geneticmaterialresultinginnoembryo

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genetic material resulting in no embryo. A partial mole results from a normal ovum that is fertilized by two sperm; may have some  embryo/fetal parts. Manifestations include: Elevated hCG levels Dark vaginal bleeding Uterine size larger than expected for gestational age No fetal heart activity Excessive nausea/vomiting Associated with early onset preeclampsia Associated complications include anemia, infection, DIC, hyperthyroidism, pulmonary edema or  emboli, and choriocarcinoma. Management includes:
Immediate evacuation of the mole is performed via vacuum aspiration followed by curettage.  A chest x-ray, CT scan, or MRI may be performed prior to evacuation to detect any  metastatic disease. An oxytocin infusion is administered after evacuation of the uterus. Post evacuation follow-up requires evaluation of serum human chorionic gonadotrophin  (hCG) levels every 1–2 weeks until normal pre-pregnancy levels return, then every 1–2  months for one year. Pregnancy must be avoided for at least one year so as not to obscure  evidence of choriocarcinoma (hCG levels will rise in the presence of choriocarcinoma). Nursing care for women experiencing early pregnancy bleeding disorders will focus on the  prevention of hemorrhage and infection. Here is a table outlining the application of the nursing  process in the care of a client experiencing early pregnancy bleeding. Assessment Vital signs and client comfort Vaginal bleeding and signs of hypovolemic shock Maternal emotional status and coping abilities Client's understanding of the treatment regimen Nursing Diagnoses Fluid volume deficit related to excessive bleeding Acute pain related to abdominal cramping Risk for infection related to anemia Grieving related to unknown pregnancy outcome Implementation Provide client education on: o Pre and post op course of care o Post discharge self-care and follow-up o Signs/symptoms of infection Provide emotional support by providing opportunities for the client and her family to express their feelings and concerns. Provide referrals for community resources after discharge. Evaluation Maternal vital signs are within expected parameters and there are no signs of shock. The woman is able to start the grieving process by verbalizing her feelings. No signs of infection are observed. Abruptio placentae   or placental abruption is the premature separation of the placenta from the  endometrium. It occurs in 1% of all pregnancies but accounts for 15% of perinatal deaths. 4 The exact  cause is unknown but is associated most with maternal hypertension, smoking, cocaine use, short  umbilical cord, abdominal trauma, and a previous history of abruption. The abruption can be  marginal, partial, or complete. It can also be concealed (bleeding occurs behind the placenta with  margins intact) or apparent (bleeding from vagina) and can be graded as: Grade 0: asymptomatic; diagnosed after birth
Grade I: mild, 10–20% separation (fetus may show signs of compromise)

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