The existence of hypertension may occur before being pregnant but eventually it develops to a pregnancy complication in the long run during pregnancy known as gestational hypertension (GH). The main goal of all health care providers and the whole medical team is to aim to have a pregnant woman deliver a healthy baby without any complications. Unfortunately pregnancy complications may still occur during any period of pregnancy such as antepartum period, intrapartum period, postpartum period, and immediate neonatal period. Close observation and nursing care plans pertaining to GH must be provided for safe pregnancy.
What is gestational hypertension (GH)? GH is usually developed around the 20th week of gestation without the presence of proteinuria. A blood pressure of 140/90 mm Hg or above is likely to be considered hypertension in pregnancy but the blood pressure turns to normal by six weeks post partum. 5% to 7% of pregnancies have hypertension complications which cause maternal and fetal morbidity when left untreated. (Lindheimer , 2008). The main cause of GH is still unknown but the only cure is by giving birth (post partum period). The risk factors of developing GH in pregnant women are very important to know such as obesity, women aged 35 or more, history (hx) of diabetes mellitus, hx of hypertension, hx of renal disease, adolescent pregnancy, first pregnancy, thrombophilis, multiple gestation, and abnormal placenta. By determining the risk factors of GH the likelihood of severe complications may be avoided and monitored.
The signs and symptoms of GH complications in antepartum period of pregnancy is closely monitored and assessed. There are several classic signs of GH during pregnancy such as ...
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...a, kidney failure, and possible convulsions. Magnesium sulfate is still continuing at this time to prevent the convulsion to occur. The mother and baby are monitored for 48 hours postpartum. The baby must be closely monitored as well, keeping the baby safe and warm. Breastfeeding is not recommended until 12 hours because of the administration of the magnesium sulfate. Formula feeding is given to the baby instead.
With the help of the health care team, pregnancy complications can be minimized and controlled significantly. Severe complications can be avoided with the mother’s compliance along with the family and friends support to the care plan given. The nurses should help the mother and family to cope, to stay positive and to stay strong. Trusting and believing that nothing will go wrong can really help with the process of controlling any complications.
These women could anticipate delays in normal growth and development for the fetus. The exact cause of post term pregnancy is unknown. The mother experiencing post term pregnancy is at risk for trauma, hemorrhage, infection, and labor abnormalities (Ward et al., 2016, p. 543). Labor induction prior to 42 weeks’ gestation prevents MAS and other complications. A biophysical profile measuring the heart rate, breathing and body movements, tone, and the amniotic fluid volume is used to monitor the fetus for intrapartum fetal stress that could cause passage of meconium. Diabetic woman is at high risk for preeclampsia or eclampsia, infection, hydramnios, postpartum hemorrhage, and cesarean birth (Ward et al., 2016, p. 383). In addition, fetal macrosomia prolongs labor due to shoulder dystocia. The glucose challenge test, and the 3- hour OGTT is used for gestational diabetes screening, done after 24 weeks of pregnancy. Abnormalities of the respiratory system as explained earlier are the most concerning complication of MAS, needing immediate
The opportunity to bring life into the world is a priceless moment, and for that to be threatened by a disease; such as Placenta Previa, is heartbreaking. Placenta previa is commonly described as the imbedding of the placenta over or close to the cervix. According to the Permanente Medical Group, during a normal pregnancy the placenta forms at the top part of the uterus far from the cervix. However in placenta previa, the placenta tends to attach to the lower section of the uterus either covering or partially over the cervix, making it almost impossible for a normal delivery (vaginal birth) to take place (Placenta Previa). Placenta previa complicates about 1 in every 200 deliveries and is one of the top leading causes of vaginal bleedings for the second and third trimester (Getahun). It is also related with the escalation of risks of maternal and infant illness and death (Getahun). Instead of there being a specific or many solutions over the years, doctors have come to agreement with different treatments for placenta previa. The obvious solution to placenta previa is to reduce your risks by avoiding cigarettes and any type of drugs, try to reduce your use of abortions an cesarean section, meaning no elective C-sections (The Bump). However, because the reduction in the things above is unlikely due to the mind-frame and unawareness of today’s women, the medical board has to think of alternative treatments to placenta previa, such as bed rest, constant monitoring through-out the pregnancy, and cesarean section. In this essay, I will evaluate the above listed treatments, which stage the doctor will suggest the treatment and explain which I believe is best.
The causes of hypertension are unknown. However; hypertension can be classified into two categories primary and secondary. Primary (essential) hypertension is increas...
It is important to understand what women commonly experience during pregnancy. With a better understanding of what happens during prenatal development and childbirth, physicians can competently develop the best plan for the mother and baby. I interviewed two women who have been previously pregnant in order to evaluate how the ideas in the book translate into real-life experiences.
Magnesium sulfate is used as a tocoytic medicine to slow uterine contractions. It is given intravenously until contr...
...o find a balance between interventional and non-interventional birth. With this being said, I also understand that there are strict policies and protocols set in place, which I must abide to as a healthcare provider, in any birth setting. Unfortunately, these guidelines can be abused. Christiane Northrup, MD, a well recognized and respected obstetrician-gynecologist has gone as far as to tell her own daughters that they should not give birth in a hospital setting, with the safest place being home (Block, 2007, p. xxiii). Although I am not entirely against hospital births, I am a firm believe that normal, healthy pregnancies should be fully permissible to all midwives. However, high-risk pregnancies and births must remain the responsibility of skilled obstetricians. My heart’s desire is to do what is ultimately in the best interest of the mother, and her unborn child.
