Quiz in NCM 107

1. Trace the pathophysiology of ectopic pregnancy

The most common site of ectopic implantation is a fallopian tube, followed by the uterine
cornua (referred to as a cornual or an interstitial pregnancy). Pregnancies in the cervix, a
cesarean delivery scar, an ovary, or the abdomen are rare.

Heterotopic pregnancy (simultaneous ectopic and intrauterine pregnancies) occurs in only

1/10,000 to 30,000 pregnancies but may be more common among women who have had
ovulation induction or used assisted reproductive techniques such as in vitro fertilization and
gamete intrafallopian tube transfer (GIFT); in these women, the overall reported ectopic
pregnancy rate is 1 to 2%. The anatomic structure containing the fetus usually ruptures after
about 6 to 16 weeks.

Rupture results in bleeding that can be gradual or rapid enough to cause hemorrhagic shock.
The later in the pregnancy the rupture occurs, the more rapidly blood is lost and the higher the
risk of death.

2. What are your nursing responsibilities to a mother who has H-mole?

Assess for signs and symptoms of pregnancy induced hypertension, because for a woman
with H-mole, they occur earlier than the 20th week of pregnancy. Instruct the woman to save all
perineal pads containing any clots or tissue that has passed out of her during bleeding.

3. What is the effect of abruptio placenta to the fetus?

Placental abruption can deprive the baby of oxygen and nutrients and cause heavy
bleeding in the mother. In some cases, early delivery is needed. Placental abruption (abruptio
placentae) is an uncommon yet serious complication of pregnancy.