BC3- maternity, complications
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| a synthetic hormone with estrogenic properties, possible cause of incompetent cervix | diethylstilbestrol
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| for patients on bedrest from incompetent cervix to increase circulation, maintain muscle flexability and prevent thrombosis | range of motion exercizes
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| surgical procedure to prevent cervix from premature dilation | cerclage
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| used to keep cervix closed, may be removed to allow vaginal delivery or left intact for c- section | sutures
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| painless dilation causing premature birth, usually around 20 weeks gestation | incompetent cervix
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| located between vagina and uterus | cervix
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| birth that occurs prior to 37 weeks | pre-term, or premature
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| surgical removal of segment of cervix for diagnostic use, to confirm abnormal pap results | cone bioposy
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| shortening of vaginal portion of cervix, thinning of walls | effacement
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| progressive openening of cervix | dilation
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| diethylstilbbestrol (DES) | synthetic hormone with estrogenic properties, used from 1948-1971 to decrease miscarriages.contraindicated now d/t vaginal cancerfor women who were exposed to DES in utero. being a DES daughter can cause an abnormally formed cervix
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| symptoms of incompetent cervix | heavyness/ marginal to large amount of discharge
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| to diagnose incompetent cervix | internal exam or ultrasound
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| to treat incompetent cervix | early detection to prevent miscarriage. bedrest, cerclage, or both if condition is severe
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| cerclage | sutures to close incompetent cervix 85-90 % success. remove at about 37 weeks Gallow vaginal or leave in place for future pregnacies and c section preformed
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| cerclage complications (RARE) | may rupture membranes, uterus may get irritated and start labor, infection of placenta or uterus, cervix can be damaged if contractions tear sutures
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| Nursing iunterventions for incompetent cervix | support group, ROM, sit up after meals reduce heartburn, fiber and fluid to prevent constipation
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| incompetent cervix rule | once diagnosed, NO sex!! due to the prostaglandins in sperm that can cause contractions
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| ectopic pregnancy | inplantation of fertilized egg in site anywhere other than endrometrial lining of uterus
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| risk factors of ectopic pregnacies | tubal damage d/t PID, previous pelvic, abdominal , tubal surgery/ sterilization, IUD presence, HIgh levels of hormones alter motility of egg in tube, ovulation inducing drugs, smoking, douching, STD, >40,exposure to DES
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| fertilized egg implanted in fallopian tube, peritoneal cavity, cervix, uterine cornea, ovary, ampulla of tube (most common place) | ectopic pregnancy
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| s/s of ectopic pregnancy | chadwicks sign (blue discoloration of cervix, soft uterus, HCG in blood or urine, pain lower abdominal, fainting dizziness, referred right shoulder pain, , slower HCG titers than a normal pregnancy
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| laproscopic salpingectomy | removal of tube if it is ruptured or if future child bearing is not an issue
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| laproscopic linear salpingostomy | evaluate pregnacy and gently preserve the tube
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