The document provides information on several medical conditions including preeclampsia, uterine fibroids, pelvic inflammatory disease, and spontaneous miscarriage. Preeclampsia is a condition of pregnancy with increased blood pressure and protein in the urine. Uterine fibroids are benign tumors that can cause heavy bleeding and pelvic pressure. Pelvic inflammatory disease is an infection usually caused by sexually transmitted infections that can lead to infertility if left untreated. Spontaneous miscarriage refers to the natural loss of a pregnancy before 20-24 weeks for various potential reasons.

1. PREECLAMPSIA (Toxemia)
- Increased blood pressure and proteinuria
- Usually begins after 20 weeks of pregnancy in
women whose blood pressure had been normal
- Normal Urine output 2000cc
Causes:
- Multiple pregnancies 5 or more
- Overproduction of amniotic fluid
- Underlying disease
Symptoms
1. Preeclampsia with Severe Features
- Proteinuria (increased protein in urine)
- Weight gain
- Mild edema in upper extremities or face
- BP is 140/90 mmHg
Management:
- Bed rest
- Good nutrition (less sodium)
- Emotional Support
- Antiplatelet Therapy (low dose of aspirin)
2. Preeclampsia without Severe Features
- BP is 160/110 mmHg
- Increased protein in the urine (3+ 4+)
- Oliguria (500ml or less in 24 hrs)
- Cerebral or Visual disturbances
- Pulmonary or cardiac involvement,
extensive peripheral edema
- Hepatic dysfunction, thrombocytopenia
- Epigastric pain, nausea, or vomiting
Management
- Bedrest (w/o bathroom)
- Monitor fetal well-being (check bp every 4hrs)
- Diet (high protein, moderate sodium)
Medication to prevent Eclampsia:
- Magnesium Sulfate IV
- Hydralazine (Apresoline) IV
- Diazepam (Valium) IV (lessen stress and anxiety)
- Calcium Gluconate IV (antidote for magnesium
sulfate intoxication)
If left untreated, it may progress to eclampsia that
may lead to maternal and fetal death.
MYOMA/ Uterine Fibroids
- Most common benign tumors in the reproductive
organ.
- Undetectable by the human eye
- Noncancerous growth that develops around the
womb
3 types of myoma
1. Intramural
- Grow within the muscular uterine walls.
2. Submucosal
- Can block or distort the fallopian tube which
makes it difficult for sperm to enter
3. Subserosal
- Most common type of fibroid
- Severe pain and anemia
Risk factors
- Older woman (a woman grows, reproductive
organs change; overproduction of estrogen,
menopausal)
- Obesity
- No history of pregnancy
- Race (due to stress)
- Heredity and Genetic factors
- Vitamin D deficiency
- Birth control
- Alcohol and Diet low in fruits and vegetables
Symptoms:
- Heavy menstrual bleeding
- Menstrual periods lasting more than a week
- Pelvic pressure (as fibroids grow larger, it presses
the pelvic organ)
- Frequent and Difficulty Urination and (As fibroids
grow larger, It compresses bladder)
- Constipation
- Backache or leg pains
Diagnostic Test:
1. Pelvic exam (for physician to feel the size)
2. MRI (Magnetic Resonance Images)
3. Transvaginal Ultrasonography (to see the
size of fibroid)
Medical Management:
1. Non-steroidal drugs, Anti-inflammatory
Drugs (NSAIDs)
- reduce the pain sensation as well as
minimize the blood loss
2. Tranexamic acid
- suffering from excessive blood loss
Surgical Management:
1. Oophorectomy (Surgical removal of both
ovaries)
2. Myomectomy (surgical removal of fibroids)
3. Laparoscope (Telescope to view the inside
of the reproductive organs; destroys
fibroids)
4. Hysterectomy (Removal of the uterus)
5. Vaginal hysterectomy (Removal of uterus
in Vagina; includes cervix, uterus, ovaries,
and fallopian tube)
- It is possible for single women to have
myoma since it depends on its
size.(irregular menstruation)
- If myoma has already been removed,
there’s a possibility that it will occur again
depending on one’s lifestyle.
Difference between OB and GYNE
1. OB - pregnant matter (normal or
complications)
2. GYNECOLOGY - disorders of the
reproductive system

2. VITAL SIGNS TAKING AND RECORDING
MIO- Measure Intake and Output
- Measure every 1-2 hours
ML - Unit of Vomit per kidney basin
- Ask client about the amount of stool
- Total all output
- Write your initial at the bottom part of the
TPR to be signed by CI.
Taking BP
- Hand of patient should be aligned with her heart
- Dial should be clipped on top
Medications
- Dosage of a child depends on its weight.
- Macro drop set (1ml) = 15 drops/ min
- Micro drop set (1ml) = 60 drops/ min
- IV is only good for 24 hours
- GTTS (drops per min)
- KVO (Keep Vein Open)
Solving Medication
Desired Dose
----------------------------------------------
Available Dose x Volume = Dose
IVF Calculation
Flow Rate =
Total volume of fluid (ml) x Drop factor
----------------------------------------------------
Total time of infusion (in mins)
PELVIC INFLAMMATORY DISEASE
Cause: STD/STI
- Sexually transmitted disease or infection
Risk Factors:
- STD/STI
- Multiple sexual partners
- Previous PID
- Sexually active less than 25 years of age.
- Douche
- Use of IUD
Vaginal Douche
Disrupts the vaginal wall or normal flora. If it is
distracted, microbes or bacteria will be introduced.
Symptoms of PID:
- Pain in the lower abdomen or pelvis
- Heavy vaginal discharge with an unpleasant odor
- Irregular menstrual bleeding
- Pain during intercourse (Dyspareunia)
- Low back pain
- Fever, fatigue, diarrhea, or vomiting
- Painful or difficult urination (Suria)
Diagnosis:
- Based on signs and symptoms
- Pelvic exam (Gram Staining - culture and
sensitivity)
- Pelvic laparoscopy
Complications:
- Scar formation leading to tubal blockage
- Ectopic pregnancy
- Infertility
- Long-term pelvic or abdominal pain
Treatment:
- Antibiotics
SPONTANEOUS MISCARRIAGE
- the loss of pregnancy before the fetus reaches the
age of viability 20 to 24 weeks of gestation or
weighing 500 grams or less.
Common Cause:
- Abnormal delta development
( teratogenic factor or chromosoml aberration)
- Abnormal Implantation
- Alcohol Intake
- Urinary Tract Infectiion
- Systemic infetions (rubella, syphilis, poliomylitis)
Symptomns:
- Heavy spotting
- Vaginal bleeding
- Discharge of tissue or fluid from the vagina
- Severe abdominal pain or cramping
- Mild to severe back pain
- Feeling fain ot light-headedness
Types of Sponteous Miscarriage:
1. Threatened Miscarriage
- abnromal bleeding and abdominal pain that
occurs while the pregnancy continues.
Total Bed rest
- patient is not allowed to get up from bed
Management:
- Bed rest or limited activity
- Medication that supports pregnancy.
(progesterone supplementation)
2. Imminent (Inevitable) Miscarriage
- Comes afer a threatened miscarriage.
- If uterine contractions and cervical dilation occur,
cervix opens.
- May experience more vaginal bleeding.
3. Complete Miscarriage

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