Obstetrics Complications

Tobacco Use:
- Effects:
- Decreased fetal growth.
- Increased risk of spontaneous abortions.
- Increased Sudden Infant Death Syndrome (SIDS) deaths.
- Increased risks of premature rupture of membranes.
- Increased risks of premature labor.
- Note: Secondhand smoke poses similar risks to the mother.
- Vaping: Current data on effects is absent.
Medication Use:
- Category C medications: Not recommended as they can remain in the fetus’s system longer than in the mother's.
- Example: A medication might last 4-5 hours in the mother but up to 7 days in the fetus.
- Many pregnant women avoid medication due to risks.
- Consideration: Evaluate if the benefits outweigh the risks.

Defined as occurring before 37 weeks of gestation.
Potential causes include:
- Abnormal placenta, cord, or membranes.
- Substance abuse (smoking/vaping).
- Trauma or unknown factors.
- Maternal health issues (cardiac, renal, infections, diabetes).
Common complications:
- Higher incidence of breech delivery.
- Risk remains elevated in subsequent pregnancies.
Diagnosis made in the hospital by observing cervical changes.

Definition: Termination of pregnancy before the 20th week of gestation.
Differential diagnosis includes miscarriage.
Symptoms: Includes cramping, abdominal pain, backache, and vaginal bleeding resembling intensified menstrual complaints.
Emotional support is crucial.

Definition: Termination of pregnancy before the 20th week, sometimes up to the 28th week.
Can be self-induced with herbal preparations.
Risks of complications include hemorrhage or sepsis due to retained fetal/placental parts.

Threatened Abortion: Vaginal bleeding during the first half of pregnancy; may either progress or subside.
- Patients can continue normal activities.
Inevitable Abortion: Cannot be prevented, with severe abdominal pain and cervical dilation.
Incomplete Abortion: Some products remain in the uterus; be cautious of shock and collect all products for evaluation at the hospital.
Missed Abortion: Fetus dies before 20 weeks but remains in utero; transport is necessary with emotional support.

Description: Premature separation of a normally implanted placenta after the 20th week.
Complications include hypovolemic shock, renal failure, and fetal hypoxia.
Symptoms: Sudden onset of severe abdominal pain, possible vaginal bleeding, and rigid uterine palpation.

Chronic Hypertension: Blood pressure of 140/90 mm Hg or higher before 20 weeks.
Gestational Hypertension: High blood pressure diagnosed after 20 weeks without systemic involvement.

Pathophysiology is poorly understood but involves uteroplacental perfusion issues leading to widespread placental ischemia.
Risk factors include previous cases of pre-eclampsia, multiple gestations, obesity, and advanced maternal age.
Symptoms include hypertension, proteinuria, and peripheral edema.
Warning signs of disease progression to eclampsia can include severe headaches, liver impairment, and visual disturbances.

A severe variant of pre-eclampsia affecting the liver and blood. Symptoms vary and may include malaise, abdominal pain, and blurred vision.

Hormonal changes can lead to unstable blood glucose levels.
Gestational Diabetes: Managed through diet and medication; there's a risk for long-term diabetes development post-pregnancy.

Major concerns for maternal mortality during and after childbirth; sudden onset of symptoms such as dyspnea and tachycardia should raise suspicion.
Maternal trauma must be approached carefully due to physiological changes that can complicate assessment and treatment.

Pregnancy leads to physiological changes that increase vulnerability to trauma.
Close monitoring of the fetal heart rate post-trauma is essential; normal rates range from 120 to 160 beats/minute.
Patient ABCs (Airway, Breathing, Circulation) remain the highest priority in treatment.