The document presents information on several medical conditions that can occur during pregnancy: 1) Hyperemesis gravidarum is severe nausea and vomiting during pregnancy that prevents adequate food/fluid intake and can cause weight loss and nutritional deficiencies. 2) Ectopic pregnancy is when a fertilized egg implants outside the uterus, usually in the fallopian tubes. 3) Gestational trophoblastic disease involves abnormal cell growth in the uterus during early pregnancy that can cause bleeding and other symptoms.

1. Presentation of the following Hyperemesis Gravidarum Ectopic Pregnancy Gestational Trophoblastic Disease Incompetent Cervix Spontaneous Abortion Placenta Previa Abruptio Placenta Premature Rupture of Membranes Pregnancy Induced Hypertension Submitted To: Submitted By: Mr.Anastacio Odulio Bolaoen, Gennevive D. Vinluan, Louella A. (BSN 2-1)

2. Hyperemesis gravidarum Definition • Excessive vomiting of pregnant women is a severe form of morning sickness, with unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. Hyperemesis is considered a rare complication of pregnancy but, because nausea and vomiting during pregnancy exist on a continuum, there is often not a good diagnosis between common morning sickness and hyperemesis. Signs and symptoms • Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with: • loss of greater than 5% of pre-pregnancy body weight (usually over 10%) • dehydration and production of ketones • nutritional deficiencies • metabolic imbalances • difficulty with daily activities

3. Ectopic Pregnancy Ectopic means "out of place." In an ectopic pregnancy, a fertilized egg has implanted outside the uterus . The egg settles in the fallopian tubes in more than 95% of ectopic pregnancies. This is why ectopic pregnancies are commonly called "tubal pregnancies."

4. Gestational Trophoblastic Disease(H.Mole) Hydatidiform moles usually are diagnosed during the first trimester of pregnancy. The most common symptom is abnormal bleeding. Other signs and symptoms include uterine enlargement greater than expected for gestational age, absent fetal heart tones, cystic enlargement of the ovaries, hyperemesis gravidarum, and an abnormally high level of hCG for gestational age. Presence of these features in the first trimester should alert the clinician to the possibility of a molar gestation.

5. Incompetent Cervix What is an incompetent cervix? > An incompetent cervix is also called cervical insufficiency. The cervix is the bottom part of your uterus (womb). Normally, the cervix remains closed during pregnancy until your baby is ready to be born. A normal pregnancy lasts for about nine months. An incompetent cervix may begin to open at 4 to 6 months of pregnancy. At this time, the cervix may begin to thin and widen without any pain or contractions. The amniotic sac, also called the bag of water, bulges down into the opening of the cervix until it breaks. This may cause a miscarriage or premature (early) delivery of your baby. What are the signs and symptoms of an incompetent cervix? > There are usually no signs and symptoms of an incompetent cervix. The cervix just slowly thins and opens without vaginal bleeding or labor contractions. You may have one or more of the following: • Backache. • Discomfort or pressure in the lower abdomen (stomach). • Gush of warm liquid from your vagina. • Mucous-like vaginal discharge. • Pain when passing urine. • Sensation or feeling of a lump in the vagina.

6. Spontaneous Abortion • Spontaneous abortion, also called a miscarriage, is loss of pregnancy during the first 20 weeks of gestation. Symptoms • Pelvic pain, passing of vaginal tissue, bleeding or spotting, or a dilated cervix. If a spontaneous abortion is occurring because of an infection in the mother, then other symptoms can be fever, chills and body aches. Maternal Causes • If the mother is older, consumes alcohol, uses caffeine heavily, smokes cigarettes or uses drugs, a spontaneous abortion can occur. Other factors concerning the mother that can contribute to a spontaneous abortion include: chronic diseases, conception immediately following a previous delivery, previous elective abortions, previous miscarriages, exposure to toxins, abdomen trauma, severe emotional change and vitamin deficiency. Fetal Causes • If the umbilical cord is twisted, limiting blood supply to the fetus, a spontaneous abortion can take place. Poor attachment to the uterine wall and genetic abnormalities can also cause a miscarriage. In 25 percent of spontaneous abortions, the cause is unknown.

7. Placenta Previa Placenta previa is a complication of pregnancy in which the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix. The placenta is the organ that nourishes the developing baby in the womb. Symptoms The main symptom of placenta previa is sudden, painless vaginal bleeding that often occurs near the end of the second trimester or beginning of the third trimester. In some cases, there is severe bleeding, or hemorrhage. The bleeding may stop on its own but can start again days or weeks later. There may be uterine cramping with the bleeding. Labor sometimes starts within several days after heavy vaginal bleeding. However, in some cases, bleeding may not occur until after labor starts. Common in women who has: Abnormally developed uterus Many previous pregnancies Multiple pregnancy (twins, triplets, etc.) Scarring of the uterine wall caused by previous pregnancies, cesareans, uterine surgery, or abortions

8. Abruptio Placenta Placental abruption occurs when the placenta separates from the wall of the uterus prior to the birth of the baby. This can result in severe, uncontrollable bleeding (hemorrhage). The cause of placental abruption is unknown. However, a number of risk factors have been identified. These factors include: older age of the mother history of placental abruption during a previous pregnancy high blood pressure certain disease states (diabetes, collagen vascular diseases) the presence of a type of uterine tumor called a leiomyoma twins, triplets, or other multiple pregnancies cigarette smoking heavy alcohol use cocaine use malformations of the uterus malformations of the placenta injury to the abdomen (as might occur in a car accident)

9. Premature Rupture Of the Membrane Premature rupture of membranes (PROM) is an event that occurs during pregnancy when the sac containing the developing baby (fetus) and the amniotic fluid bursts or develops a hole prior to the start of labor. Risk Factors Smoking multiple pregnancies (twins, triplets, etc.) and excess amniotic fluid (polyhydramnios) >The main symptom of PROM is fluid leaking from the vagina. It may be a sudden, large gush of fluid, or it may be a slow, constant trickle of fluid. The complications that may follow PROM include premature labor and delivery of the fetus, infections of the mother and/or the fetus, and compression of the umbilical cord (leading to oxygen deprivation in the fetus).

10. (the client undergone for monitoring blood pressure) Pregnancy Induced Hypertension > Pregnancy-induced hypertension (PIH) is a form of high blood pressure in pregnancy. It occurs in about 5 percent to 8 percent of all pregnancies. Another type of high blood pressure is chronic hypertension - high blood pressure that is present before pregnancy begins. Three primary characteristics of this condition, includes the following : high blood pressure (a blood pressure reading higher than 140/90 mm Hg, or a significant increase in one or both pressures) protein in the urine edema (swelling) Treatment for pregnancy-induced hypertension (PIH) may include: bedrest hospitalization magnesium sulfate fetal monitoring continued laboratory testing of urine and blood medications, called corticosteroids, that may help mature the lungs of the fetus delivery of the baby (cesarean section )