Effects Of Pregnancy On Women And Babies

Preeclampsia (PE) is a multisystem disorder complicating 5-7% of all pregnancies that manifests abruptly with a variety of maternal clinical symptoms (e.g. hypertension) and remains a major cause of maternal and perinatal morbidity and mortality worldwide. The traditional definition of preeclampsia according to the ACOG (American Congress of Obstetricians and Gynecologists) criteria refers to the onset of high blood pressure (140/90 or higher) after 20 weeks of gestation in a previously normotensive woman 62, 63. The most severe cases are characterized by a variety of other clinical disturbances including proteinurea (≥0.3 gr/day), edema, neurologic involvement, epigastric pain, impaired liver function, thrombocytopenia 62 and are often associated

Maternal mortality represents more than the loss of lives for individual women, as it also reflects the larger value and prioritization of women 's health and threatens the health and survival of families, young children, and even the communities in which they live (Royston and Armstrong, 1989). Maternal mortality is unacceptably high (WHO, 2015b). Globally, approximately 830 women die every day from pregnancy- or childbirth-related complications (ibid.). The causes of maternal mortality are predominately preventable and can be classified into three fundamental causes: (1) medical - consisting of direct medical problems and pre-existent/coexistent medical problems that are aggravated by pregnancy, (2) underlying - social and legal conditions, and (3) health systems laws and policies that address availability, accessibility, and quality of reproductive health services (PHP et al, 2011).

(2) Therefore, for medics to effectively manage the eclamptic patient, they should understand key signals and, ideally, the patient’s past medical history. Based on data analysis of patients considered to be “at risk” for developing eclampsia, those with “prior pre-eclampsia, chronic hypertension (HTN), pre-gestational diabetes, assisted reproductive technology, and BMI >30 were most strongly associated with a high rate of pre-eclampsia.” (4) Lastly, women at both extremes of childbearing age (young and old) are more likely to develop pre-eclampsia than other parous women. These are key factors to consider when initially evaluating a patient at greater than 20 weeks gestation with BP of over 140/90. (2)

Pre-eclampsia and complications associated with this condition account for 15% of direct maternal mortality, 10% of perinatal mortality in Australia (Brennecke, East, Moses, & Blangero) and around fifty thousand maternal deaths a year worldwide. (T. E. T. C. Group, 1995; Vigil-De Gracia et al., 2006) It is estimated that pre-eclampsia complicates about 2-8% of pregnancies. (M. T. C. Group, 2002) Immediate recognition and treatment in the pre-hospital setting is important to reduce the risk of hypertension related injuries (i.e. intracranial haemorrhage) and the progression of pre-eclampsia to eclampsia. Treatment aims are immediate termination of seizures in pregnancy and rapid but safe lowering of the patient’s blood pressure.

She carried out a risk assessment to identify prelabour risk factors of PPH described by Cathy et al. (2013), such as previous retained placenta, previous caesarean section, placenta praevia, accrete or percreta, antepartum haemorrhage, pre-eclampsia, BMI over 35, increased maternal age, uterine abnormalities, maternal haemoglobin below 9g/dL, grand multiparity. Laura’s risk assessment did not highlight any prelabour risk factor, therefore she was not considered to be a high risk of

Preeclampsia is defined by hypertension and proteinuria during pregnancy. It tends to occur after 20 weeks in gestation.

This may help reduce the occurrence of high risk pregnancies associated to maternal age. Should the patient continue with their efforts to conceive, proper patient education would include the necessity for adequate and frequent prenatal care during the pregnancy. The benefits of timely prenatal care is of the utmost priority for the mother as well as the fetus. Finally, knowing the age of the patient and the complications associated with that particular age group would allow the nurse to provide individualized care during labor and delivery as well as post-partum care. Prevention of fetal demise is the goal of all high risk pregnancies in addition to maintaining the health of the mother. Extensive knowledge is the only adequate knowledge in the health care field, especially when lives are the price paid for a knowledge deficit of the care

Preeclampsia, a disorder of pregnant women, is a major contributor of maternal and fetal morbidity and mortality. It afflicts 5-7% of pregnancies worldwide, creating an enormous disease burden. Despite intensive research in this area, the etiology of preeclampsia is elusive. However, multiple factors have been associated with the disorder, including insulin resistance, genetic predisposition, and angiogenic factors. The diagnosis of preeclampsia is based on symptoms of hypertension and proteinuria, but the disorder is not always accompanied by an increase in blood pressure and proteinuria. Other diagnostic criteria include laboratory testing, persistent epigastric pain, and cerebral disturbances. The currently used diagnostic criteria are not

