Disorder Definition Signs and symptom Management

Endometritis Endometritis is an infection of the endometrium or History Medical

decidua, with extension into the myometrium and
Diagnosis usually is based on clinical findings.
parametrial tissues. Endometritis is divided into  Combination intravenous clindamycin and
obstetric and nonobstetric endometritis. It is the gentamicin administered every 8 hours has been
most common cause of fever during the postpartum  Fever
considered the criterion standard treatment.
period  Lower abdominal pain
Some studies have revealed adequate efficacy
 Foul-smelling lochia in the obstetric
with daily dosing as well.2
population
Acute Endometritis  Second- or third-generation cephalosporin in
 Abnormal vaginal bleeding
combination with metronidazole is another
Acute Endometritis is characterized by infection. The  Abnormal vaginal discharge
popular choice.
most causative agents are Staphylococcus  Dyspareunia (may be present in patients
 Improvement is usually noted within 48-72 hours
aureus and Streptococcus. The most common causes with pelvic inflammatory disease [PID])
in nearly 90% of women. Parenteral therapy is
of infection are believed to be because of  Dysuria (may be present in patients with
continued until the patient has been afebrile for
compromised abortions, delivery, medical PID)
longer than 24 hours. Thereafter, oral antibiotics
instrumentation, and retention of placental  Malaise
are not usually necessary.
fragments. 
Physical
Chronic Endometritis  Gentamicin
Chronic Endometritis is characterized by the presence  Garamycin
 Fever, usually occurring within 36 hours  Clindamycin
of plasma cells in the stroma. The most common
of delivery, in the obstetric population  Cleocin
causes are chronic pelvic inflammatory
 Lower abdominal pain  Cefoxitin
disease (PID), tuberculosis, and chlamydia. Patients
suffering from chronic endometritis often have an  Uterine tenderness  Mefoxin
underlying cancer of the cervix or endometrium.  Adnexal tenderness if there is an  Doxycycline
Chronic granulomatous endometritis is most often associated salpingitis  Bio-tab
tuberculous in etiology. The granulomas are small,  Foul-smelling lochia  Doxy
sparse, and without caseation. The granulomas take  Tachycardia  Vibramycin
up to 2 weeks to develop and since the endometrium  Vibra-tabs
is shed every 4 weeks, the granulomas are poorly
formed
Surgical
Dilatation and curettage 

