URDANETA CITY UNIVERSITY

San Vicente West, Urdaneta City, Philippines-2428

COLLEGE OF HEALTH SCIENCES
Bachelor of Science in Nursing Program

Name: Mary Ruth D. Cruz Course and Year: BSN 2

Date: January 12, 2021 Block: Blk. 1
Subject: Care of Mother, Child, Adolescents Code: N001

Complications of Childbearing

Increased risk of complications during pregnancy, birth, and the postpartum period may involve
psychosocial, medical findings, or obstetrical deviations from normal.

Bleeding is a major complication that can occur during pregnancy. The bleeding evident during
pregnancy may not be indicative of the actual amount of bleeding occurring because so much internal
bleeding may also be happening.

Vaginal bleeding during pregnancy is always serious until ruled otherwise because it has the potential to
diminish the blood supply of both mother and fetus. Spontaneous miscarriage is the loss of a pregnancy
before viability of the fetus. (20-24 weeks).

Ectopic pregnancy is a pregnancy implantation outside the uterus, usually in the fallopian tube. If
discovered before the tube ruptures, this can be treated with methotrexate or mifepristone. If not
discovered early, it produces sharp lower quadrant pain at about 6-12 weeks as the tube ruptures.

Placenta previa is low implantation of the placenta so that it crosses the cervical os. If it is not
discovered before labor, cervical dilatation may cause the placenta to tear, causing severe blood loss.
Women who have symptoms of placenta previa should not have vaginal examinations done to prevent
disruption of the low implanted placenta.

Preterm labor is labor that occurs after the 20 weeks and before the end of the 37th week of pregnany.
Tocolytic drugs that can halt labor, includes magnesium sulfate and beta-sympathomimetic agents such
as terbutaline (Brethine).
Pregnancy induced hypertension is a unique disorder that occurs with pregnancy with 3 classic
symptoms; hypertension, edema, and proteinuria. It is categorized as preeclampsia or eclampsia.

Exercise A. Bleeding disorders: A common is a threat to mother and fetus. A large group of obstetric
complications may cause significant bleeding. List at least 8 and indicate when they occur.

First Half of Pregnancy:

Miscarriage: Bleeding can be a sign of miscarriage, but does not mean that miscarriage is imminent.
Studies show that anywhere from 20-30% of women experience some degree of bleeding in early
pregnancy. Approximately half of the pregnant women who bleed do not have miscarriages.
Approximately 15-20% of all pregnancies result in a miscarriage, and the majority occur during the first
12 weeks.

Signs of Miscarriage include:

 Vaginal bleeding
 Cramping pain felt low in the stomach (stronger than menstrual cramps)
 Tissue passing through the vagina

Most miscarriages cannot be prevented. They are often the body’s way of dealing with an unhealthy
pregnancy that was not developing. A miscarriage does not mean that you cannot have a future healthy
pregnancy or that you yourself are not healthy.

Ectopic Pregnancies:

Ectopic pregnancies are pregnancies that implant somewhere outside the uterus. The fallopian tube
accounts for the majority of ectopic pregnancies. Ectopic pregnancies are less common than
miscarriages, occurring in 1 of 60 pregnancies.

Signs of Ectopic Pregnancies:

 Cramping pain felt low in the stomach (usually stronger than menstrual cramps)
 Sharp pain in the abdominal area
 Low levels of hCG
 Vaginal bleeding

Women are at a higher risk if they have had:

 An infection in the tubes

 A previous ectopic pregnancy
 Previous pelvic surgery

Molar Pregnancies:
Molar pregnancies are a rare cause of early bleeding. Often referred to as a “mole”, a molar pregnancy
involves the growth of abnormal tissue instead of an embryo. It is also referred to as gestational
trophoblastic disease (GTD).

Signs of a Molar Pregnancy:

 Vaginal bleeding
 Blood tests reveal unusually high hCG levels
 Absent fetal heart tones
 Grape-like clusters are seen in the uterus by an ultrasound

Second Half of Pregnancy:

Common conditions of minor bleeding include an inflamed cervix or growths on the cervix. Late bleeding
may pose a threat to the health of the woman or the fetus. Contact your health care provider if you
experience any type of bleeding in the second or third trimester of your pregnancy.

Placental Abruption:

Vaginal bleeding may be caused by the placenta detaching from the uterine wall before or during labor.
Only 1% of pregnant women have this problem, and it usually occurs during the last 12 weeks of
pregnancy.

Signs of Placental Abruption:

 Bleeding
 Stomach pain

Women who are at higher risks for this condition include:

 Having already had children

 Are age 35 or older
 Have had abruption before
 Have sickle cell anemia
 High blood pressure
 Trauma or injuries to the stomach
 Cocaine use

Placenta Previa:

Placenta previa occurs when the placenta lies low in the uterus partly or completely covering the cervix.
It is serious and requires immediate care. It occurs in 1 in 200 pregnancies. Bleeding usually occurs
without pain.

Women who are at higher risks for this condition include:

 Having already had children

 Previous cesarean birth
 Other surgery on the uterus
  Carrying twins or triplets

Preterm Labor:

Vaginal bleeding may be a sign of labor. Up to a few weeks, before labor begins, the mucus plug may
pass. This is normally made up of a small amount of mucus and blood. If it occurs earlier, you could be
entering preterm labor and should see your physician immediately.

Signs of Preterm Labor include these symptoms that occur before the 37th week of pregnancy:

 Vaginal discharge (watery, mucus, or bloody)

 Pelvic or lower abdominal pressure
 Low, dull backache
 Stomach cramps, with or without diarrhea
 Regular contractions or uterine tightening

Contrast the 2 Hemorrhagic conditions involving the placenta considering the anatomy involved, the
predisposing factors, signs & symptoms & type of care.

Type Cause Assessment Cautions

Placenta previa Low implantation of Painless bleeding at No vaginal
placenta possibly beginning of cervical examinations to
because of uterine dilatation minimize placental
abnormality trauma
Premature separation Unknown cause: Sharp abdominal pain Disseminated
of the placenta associated with followed by uterine intravascular
(abruptio placentae) hypertension, placenta tenderness; sign of coagulation associated
separates from uterus maternal shocks, fetal with condition
distress