Complications of Pregnancy

Cervical Insufficiency

Definition: Premature dilation of the cervix, also known as an incompetent cervix, leading to preterm birth or loss of the baby.
Signs & Symptoms:
- Increased pelvic pressure
- Vaginal bleeding or pink-tinged discharge
- Gush of fluid from the vagina
- Cervical dilation detected by a provider
Diagnosis:
- Transvaginal ultrasound in the third trimester to measure cervix length
Treatment:
- Cervical cerclage (suture placed to close the cervix) at 12-14 weeks, removed at 36-38 weeks
- Bed rest and medication management as needed
- Pelvic rest (avoid penetrative sexual activity)

Definition: Placenta implants near or over the cervical OS, causing bleeding.
Types: Complete, partial, marginal, low-lying
Signs & Symptoms:
- Painless bright red bleeding
Diagnosis:
- Ultrasound detection
- Avoid cervical checks in cases of vaginal bleeding
Management:
- Administer IV fluids and blood products
- Corticosteroids for fetal lung maturation if preterm birth is imminent

Definition: Premature separation of the placenta from the uterine wall after 20 weeks gestation.
Risks: High maternal-fetal mortality
Signs & Symptoms:
- Dark red vaginal bleeding
- Severe abdominal pain
- Rigid, board-like abdomen
- Signs of hypovolemic shock (tachycardia, hypotension, pallor, tachypnea)
Risk Factors:
- Smoking
- Maternal hypertension
- Trauma (e.g., car accident)
- Multiparity (e.g., twins, triplets)
- Cocaine or stimulant use
Treatment:
- Emergency C-section
- Nursing care for hemorrhagic shock (oxygen, IV fluids, blood products)
- Avoid vaginal exams

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