Nursing management

vaginitis Vaginitis is described medically as irritation and/or Vaginitis symptoms may include: Medical
inflammation of the vagina. Vaginitis is a very The type of medication used for vaginitis treatment
 common disease affecting millions of women each
year.
Bacterial - this type of infection is caused when
healthy vaginal organisms are replaced by bacteria. It
is referred to as bacterial vaginosis and is the most
common type of vaginitis.
Yeast - this type of infection is called candidiasis. It is
caused by a fungus and is the second most common
type of vaginitis.
Protozoan - this type of infection is called
trichomoniasis and it is considered a sexually
transmitted disease (STD). It is the least common and
comprises 3% to 5% of all vaginitis infections.
Trichomoniasis - Trichomoniasis is a sexually
transmitted disease that is caused by a single-cell
parasite. It can cause vaginal itching, burning,
and soreness of the vagina and vulva, as well as
burning during urination. Many women with
trichomoniasis do not develop any symptoms.
Non-infectious vaginitis - This form of vaginitis is
usually caused by an allergic reaction or irritation
from vaginal sprays,douching, spermicidal products,
soaps, detergents, or fabric softeners. It can cause
burning, itching, or vaginal discharge even if there is
no infection
cervicitis inflammation of the cervix - the lower part of the
uterus that extends about one inch into the vaginal
canal
 Change in color, odor or amount of discharge
from your vagina
 Vaginal itching or irritation
 Pain during intercourse
 Painful urination
 Light vaginal bleeding
Additionally, you may have these signs and
symptoms depending on the type of vaginitis:
 Bacterial vaginosis. You may develop a
grayish-white, foul-smelling discharge. The
odor, often described as fish-like, may be
more obvious after sexual intercourse.
 Yeast infections. The main symptom is itching,
but you may have a white, thick discharge that
resembles cottage cheese.
 Trichomoniasis. This infection can cause a
greenish yellow, sometimes frothy discharge.
In the mildest form of cervicitis, you may not notice
any symptoms at all.
 The first symptom of cervicitis likely will
be a vaginal discharge that becomes more
pronounced immediately following
yourmenstrual period.  used in women who have reached menopause
Other signs include the following: 
depends on which type you have:
Bacterial vaginosis.  metronidazole (Flagyl,
MetroGel) or clindamycin (Cleocin) as tablets or vaginal
gels or creams.
Yeast infections. Yeast infections usually are
treated with an antifungal cream or suppository, such as
miconazole (Monistat), clotrimazole (Gyne-Lotrimin) and
tioconazole (Vagistat). Yeast infections may also be treated
with an oral antifungal medication, such as fluconazole
(Diflucan).
Trichomoniasis.  metronidazole (Flagyl) or
tinidazole (Tindamax) tablets.
Atrophic vaginitis. Estrogen, in the form of
vaginal creams, tablets or rings, can effectively treat
atrophic vaginitis
Noninfectious vaginitis. To treat this type of
vaginitis, you need to pinpoint the source of the irritation
and avoid it. Possible sources include new soap, laundry
detergent, sanitary napkins or tampons.
Surgical
Nursing
Medical
Antibiotics are used to treat bacterial infections, such as
chlamydia, gonorrhea, and others. Drugs called antivirals
may be used to treat herpes infections.
Hormonal therapy (with estrogen or progesterone) may be
(postmenopausal).
Surgical
 When these treatments have not worked or when
o Bleeding  cervicitis has been present for a long time, treatment may
include:
o Itching 

o Irritation of the external  Cryosurgery (freezing)

genitals   Electrocauterization
 Laser therapy
o Pain during intercourse 

o Bleeding or spotting after

sexual intercourse or between periods 

o A burning sensation during
urination
o Lower back pain or pain low
in the abdomen, sometimes felt only during
sexual intercourse

 A more severe case of cervicitis can

cause a profuse, almost puslike,discharge with
an unpleasant odor, accompanied by intense
vaginal itchiness or abdominal pain. 

 If the infection gets into your system,

you may also have fever, nausea,
andabdominal pain.

Toxic Shock syndrome  a potentially fatal illness caused by a bacterial toxin. Medical
(TSS) Different bacterial toxins may cause toxic shock The goal of treatment is to maintain important body
syndrome, depending on the situation.
functions. This may include:
The causativebacteria include Staphylococcus
aureus and Streptococcus pyogenes. Streptococcal
TSS is sometimes referred to as toxic shock-like  Antibiotics for any infection (may be given
syndrome (TSLS) or streptococcal toxic shock
through an IV)
syndrome (STSS).
 Dialysis (if severe kidney problems are present)
Possible Complications  Fluids through a vein (IV)
 Methods to control blood pressure
  Intravenous gamma globulin may help in severe
 Severe organ dysfunction cases
o Kidney failure
o Heart failure Nursing:
o Liver failure Any foreign materials, such as tampons, vaginal sponges,
 Shock or nasal packing, will be removed. Sites of infection (such
as a surgical wound) will be drained.
Risk factors include:

 Childbirth
 Staphylococcus aureus (S. aureus) infection,
commonly called a Staph infection
 Foreign bodies or packings (such as those
used to stop nosebleeds)
 Menstruation
 Surgery
 Tampon use (particularly if you leave on in
for a long time)
 Use of barrier contraceptives such as a
diaphragm or vaginal sponge
 Wound infection after surgery

