ARELLANO UNIVERSITY

COLLEGE OF NURSING
CAPP – 1 , CA – 1 , Eteeap
OBSTETRIC NURSING
DLP

BITO, ADAM SEALTIEL

PASAY
BSN-4
19-00212

I.MATERNAL CHANGES DURING PREGNANCY

Give at list three answers ( 1pt. )

Reproductive Organs:

Uterine Changes
- Lower segment softens (Hegar’s sign)
- Blood vessels increase in size.
- Increase in fibroelastic tissue

Cervix
- Formation of operculum (mucus plug)
- Softening of cervix (Goodell’s sign)
- Increasing vascularity causes it to darken its color from pale pink to violet blue.

Vagina
- Swollen
- Change in color from pink to violet blue (Chadwick’s)
- change in ph. = from over 7 to 4 or 5 due to the action of lactobacillus acidophilus. This
activity of the vagina protects its bacterial invasion during pregnancy.

II. BLEEDING DISORDERS (20pts.)

FIRST TRIMESTER BLEEDING

Abortion:
-Termination of pregnancy before the period of validity, which 24 weeks of gestation.

TERM DESCRIPTION ASSESSMENT MANAGEMENT

GUIDLINES
SPONTANEOUS  Termed early  History of the  Depending on her
ABORTION when it occurs episode (attempt history woman
before the 6th to self-abort). may be confined in
week and late if an ambulatory
it occurs before setting or in a
 the 16th-24th hospital.
week.
 Vaginal spotting,
 Also termed which is
miscarriages, presenting
which occurred symptom
from natural
causes.
 Often due to
abnormal fetal
presentation

 Immunologic
factors causing
rejection of the
fetus.
 Trauma and
maternal
infection

THREATENED  The continuation of  Positive vaginal  Limit activities to

ABORTION the pregnancy is in bleeding, which is 24-28 hours
doubt. usually bright red  Provide Emotional
in color and Support
moderates in  Reassure the
amount. woman that it is
not her fault that
 No cramping or abortion occurred
cervical dilation spontaneously
 Estrogen and
Progesterone
Therapy
(diethylstilbestrol)
can be
administered
though it has not
yet proven to be
effective
 Advice Regarding
restriction of
coitus for 3
IMMINENT ABORTION  The product of  If there are
conception is complete
inevitable contractions and
cervical dilatation
accompanying the
passage of a
moderate amount
 of bright red
vaginal bleeding

MISSED  Positive  Intermittent  Intermittent

ABORTION symptoms of bleeding, absence bleeding, absence
threatened of uterine growth of uterine growth
abortion  Painless vaginal  Painless vaginal
bleeding bleeding
 Retention of the  No fetal heart
products of  No fetal heart sounds
conception after sounds  Failure of growth
fetal death  Failure of growth support
RECURRENT/  Three or more  Provide IV,
HABITUAL ABORTION spontaneous Monitor bleeding,
abortions Count perineal
pads, and
psychological
support Note:
Because
spontaneous
abortion is
threatening, all
perineal pads must
be inspected for
the products of
conception. Fluid
replacement is
necessary because
of blood loss
INDUCED ABORTION  Can be therapeutic
but never allowed
in the Philippines.

References and pages: RNpedia Complete Nursing Notes and Community (1pt)