Performance Characteristics of Postpartum Screening Tests for Type 2 Diabetes Mellitus in Women with a History of Gestational Diabetes Mellitus: A Systematic Review, 18(7), Retrieved from http://lib-proxy.calumet.purdue.edu:2461/ehost/pdfviewer/pdfviewer?hid=15&sid=af725124-1c4c-4d18-9e92-35d14ad23d66%40sessionmgr4&vid=15&sid=af Diabetes Information Hub -. (2011). The 'Standard' of the 'Standard'. Retrieved from http://diabetesinformationhub.com/GestationalDiabetes.php. Mayo Clinic. (2010).
Gestational diabetes is a form of diabetes that occurs during pregnancy. Although it usually goes away after the baby is born, it does bring health risks for both the mother and baby. When you’re pregnant, pregnancy hormones make it harder for insulin to move glucose from your blood into the cells. If your body can’t produce enough insulin to overcome the effects of insulin resistance, you’ll develop gestational diabetes. (IHC, 2013)
Postpartum hemorrhage is the leading cause of maternal mortality in the world, according to the World Health Organization. Postpartum hemorrhage (PPH) is generally defined as a blood loss of more than 500 mL after a vaginal birth, more than 1000 mL after a cesarean section, and a ten percent decrease in hematocrit levels from pre to post birth measurements (Ward & Hisley, 2011). An early hemorrhage occurs within 24 hours of birth, with the greatest risk in the first four hours. A late hemorrhage happens after 24 hours of birth but less than six weeks after birth. Uterine atony—failure for the uterine myometrium to contract—is the most common postpartum hemorrhage (Venes, Ed.).(2013). Other etiologies include lower genital tract lacerations, uterine inversion, retained products of conception and bleeding disorders (Kawamura, Kondoh, Hamanishi, Kawasaki, & Fujita, (2014).
Whereas signs and symptoms to the mother can include: rapid uterine contractions, back and abdominal pain, vaginal bleeding, and uterine tenderness. Direct causes sometimes can correlate with direct injury to abdominal wall, rapid loss or excess of amniotic fluid, the mother’s lifestyle choices, hypertension, advanced maternal age, diabetes mellitus, and prior placental abruption. Although, preventive measures for placenta abruption is uncommon, attention to ongoing medical evaluation of fetal and maternal welfare connected with consideration of risk factors, outcomes can be
One of the primary prevention methods in maternal health is the utilization of prenatal care. During the provision of prenatal care, a healthcare provider counsels and discusses information with the expecting mother. Conversations about smoking and alcohol use, what to expect during pregnancy, when to seek help, and limitations on activities are put in place (Kirkham, Harris, & Grzybowski, 2005). Discussions about possible complications and potential warning signs are also an important part of prenatal education. Providing supplements, such as, calcium (1,000 to 1,300 mg per day), folic acid (0.4 to 0.8 mg), and iron (30 mg per day) to an expecting mother is also an important part of primary prevention, as they aid in the fight against blood pressure disorders, anemias, and defects in the unborn child (Kirkham, Harris, & Grzybowski, 2005). Additionally, the vaccination of expecting mothers has been shown to keep mothers and the unborn child healthy during pregnancy. Certain vaccinations, such as Tdap (tetanus, diphtheria, and pertussis) and inactivated influenza vaccinations, have been shown to be protective to the fetus, as the mother’s antibodies against the disease are transferred to the unborn child (Esposito et al., 2012).
Over the years birthing methods have changed a great deal. When technology wasn’t so advanced there was only one method of giving birth, vaginally non-medicated. However, in today’s society there are now more than one method of giving birth. In fact, there are three methods: Non-medicated vaginal delivery, medicated vaginal delivery and cesarean delivery, also known as c-section. In the cesarean delivery there is not much to prepare for before the operation, except maybe the procedure of the operation. A few things that will be discussed are: the process of cesarean delivery, reasons for this birthing method and a few reasons for why this birthing method is used. Also a question that many women have is whether or not they can vaginally deliver after a cesarean delivery, as well as the risks and benefits if it. Delivering a child by a c-section also has a few advantages and disadvantages for both the mother and child; this will also be discussed in more depth a bit later.
Jancárková, N., & Gregor, V. (2000). [Teratogens during pregnancy]. Ceska gynekologie/Ceska lekarska spolecnost J. Ev. Purkyne, 65(3), 188-194.
Also known as perinatology, Maternal-Fetal Medicine is an evolving field in medicine. This field refers to the specialized care of pregnant women and their unborn babies. There are several needs and uses for Maternal Fetal Medicine (MFM) doctors. Some uses include having a consultation from MFM doctors because they are at “high risk” and are considering getting pregnant or are already pregnant and have high risk for complications.
Many studies done during normal labor failed to prove the effect of magnesium sulfate on uterine muscle on prolonging labor or prompting cesarean section (7-10). However one study in mild preeclampsia during labor induction reported that i.v. magnesium sulfate resulted in a significantly higher maximum oxytocin dose required in labor when compared to placebo (8).