MindMap Gallery spontaneous abortion
Pregnancy abnormalities, such as spontaneous abortion, which refers to the termination of pregnancy before the embryo and fetus are viable; premature rupture of membranes: the natural rupture of fetal membranes before delivery, including term premature rupture of membranes and preterm premature rupture of membranes.
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This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about the reproductive development of animals, and its main contents include: insects, frogs, birds, sexual reproduction, and asexual reproduction. The summary is comprehensive and meticulous, suitable as review materials.
pregnancy abnormalities
spontaneous abortion
Overview
Definition: Abortion is the termination of pregnancy before the embryo and fetus are viable.
Estimation of expected delivery date: The expected delivery date is calculated from the first day of the last menstrual period, and the entire pregnancy period is 280 days in total.
nursing assessment
Physiological assessment
Causes: embryonic factors (the most common cause), maternal factors, paternal factors and environmental factors.
Pathology: Miscarriage before 8 weeks of pregnancy: often presents with vaginal bleeding first, then abdominal pain, complete miscarriage often occurs, and the bleeding is not much. Incomplete abortion often occurs between 8 and 12 weeks of pregnancy, with heavy bleeding. After 12 weeks of pregnancy, the placenta has been completely formed, and the abortion process is the complete delivery process: abdominal pain first, and then the fetus and placenta are expelled.
health history
Common types and clinical manifestations
The main symptoms are vaginal bleeding and abdominal pain after menopause.
type
threatened abortion
Symptoms include a small amount of vaginal bleeding before 28 weeks of pregnancy without discharge of pregnancy products, and then mild lower abdominal pain, low back pain and a sinking feeling.
Gynecological examination: the cervix is not dilated, the fetal membranes are not ruptured, the size of the uterus is consistent with the pregnancy month, and the urine pregnancy test is positive.
Miscarriage is inevitable
Miscarriage is unavoidable and often develops from threatened abortion, manifested by increased vaginal bleeding or discharge, and worsening paroxysmal lower abdominal pain.
Gynecological examination: The cervix has been dilated, and the size of the uterus is consistent with the month of pregnancy or slightly smaller.
incomplete abortion
It shows that some of the products of pregnancy have been excreted from the body, but some remain in the uterine cavity. This is the inevitable result of the continued development of miscarriage, which often leads to heavy bleeding and even shock.
Gynecological examination: the cervix has been dilated and the uterus is smaller than the month of pregnancy.
complete miscarriage
All the pregnancy products have been discharged, vaginal bleeding gradually stopped, and abdominal pain gradually disappeared.
Gynecological examination: the cervix is closed, the uterus is close to normal size, and the urine pregnancy test is negative.
missed abortion
Also known as "expired abortion", the embryo or fetus has died in the uterine cavity but has not been expelled in time.
The symptoms of early pregnancy disappear, the uterus does not increase with the pregnancy month but shrinks, and if it reaches the second trimester, the fetal movement may disappear.
Gynecological examination: the cervix is not opened or the cervix is closed, the fetal heartbeat cannot be heard, and the urine pregnancy test is negative.
Recurrent miscarriage (habitual miscarriage): refers to three or more consecutive spontaneous miscarriages with the same sex partner
Miscarriage combined with infection
Related inspections
Processing principles
Threatened miscarriage: identify the cause and actively treat miscarriage
Miscarriage is unavoidable: promote the complete discharge of the embryo and pregnancy products as early as possible to prevent bleeding and infection, and timely evacuation of the uterus
Incomplete abortion: uterine evacuation, prompt fluid replacement, and blood transfusion if necessary. If bleeding lasts for a long time, antibiotic prophylaxis should be given
Complete miscarriage: generally no special treatment is required
Missed abortion: handle it promptly after diagnosis, prevent DIC, and check coagulation function before treatment
Recurrent miscarriage: focus on prevention
Miscarriage complicated by infection: While controlling the infection, remove the residue in the uterine cavity
psychosocial assessment
Common nursing diagnoses
Nursing measures
Nursing care for pregnant women with threatened abortion
general care
psychological care
Take medication as directed by your doctor
For patients with luteal insufficiency, intramuscular injection of progesterone 20mg
For patients with hypothyroidism, when taking oral low-dose thyroxine tablets, pay attention to monitoring the patient's fall during medication.
Take medication as directed by your doctor
For patients with luteal insufficiency, intramuscular injection of progesterone 20mg
For patients with hypothyroidism, when taking oral low-dose thyroxine tablets, pay attention to monitoring the patient's fall during medication.
health education
Pregnant women with loose cervical os should undergo internal cervical os repair surgery before pregnancy or internal cervical cerclage at 12-14 weeks of pregnancy.
Care for those who cannot continue the pregnancy
General care: closely monitor the amount of vaginal bleeding
psychological care
Care before and after surgery
health education
premature rupture of membranes
Natural rupture of fetal membranes before labor, including premature rupture of membranes at term and premature rupture of membranes before term
nursing assessment
Physiological assessment
Cause
Reproductive tract infections: important causes
Increased amniotic pressure, uneven stress on fetal membranes, trauma, and nutritional factors
Pathology, health history
clinical manifestations
Symptoms: Pregnant women suddenly experience uncontrollable vaginal discharge, which starts in large quantities and then gradually decreases, with intermittent discharge.
Signs: During anal examination, the posterior vaginal fornix is pulled up or the presenting part of the fetus is pushed up, and the amount of vaginal fluid (thin and may be mixed with vernix or meconium) is increased.
Mother and child influence
Pregnant women: intrauterine infection, puerperal infection
Fetus: premature birth, perinatal death, pneumonia, umbilical cord prolapse, etc.
Related inspections
Vaginal smear test, amnioscopic examination
Vaginal fluid pH test (the most important auxiliary test method)
Treatment principles: Prevent umbilical cord prolapse and infection; terminate pregnancy if it is <24 weeks or ≥36 weeks of pregnancy
psychosocial assessment
Common nursing diagnoses
Nursing measures
Expectant care for pregnant women
Prevent umbilical cord prolapse
Absolute bed rest, lie on the left side, and raise the buttocks to prevent umbilical cord prolapse or umbilical cord compression, which may cause fetal hypoxia or intrauterine distress.
Early detection and early treatment through fetal heart rate monitoring
Umbilical cord prolapse can be treated under strict disinfection and the umbilical cord can be retracted. End labor within minutes if necessary
Prevent infection
Closely observe the amniotic fluid properties, color, smell, and vital signs
Use antiseptic cotton balls to scrub the perineum twice a day
If the membranes are ruptured for more than 12 hours, use prophylactic antibiotics as directed by your doctor.
Reduce irritation: prohibit enemas and avoid unnecessary anal and vaginal examinations
Closely observe the condition of the fetus: follow the doctor’s advice and use tocolytics to prevent premature birth
Monitor contractions
Nursing care and health education for patients with termination of pregnancy