Complications of Pregnancy: Hemorrhagic Conditions, Ectopic Pregnancy, Gestational Trophoblastic Disease, Placental Disorders, Hyperemesis Gravidarum, Hypertensive Disorders, and Blood Incompatibilities

Vocabulary flashcards covering key terms and definitions from the lecture notes on pregnancy complications, including hemorrhagic conditions, ectopic pregnancy, GTD, placental disorders, HG, hypertensive disorders, and blood incompatibilities.

Spontaneous abortion

Termination of a pregnancy without the client's action, also called miscarriage; most occur in the first 12 weeks; major causes include chromosomal abnormalities; incidence about 8%–15% with any pregnancy.

Threatened abortion

Vaginal bleeding before 20 weeks of gestation with a closed cervix and no tissue passage; management includes monitoring viability via ultrasound and hCG/progesterone, advising limited activity, and documenting bleeding.

Inevitable abortion

Miscarriage in which membranes rupture and the cervix dilates, making it unlikely to stop; natural expulsion may occur, or procedures like vacuum curettage or D&C may be needed.

Incomplete abortion

Some products of conception are expelled while others remain; characterized by heavy bleeding and abdominal cramps; managed with stabilization followed by D&C/D&E or other measures.

Complete abortion

All products of conception are expelled; bleeding and contractions subside; pregnancy tests become negative and ultrasound confirms absence of gestational sac.

Missed abortion

Fetus dies but remains in the uterus; fetal death shown by ultrasound (no heartbeat) and falling hCG; several management options include spontaneous expulsion or evacuation with D&C/D&E.

Recurrent pregnancy loss

Three or more consecutive pregnancy losses before 20 weeks or <500 g; evaluation includes anatomical assessment, genetic screening, and targeted therapies (e.g., cerclage for cervical insufficiency, diabetes management if present).

Ectopic pregnancy

Implantation of a fertilized ovum outside the uterine cavity, most commonly in the fallopian tube; risk factors include tubal damage and prior ectopic; diagnosed with ultrasound and beta-hCG levels; treated with methotrexate if unruptured or with surgical intervention if ruptured.

Methotrexate (ectopic pregnancy therapy)

Chemotherapy agent used as medical management for early, unruptured ectopic pregnancies to preserve the tube; given in single or multi-dose protocols with serial hCG monitoring until negative.

Gestational trophoblastic disease (hydatidiform mole)

Abnormal proliferation of trophoblastic tissue; complete mole has no fetus, partial mole may have fetal tissue; ultrasound often shows a snowstorm pattern; high hCG; potential progression to choriocarcinoma; treated in two phases: evacuation of mole and ongoing hCG follow-up.

Hydatidiform mole (molar pregnancy)

Molar pregnancy; complete mole lacks fetal tissue; partial mole contains fetal tissue with triploidy; higher risk with certain demographics; requires follow-up to rule out malignancy.

Snowstorm pattern (ultrasound)

Ultrasound appearance characteristic of molar pregnancy—grape-like vesicles with absence of a fetal sac or fetal cardiac activity.

Placenta previa

Abnormal placental implantation low in the uterus covering or near the cervical os; presents with painless vaginal bleeding in the late second/third trimester; diagnosed by ultrasound; management ranges from surveillance to cesarean delivery depending on bleeding, fetal maturity, and location.

Placental abruption (abruptio placentae)

Premature separation of the placenta from the uterus, which may be apparent or concealed; presents with abdominal pain, vaginal bleeding, uterine tenderness, and signs of fetal/maternal compromise; requires hospitalization and often delivery.

Hyperemesis gravidarum (HG)

Severe, persistent nausea and vomiting in pregnancy with weight loss and dehydration; higher risk with high hCG/estrogen; treated with antiemetics, vitamin B6, doxylamine, hydration, thiamine, and sometimes hospitalization for IV fluids and nutritional support.

Preeclampsia

Pregnancy-specific multisystem disorder with new-onset hypertension after 20 weeks plus proteinuria or other signs of organ dysfunction; managed to prevent progression and deliver the fetus as cure.

Preeclampsia with severe features

Preeclampsia accompanied by additional dangerous findings (e.g., BP ≥160/110 mm Hg, thrombocytopenia, elevated liver enzymes, renal insufficiency, pulmonary edema, cerebral/visual disturbances) requiring intensified management and often inpatient care.

HELLP syndrome

A severe form of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelets; associated with high maternal and fetal risk; treatment includes seizure prevention, BP control, and delivery.

Magnesium sulfate

Anticonvulsant used to prevent seizures in preeclampsia/eclampsia; not a primary antihypertensive; dosing involves a loading dose (4–6 g) followed by maintenance infusion (1–2 g/hour); monitor deep tendon reflexes, respiratory rate, and urine output; toxicity treated with calcium gluconate.

Rho(D) immune globulin (RhoGAM)

Immunoglobulin given to unsensitized Rh-negative mothers to prevent Rh sensitization; standard dose 300 mcg at 28 weeks and within 72 hours after birth to an Rh-positive infant; microdose used for earlier gestation; administered after abortion, ectopic pregnancy, or placental abruption when indicated.

Rh incompatibility (HDN/HDFN)

Maternal Rh-negative status with an Rh-positive fetus can lead to maternal antibodies attacking fetal RBCs, causing hemolytic disease of the fetus and newborn; prevented with RhoGAM and monitored via Coombs tests.

ABO incompatibility

Maternal blood type O with fetus A, B, or AB can lead to neonatal jaundice due to antibodies crossing the placenta; typically milder than Rh incompatibility and often requires newborn jaundice monitoring but not extensive preventive prenatal measures.

Choriocarcinoma

Malignant form of gestational trophoblastic disease that can follow mole; requires ongoing hCG monitoring and surveillance for metastasis after mole evacuation.

Indirect Coombs’ test

Screening test to detect maternal antibodies against Rh antigens in serum; used during pregnancy to assess sensitization status; repeated if negative to monitor for later sensitization.

Direct Coombs’ test

Test performed on the newborn’s RBCs to detect fetal/metal antibodies attached to RBCs; helps diagnose hemolytic disease of the fetus and newborn.

Cerclage

Surgical stitching of the cervix to prevent cervical insufficiency and second-trimester pregnancy loss; typically placed before significant dilation and removed near term if vaginal delivery is planned.

Dilation and curettage (D&C)

Surgical removal of products of conception from the uterus by dilating the cervix and scraping the uterine walls; used in early pregnancy loss or incomplete abortion.

Dilation and evacuation (D&E)

Surgical removal of uterine contents in the second trimester through dilation and suction/curretage; used when miscarriage is later or when larger tissue needs removal.

Percutaneous umbilical blood sampling (PUBS/cordocentesis)

Invasive procedure to sample fetal blood from the umbilical cord for diagnosing fetal anemia, infections, or other conditions; used in managing fetal conditions such as severe fetal anemia.