Preeclampsia is a common hypertensive disorder that occurs only during pregnancy in some individuals. Diagnosis of preeclampsia is made with a new onset of high blood pressure with numbers greater than 140/90 and protein in her urine. Currently the cause of preeclampsia remains unknown. However, preeclampsia is also associated with a decrease in placental perfusion which could restrict uterine growth, decrease fetal movement and cause hypoxia and fetal distress (London, Wieland Ladewig, Davidson, Ball, McGillis Bindler, & Cowen). . Around twelve to twenty-five percent of growth-restricted fetuses and small for gestational age infants along with fifteen to twenty percent of preterm births are correlated with preeclampsia the complications

Preeclampsia the disease of the first pregnancies. Preeclampsia has several potential adverse outcomes for a pregnant woman and the neonate. Preeclampsia can occur anywhere after the 20th week of pregnancy. Cunningham (2010) described preeclampsia as a continuum of worsening disease. Each case of preeclampsia varies in symptoms and severity depending on the health of the pregnant woman, and usually resolves after delivery within 2-3 weeks. “Healthcare indicators are shown to be useful to assess, monitor, and improve quality of care” (Wollersheim et al., 2007). Recognizing characteristics of preeclampsia can save maternal and fetal lives.

Medical and technological advances in maternal and neonatal care have significantly reduced maternal and infant mortality and medical interventions have become commonplace and arguably routine. Used appropriately, they can be lifesaving procedures. Routine use, without valid indication though, can transform childbirth from a natural physiologic process and family event into a medical or surgical procedure. Every intervention presents the possibility of unwanted effects and subsequent risks that can potentiate more interventions with their own inherent risks.

According to Ricci (2013), “The woman will be asked to monitor her blood pressure daily (every 4 to 6 hours while awake) and report any increased readings; she will also measure the amount of protein found in urine using a dipstick and will weigh herself for any weight gain”. Patient at this point has developed mild edema at this point in the disease, but it will be important to monitor for signs and symptoms of worsening of the disease. If severe preeclampsia is noted due to ineffective interventions and treatment, then a more vigorous treatment is needed. First, the patient is admitted to the hospital because this disease may be a danger to her life and the life of the fetus. It is recommended to be admitted because nurses and healthcare professionals can monitor closely and act if something happens. The treatment depends on person by person and fetal age. “The woman in labor with severe preeclampsia typically receives oxytocin to stimulate uterine contractions and magnesium sulfate to prevent seizure activity” (Ricci, 2013, p. 628). Magnesium sulfate should be monitored to ensure it is at therapeutic levels (4 to 7 mEq/L) because high levels can lead to respiratory distress and cardiac arrest. “Delivery of the fetus and placenta remains the only definitive treatment for preeclampsia to prevent maternal and fetal complications from disease progression” (Feulner, 2015, p. 56). This will depend on many factors including the severity of the

Sensitivity: probability that the test results will be positive when the disease is present (true positive rate, expressed as a percentage); Specificity: Probability that the test results will be negative when the disease is present (true negative rate, expressed as a percentage); Positive Predictive value (PPV: probability that the disease is present when the test is positive); Negative Predictive value (NPV: probability that the disease is present when the test is negative) and accuracy is the ratio of the true positive and true negative on all patients. Result was considered significant at a P value of 400ml/24hrs). Oliguria was found in 25% of severe preeclampsia cases as shown in Table (1).

Laboratory tests were ordered to allow for an appropriate diagnosis. A chemistry panel test and a complete blood count (CBC) with platelets were ordered. A 24-hour urinary protein test was also ordered. Chemistry panels are groups of tests performed on a blood sample that can be used to determine a person’s general health status. For the chemistry panel, a comprehensive metabolic panel (CMP) was done. The 24-hour urinary protein test was ordered in order to obtain a measurement of the protein released in urine over a 24-hour period. The urine tests did not reveal a significant amount of protein in the urine, but the CMP showed the likelihood of hypertension. After further review, M.W. was diagnosed with mild gestational hypertension, a form of pregnancy-induced hypertension (PIH).

From taking this class, I have gained significant understanding of biological determinants of women’s health. Learning about the number of unique biological risks women face is important to understand for me because I am a woman and this risks are likely to pertain to me as well. One of topic of biological aspect of women’s health we covered in class were risks factors associated with pregnancy, its complication and pregnancy itself. Understanding about maternal death and number of causes such as hemorrhage, sepsis, hypertensive, and abortion