Sexually transmitted Sexually transmitted diseases (STDs) are infections
Disease (STD)
that you can get from having sex with someone who
has the infection.
Bacterial
 Chancroid (Haemophilus ducreyi)
 Chlamydia (Chlamydia trachomatis)
 Granuloma inguinale or (Klebsiella
granulomatis)
 Gonorrhea (Neisseria gonorrhoeae)
 Unusual vaginal discharge, or any Medical:
discharge from the rectum or penis.
 Painful intercourse. Antibiotics for infections such as Chlamydia, syphilis,
 Burning or discomfort during urination. gonorrhoea and Trichomonas
 Unusual pain or discomfort in the
abdomen in women or the testicles in men.
Also be aware of any unusual pain in both the  Penicillin
buttocks and legs.  Amoxicillin
 Swelling, blisters, open sores, warts, or a
 Azithromycin
rash in the genital area, on the sexual organs, or
in the mouth.  Metronidazole
 Flu-like symptoms such as fever,  Tinidazole
headache, aching muscles, or swollen glands.
 Ceftriaxone
 Doxycycline

 Syphilis (Treponema pallidum)  Management of HIV

Fungal
 Tinea cruris, "jock itch," may be sexually  Antiretrovirals

transmitted.[2]
 Management of genital warts
 Candidiasis, yeast infection
Viral o Cryotherapy
o Podophyllin cream
 Viral hepatitis (Hepatitis B virus)—saliva, o Imiquimod cream

venereal fluids. o Freezing

(Note: Hepatitis A and Hepatitis E are

transmitted via the fecal-oral route; Hepatitis

C (liver cancer) is rarely sexually transmittable,

[3]
 and the route of transmission of Hepatitis

D (only if infected with B) is uncertain, but may

include sexual transmission.[4][5][6])

 Herpes simplex (Herpes simplex virus 1, 2)

skin and mucosal, transmissible with or without

visible blisters

 Retrovirus like XMRV, HTLV or HIV/ AIDS (H

uman Immunodeficiency Virus)— venereal fluids,

semen, breast milk, blood

 HPV (Human Papilloma Virus)— skin and

mucosal contact. 'High risk' types of HPV are

known to cause most types of cervical cancer, as

well as anal, penile, and vulvar cancer,

and genital warts.

 Molluscum contagiosum (molluscum

contagiosum virus MCV)—close contact

Parasites

 Crab louse, colloquially known as "crabs" or

 "pubic lice" (Phthirius pubis)
 Scabies (Sarcoptes scabiei)
Protozoal
 Trichomoniasis (Trichomonas vaginalis)
Gestational Diabetes
Mellitus a condition in which women without previously
diagnosed diabetes exhibit high blood glucose levels
during pregnancy.
Gestational diabetes generally has few symptoms and
it is most commonly diagnosed by screening during
pregnancy. Diagnostic tests detect inappropriately
high levels of glucose in blood samples. Gestational
diabetes affects 3-10% of pregnancies, depending on
the population studied.[2] No specific cause has been
identified, but it is believed that the hormones
produced during pregnancy increase a woman's
resistance to insulin, resulting in impaired glucose
tolerance.
Babies born to mothers with gestational diabetes are
typically at increased risk of problems such as
being large for gestational age (which may lead to
delivery complications), low blood sugar,
andjaundice. Gestational diabetes is a treatable
condition and women who have adequate control of
glucose levels can effectively decrease these risks.
 Blurred vision Medical:
 Fatigue Nursing:
 Frequent infections, including those of
the bladder, vagina, and skin  Avoid high-calorie snacks and desserts, including
 Increased thirst soda with sugar, fruit punch, candy, chips,
 Increased urination cookies, cakes, and full-fat ice cream
 Nausea and vomiting  Using artificial sweeteners, such as aspartame
 Weight loss in spite of increased appetite (Nutrasweet®), sucralose (Splenda®), stevioside
(Stevia®), or saccharin (Sweet 'N' Low®) has not
been linked to an increased risk of birth defects.
There is no information on the safety of
acesulfame potassium (Sunnet®) in pregnancy.
 Eat a lot of vegetables and fruits, at least five
servings a day. Some fruits (like grapes, dried
fruit) can increase your blood sugar level
significantly and should be eaten in limited
amounts. Limit starchy vegetables (eg, potatoes),
but eat as many nonstarchy fruits or vegetables
as you like.
 Choose foods with whole grains. This includes
whole-wheat bread, brown rice, or whole-wheat
pasta instead of white bread, white rice, or
regular pasta.
 Eat a limited amount of red meat, and choose
lean cuts of meat that end in "loin" (eg, pork loin,
tenderloin, sirloin). Remove skin from chicken
and turkey before eating.
 Choose low- or fat-free dairy products, such as

