnancy as high risk include poor self-assessment, pre-existing conditions, and V.A.W.C.
• The likelihood of DVT leading to pulmonary emboli increases for women 30 years of age or older because increased age is yet another risk factor for thrombosis formation.
• Thalassemia is a condition where the body has problem forming hemoglobin and there’s a higher chance of anoxia.
• When this triad of effects is in place (stasis, vessel damage, and hypercoagulation), the stage is set for thrombus formation in the lower extremities.
• If there’s thrombus formation, there’s a blood clot.
• Urinary Tract Infection is a high risk to pregnant woman because urethral meatus is near vaginal opening.
• Anemia is a common condition during pregnancy due to increased blood volume and can be exacerbated by bleeding.
• Iron supplements are used to restore hemoglobin in the body.
• Folic Acid helps with the spine and brain developments of fetus.
• Cardiovascular disorders are a major concern in high risk pregnancy, with conditions such as left sided heart failure, cough, fatigue, increased respiratory rate, and decreased amniotic fluid.
• Pregnancy can increase the risk of thromboembolic disease due to increased blood volume and changes in coagulation factors.
• Sickle Cell Anemia is a condition where the RBC malforms/depletes (nayupi ang hugis) and if there’s a problem in RBC then there’ll be problem in hemoglobin.
• Increased estrogen level can lead to high risk that blood will be stasis or slower flow because of hormonal changes.
• Varicose veins and huge veins in the legs are risk factors for thrombus formation.
• A blood clot can dislodge and travel to some areas of the body.
• Incomplete abortion occurs when not all the products of conception are expelled from the uterus, resulting in active uterine bleeding and severe abdominal cramping.
• Malaria is a protozoan infection that infects RBC and can lead to blockage, poor tissue perfusion, and treatment depends on Doctor’s Order.
• Psychological support is provided to patients who are anxious about miscarriage.
• Primary causes of RSA include genetic, chromosomal abnormalities, and anomalies of reproductive tract such as bicornuate uterus or incompetent cervix.
• Therapeutic management for miscarriage includes ultrasound to confirm fetal death by identifying the gestational sac or fetus that is too small for the presumed AOG, no fetal heart activity can be found, and pregnancy test for hCG shows a decline in placental hormone production.
• Management of hypovolemic shock is a nursing consideration in the care of a woman with a ruptured ectopic pregnancy.
• Recurrent Spontaneous Abortion- three or more spontaneous abortions