Question

Define, Risk factor, patho, sign and symptoms; What do we went to prevent? Nursing management; Asess, Do Treatments, medication for Hydatidform

Define, Risk factor, patho, sign and symptoms; What do we went to prevent? Nursing management; Asess, Do Treatments, medication for cesarean delivery

Define, Risk factor, patho, sign and symptoms; What do we went to prevent? Nursing management; Asess, Do Treatments, medication for vaginal delivery

Define, Risk factor, patho, sign and symptoms; What do we went to prevent? Nursing management; Asess, Do Treatments, medication placenta abruption

Define, Risk factor, patho, sign and symptoms; What do we went to prevent? Nursing management; Asess, Do Treatments, medication placenta abruption

Define, Risk factor, patho, sign and symptoms; What do we went to prevent? Nursing management; Asess, Do Treatments, medication for gestation hypertension

Define, Risk factor, patho, sign and symptoms; What do we went to prevent? Nursing management; Asess, Do Treatments, medication for STI's

Answer 1

Answer :

1) hydatiform mole :

Definition : it is the abnormal condition of the placenta where there are partly degenerative and partly proliferative changes in the young chorionic villi .these results in the formation of clusters of small cysts of varying sizes .because of its superficial resemblance to hydatid cyst ,it is named as hydatiform mole .it is best regarded as a benign neoplasia of the chorion with malignant potential .

Risk factors :

• Prevalence is higher in teenage pregnancies and women those more than 35 years .
• Faulty nutrition ,low dietary intake of carotine is associated with increased risk .
• Race and ethnicity varies .
• Rise in gammaglobulin level in absence of hepatic disease.
• Increased association with AB blood group which possesses on ABO antibody .
• Cytogenic abnormality
• History of prior hydatiform mole

Pathophysiology :

• The uterus is distened by thin walled transucent ,grape like vesicles of different sizes .these are degenerated chorionic villi filled with fluid .
• There is no vasculature in the chorionic villi leads to early to early death and absorption of the embryo.
• There is trophoblastic proliferation ,with nmmitotis activity affecting both syncytial and cytotrophoblastic layers .this causes excessive secretion of hCG ,chorionic thyrotrophin and progesterone .on the other hand , oestrogen production is low due to absence of the foetal supply of precursors .
• High hCG causes multiple theca lutein cysts in the ovaries in about 50% of cases .it is also results in exaggeration of the normal early pregnancy symptoms and signs .

Types : complete mole ,incomplete mole .

Signs and symptoms :

• Vaginal bleeding .
• Varying degree of lower abdominal pain
• Constitutional symptoms : the patient becomes sick without any apparent reason , breathlessness, vomitings of pregnancy becomes excessive , thyrotic features of trmors. Or tachycardia .
• Expulsion of grape like vesicles per vaginam is diagnostic of vesicular mole .
• Features of early onset of preeclampsia
• Absent foetal parts and FHS
• Hyperthyroidism.
• Serum hCG > 100,000 ml U / ml.

Prevention :

• There is no way to prevent hydatiform mole .if some body have molar pregnancy previously avoid another pregnancy For one year .
• Recognition of high risk factors related to choriocarcinoma
• Careful folloe up with serum beta hCG
• Use of cytotoxic drugs at optimum time and in the right care

Treatment :

• Suction and evacuation of the uterus as early as the diagnosis is made .
• Supportive therapy : correction of anemia and infection
• Counselling For regular follow ups

2) cesarean delivery :

Definition : it is an operative procedure where by the fetuses after the Whs of 28 th week are delivered through an incision on the abdominal and uterine walls .

Indications :  

• Vaginal delivery not possible .
• Central placenta praevia .
• Contracted pelvis or cephalopelvic did proportion .
• Pelvic nass
• Afvanced carcinoma cervix
• Previous caesarian delivery .
• Dystocia
• Failed induction.
• Mal presentation.
• Bad obstetric history
• Antepartum haemorrhage .etc

Signs and symptoms :

Pain in lower abdomen

Bleeding

Dehydration

Infection .

Types :

Elective

Emergency

Post operative care :

• Observation
• Fluids
• Oxytocics
• Prophylactic antibiotics
• Analgesics
• Ambulation

3) vaginal delivery :

Child birth is the period from the expulsion of regular uterine contractions until expulsion of the placenta .