CONDITIONS ASSOCIATED WIT FIRST TRIMESTER BLEEDING

COMPLICATIONS DEFINITIONS CAUSE COMPLICATIONS SIGNS AND DIAGNOSTIC NURSING MEDICAL NURSING
OF PREGNANCY SYMPTOMS TEST DIAGNOSIS MANAGEMENT INTERVENTIONS
SPONTANEOUS  The most FETAL CAUSES: hemorrhage TYPES of
ABORTION common Developmental Infection/septic SPONTANEOUS
form of anomalies, abortion ABORTION:
bleeding chromosomal Disseminated recall acronym:
disorder in and implantation intravascular MIITCH’S
early abnormalities coagulation 1) Missed Insertion of 1) Provide
pregnancy MATERNAL (DIC) if missed abortion – fetus 20mg emotional
 The CAUSES: abortion is dies in utero but dinoprostone support
expulsion Age, structural retained beyond is not expelled (prostaglandin)
of the fetus abnormalities of 1 month, S/S: cervix is suppository in
and other reproductive common in late closed the vagina
products of tract, inadequate abortion cessation of S/S every3-4 hours
conception progesterone of pregnancy (no as necessary to
from the production, uterine produce
uterus systemic enlargement, contractions to
before the infection, chronic absence of FHT) expel products
fetus is maternal painless vaginal of pregnancy
viable diseases, bleeding – Misoprostol
(viability) ingestion of brown vaginal (cytotec)
that is teratogenic discharge or introduce into
before 20 drugs, chronic may have no the cervix to
weeks AOG smoking, prior clinical cause dilatation.
from LMP ingestion of symptoms. D&C to remove
or before alcohol, fragments of
the fetus exposure to placenta
weighs radiation and
500grams high doses of
 Usually caffeine
occurs in
15-20% of
pregnancy 2) Imminent or Hospitalization, 1) Position
Inevitable D&C, Oxytocin patient flat on
abortion – after D&C bed and
characterized by massage the
bleeding, uterus
cramping and 2) Monitor for
cervical dilation shoulder pain
and the and abdominal
termination pain that may
cannot be suggest
prevented perforation of
S/S: uterus
Moderate to 3) Monitor VS
profuse for shock
bleeding, 4) Monitor blood
moderate to loss
severe uterine 5) Monitor I & O
cramping, and blood
dilation of studies
cervix, rupture
of membranes, 1. Ask LMP if it is
no tissue as more than 20
passed yet weeks AOG it
3) Incomplete may be due to
abortion – Dilatation & placenta previa
characterized by Curettage and not abortion
expulsion of only – DO NOT DO
part of the INTERNAL
products of EXAMINATION
conception 2. Assess pain –
(usually the UTZ – shows usually in the
fetus) and some products suprapubic area
bleeding occurs of pregnancy that radiate in
with cervical are still inside the lower back,
dilation the uterus buttocks,
S/S: genitalia and
Heavy vaginal perineum. If
bleeding, severe occurring in only
uterine one side,
cramping, open consider ectopic
cervix, passage pregnancy or
of tissue ruptured ovarian
cyst. When the
pain subsides, it
3) Threatened may suggest
abortion – completion of
characterized by the abortion.
cramping and 4. Bedrest until 3
vaginal bleeding days after
in early bleeding as
pregnancy with stopped, if
no cervical bleeding and
dilation and pain persist –
there is advised to go to
possibility of loss the hospital.
of the products 5. Advise couple
of conception. It no coitus up to 2
may subside or weeks after
an incomplete bleeding
abortion may stopped.
follow.
S/S: 1) No therapy
Light vaginal other advising
bleeding, no or the woman to
mild uterine report heavy
cramping bleeding or signs
of infection
4) Complete
abortion –
characterized by UTZ – empty
complete uterus
expulsion of all
the products of
conception
S/S:
Light vaginal
bleeding,
abdominal pain
and passage of
tissue ten no
pain and
tenderness after
passage of
tissue, no or
mild cramping,
closed cervix
and in UTZ
empty uterus
5) Habitual –
abortion or
recurrent
pregnancy loss –
is spontaneous
abortion of tree
or more
consecutive
pregnancies
6) Septic
abortion