​Why might this pregnancy be considered high risk?
How do you think the couple may react on learning this information?

​Consider the following scenario: A couple has finally become pregnant after numerous attempts over the last 4 years. The woman is now 37 years old, and her partner is 40. The couple is informed that the pregnancy, for various reasons, is considered high risk.

Pregnancy Complications

(Spontaneous abortion, Ectopic pregnancy, and Gestational trophoblastic disease were covered in Previous Class)

• Cervical Insufficiency

• Bleeding during pregnancy

• Hyperemesis gravidarum

• Gestational hypertension

• HELLP syndrome

• Gestational diabetes

• Blood incompatibility

• Amniotic fluid imbalances

• Multiple gestation

• Premature rupture of membranes

Cervical Insufficiency

Premature dilatation of cervix

• Cause unknown; possibly due to cervical damage

• Therapeutic management:

  • Bed rest, pelvic rest, avoidance of heavy lifting

  • Cervical cerclage

• Nursing assessment

  • Risk factors

  • Pink-tinged vaginal discharge or pelvic pressure

  • Cervical shortening via transvaginal ultrasound

• Nursing management

  • Continuing surveillance; close monitoring for preterm labor

  • Emotional support

  • Education

Hemorrhagic Disorders

OB Emergency

-> Leading cause of maternal death

-> Can occur during pregnancy, during labor, and/or after delivery antepartum, intrapartum, postpartum

when the placenta is inserted wholly or partly into the lower uterine segment of the uterus, partially or completely covering the internal cervical opening

Placenta Previa

​the early separation of a normally implanted placenta after the 20th week of gestation, prior to birth

Placental Abruption

​placenta abnormally adherent to the myometrium; penetration of the myometrium; invasion of the myometrium to the peritoneal covering

​​Placenta Accreta, Increta, and Percreta