Ectopedic Assessment

admitted from the ED today for a GI bleed. She¶s had one unit of packed RBCs

RU 486 can cause few serious side effects. Again, from Costa’s, Abortion: A Reference Handbook demonstrate how heavy bleeding can cause hemorrhage. Hemorrhage is rare to happen because Michelle M. Isley, MD, and Paul Blumenthal, MD, who wrote, What’s old, what’s new, add that between 2% and 10% of women will need operation to control hemorrhage.

Marie is pale, weak, and anxious, but no longer disoriented. Her fundus is firm and is 1 cm above the umbilicus. She is receiving O2 per nasal cannula at 4 liters/minute and has an O2 saturation of 88%. Her vital signs are: BP 74/44, pulse 116 and respirations 26. Her bleeding has slowed considerably. The nurse asks the UAP to bathe Marie and change the bed linens.

The nurse assesses a client admitted to the labor and delivery unit and obtains the following data: dark red vaginal bleeding, uterus slightly tense between contractions, BP 110/68, FHR 110 beats/minute, cervix 1 cm dilated and uneffaced. Based on these assessment findings, what intervention should the nurse implement?

This particular case study involves a 29 year old obstetric patient who presented to the labor and delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks

A more rare cause of thrombocytopenia in pregnancy is the immune thrombocytopenic purpura (ITP), an autoimmune disorder characterized by the anti-platelet glycoprotein antibodies that stimulate the platelet destruction in the spleen.6 There are two types of ITP: the acute form that is common in children, is associated with viral infections and is self-limiting and the chronic form which predominantly affects women. The diagnosis is clinical. Thrombocytopenia in ITP is generally moderate but with platelet count usually below 100,000/µL and the symptoms are in direct relation to the platelet levels. Patients could be completely asymptomatic or present ecchymosis, petechiae, purpura, gums bleeding or menorrhagia.1 Unlike gestational thrombocytopenia,

medicines to cause a miscarriage or by surgery, where the pregnancy is out of the uterus. The

pregnancy. This serious complication results in a miscarriage and can cause death of the mother.

afterword, moderate flow of bright red blood, no clots; mild increase in appetite 2-3 days prior to periods, no other PMS symptoms; no history of dysmenorrhea or abnormal bleeding; no menopausal symptoms

The principal mode of diagnosis is a differential diagnosis, and it includes a plethora of facets; bleeding from implantation site, which may be due to uterine atony, with predisposing factors such as infections, and retained placenta or abnormal placentation (Sheiner, 2011). Coagulation disorders and trauma are also essential facets considered during diagnosis (Sheiner, 2011). Conventionally, there are different methods used for the estimation of blood loss during diagnosis, and they are majorly classified as clinical and quantitative methods (Ricci & Kyle, 2009). Clinical method remains the primary means to

Many women don’t even know when they have a miscarriage. Some women experience cramping, spotting, heavier bleeding, abdominal pain, pelvic pain, weakness, or back pain. Spotting is often not a sign of a miscarriage, many women experience it early on in pregnancy. Most miscarriages are related to fetal chromosome abnormalities. Alcohol and smoking is a cause of some pregnancy losses and a sudden fall can also contribute.

In the United States today, 25% of all pregnancies end in abortion (Abortion: All Sides). With so many lives in the balance, one of the primary arguments has become the physical health of women who have abortions. Of the women that previously had a surgical abortion 90% said they would prefer the pill if they had another abortion and would recommend it to others (Robinson). However one of the side effects of RU 486 is bleeding up to 9 days, compared to a surgical abortion’s five day duration (Robinson). The recovery process is quicker with a surgical abortion but more traumatic. One death in 200,000 occur with a surgical abortion, compared to one in 500,000 with the abortion pill. Both of these alternatives are far safer for the mother than childbirth that claims one death in every 14,300 births (Robinson). These statistics prove that the safest alternative for the mother in the event of a pregnancy is an abortion using the abortion pill and the most dangerous is going through with childbirth. However the safest thing for the child is natural childbirth by far. The voice of the life in question is never heard and it has a one hundred percent chance of death in the first 2 cases.

There are other complications that are not life threatening but are still dangerous to the mother’s health. One example is uterine perforation, occurring when the abortionist misses the child with his knife and cuts the mother’s uterus. This may cause hemorrhaging and complications in childbirth later on. The uterus now cannot hold a child and may rip; causing problems in birth that may lead to the death of the child. Prominent damage to the uterus may require a hysterectomy (“A List of Major Physical Sequelae Related to Abortion”). Another complication is cervical lacrations, which are the tearing of the cervix. These are prominent in childbirth also. These lacerations cause major hemorrhaging and may result in cervical incompetence, premature delivery, and complications of labor (“A List of Major Physical Sequelae Related to Abortion”). Cervical incompetence causes miscarriages. Another complication is placenta previa, which is the “abnormal development of the placenta due to uterine damage” (“A List of Major Physical Sequelae Related to Abortion”). This

This usually occurs during the second or third trimester. The cervix is dilated for the entry of surgical forceps (AbortionTV). The fetus is partly pulled though the vagina in a breech style. The legs of the fetus are hanging out of the womb. The doctor forces the scissors into the back of the head and spreads the scissors to increase the wound size. A suction cup is held over the fetus’s head as the brains are sucked out (AbortionTV). The body is removed and the womb is cleaned of any other birthing particles. The partial abortion procedure can have fatal side effects such as infection of the cervix, excessive bleeding of the womb, chances for the mother to be fertile decreases, and causes scarring of the uterine wall. Medical experts thought the fetus couldn’t feel the pain of the scissors going through its head but, they were wrong. Studies show that it can feel the pain three to five times more than an adult that would experience it (AbortionTV). The tiny fetus’s are sedated and numbed up so the won’t feel the intense pain.

The patient was on 17 weeks and 5 days of pregnancy on the admission day. The patient had experienced two previous miscarriages which happened two years ago. Two previous pregnancies also because of cervical incompetence secondary to bicornuate uterus. Instead of being pear-shaped, bicornuate uterus looks more like a heart, with a deep indentation at the top. Most of the women with bicornuate uterus might present with cervical incompetence or early pregnancy loss. Clinical manifestations of the patient shown are quite significant which are changed in vaginal discharge for one week and also light vaginal bleeding in the later stage. Vaginal discharges are thick in consistency, whitish in color and no foul