Women with gestational diabetes are at increased
risk of developing type 2 diabetes mellitus (or, very
rarely, latent autoimmune diabetes or Type 1) after
pregnancy, as well as having a higher incidence
of pre-eclampsia and Caesarean section 
Molar pregnancy A molar pregnancy happens when tissue that
normally becomes afetus instead becomes a growth,
called a mole, in your uterus. Even though it is not
an embryo, a mole triggers symptoms of pregnancy.
A molar pregnancy should be treated right away. This
will make sure that all of the mole tissue is removed.
This tissue can cause serious problems in some
women.
About 1 out of 1,000 women with early pregnancy
symptoms has a molar pregnancy.1 This means that
999 women out of 1,000 do not have this problem.
There are two types of molar pregnancy: complete
and partial.
Complete molar pregnancy. An egg with no
genetic information is fertilized by a sperm. The
sperm grows on its own, but it can only become a
lump of tissue. It cannot become a fetus. As this
tissue grows, it looks a bit like a cluster of grapes. This
cluster of tissue is called a mole, and it can fill the
uterus.
Partial molar pregnancy. An egg is fertilized
by two sperm. Normally this creates twins. But in a
partial molar pregnancy, something goes wrong. The
placenta grows into a mole instead. Any fetal tissue
that forms is likely to have severe defects.
Abortion
A molar pregnancy causes the same early
symptoms that a normal pregnancy does, such as a
missed period or morning sickness. But a molar
pregnancy usually causes other symptoms too.
These may include:
 Bleeding from the vagina.
 A uterus that is larger than normal.
 Severe nausea and vomiting.
 Signs of hyperthyroidism. These include
feeling nervous or tired, having a fast or
irregular heartbeat, and sweating a lot.
 An uncomfortable feeling in the pelvis.
 Vaginal discharge of tissue that is shaped
like grapes. This is usually a sign of molar
pregnancy.
 
skim milk, nonfat yogurt, and low-fat cheese
 Use liquid oils (olive, canola) instead of solid fats
(butter, margarine, shortening) for cooking
Blood sugar monitoring — You will learn how to check
your blood sugar level and record the result
Medical
Surgical:
  vacuum aspiration 
 dilatation and curettage (D&C)
 hysterectomy, 
Nursing
 Measuring hCG levels every 1 to 2 weeks until
they are normal, then measuring them every 1 to
2 months for 6 months to a year. Levels of hCG
that stay high may be a sign of cancer.
 Preventing pregnancy while hCG levels are being
monitored, usually about 6 months. It is very
important that you practice highly effective birth
control during the entire period of follow-up. For
more information on contraception, see the
topic Birth Control.
Close medical supervision if you happen to
conceive within 12 months of molar pregnancy
treatment.
Types of Abortion:
1. Spontaneous abortion or miscarriages - is a
type of abortion that occur without medical
or other intervention.
 Threatened abortion 
 Inevitable abortion
 Complete abortion .
 Incomplete abortion 
 Missed abortion 

2. Induced abortion - this type of abortion

uses drugs or instruments to stop the normal
course of pregnancy

 Menstrual Extraction (endometrial or

vacuum aspiration).
 Dilation and Evacuation (D & E)