Obstetrics and Gynecological Conditions - NCLEX-PN

75 to 90% of cases of pelvic inflammatory disease are caused by neisseria gonorrhoeae and/or chlamydia trachomatis infections. This condition, typified by adhesion formation in the uterus and fallopian tubes, can result in serious issues such as infertility, ectopic pregnancy, or reproductive cancer.

The criteria for diagnosis of PID are as follows: fever, cervical motion tenderness, abdominal pain, leukocytosis, elevated ESR, and purulent cervical discharge.

The primary risk in rubella infection during pregnancy is to the fetus. The rubella virus is able to cross the placenta, and acts as a teratogen by inducing apoptosis in fetal cells. This is termed congenital rubella syndrome. Birth defects can include deafness, ocular damage, cataracts, congenital heart defects, hepatomegaly, and developmental disability or delays.

Rh sensitization can be prevented by treatment of an Rh negative mother with Rho(D) immunoglobulin at 28 weeks, then again within 72 hours of delivery. This is a solution of IgG antibody to Rh-D, which is able to destroy any fetal red blood cells that enter the mother's bloodstream before her own immune system is able to form develop a sensitization.

In placenta previa, the placenta develops in such a way that all or part of it is positioned in the lower one-third of the uterus, placing it between the fetus and the cervix. This can cause the placenta to tear and bleed. The most common sign is painless vaginal bleeding in the third trimester (generally after week 32).

A Shirodkar procedure involves sewing a suture in and around the cervix to hold it closed. This is usually performed within the first trimester and later removed when the risk of miscarriage has lessened.

Oxytocin is often used to help augment labor by inducing contractions. This hormone is naturally made in the body and works as an anti-diuretic hormone (thus promotes the excretion of water). In labor, this hormone also works to stimulate uterine contractiity.

Fundal height (sometimes referred to as McDonald's rule) is measured in centimeters from the top of the pubic bone to the top of the uterus. The top of the uterus may also be called the fundus of the uterus. It is used to assess the growth and development of the fetus inside the womb.

This woman could be experiencing pre-term labor. A 20 week pregnancy is not considered viable. She should be seen immediately to determine if there is a cause such as cervical insufficiency (premature dilation of the cervix).

Menometrorrhagia is a term used to describe a menstrual cycle that is irregular, of shorter duration than normal, and of excessive volume or duration. Amenorrhea is the absence of a menstrual cycle. Metrorrhagia is a term for a menstrual cycle that is of normal flow duration and volume, but which is irregular and has a shorter-than normal cycle length. Oligomenorrhea describes a menstrual cycle that is longer than 35 days, often characterized by a prolonged follicular phase.

All of these could be possible reasons for bleeding in early pregnancy, including physiologic or implantation bleeding. Bleeding may indicate threatened miscarriage or other serious condition, or it may simply be due to the implantation of the embryo into the endometrium.

Preeclampsia is a potentially life-threatening disorder that generally includes gestational hypertension, proteinuria, edema, red-blood cell dysfunction, and signs of liver or kidney dysfunction. It is more common in weeks 32-40 and develops in 2-8% of pregnancies worldwide.

There are several risk factors for preeclampsia. These include history of hypertension, diabetes, older maternal age, first-time pregnancies (primigravida), and pregnancies with twins or multiples.

Preeclampsia develops into eclampsia at the onset of seizures. Seizures are tonic-clonic and may appear during pregnancy, during labor, or postpartum. It is relatively rare, affecting only approximately 1.2-1.8% of pregnancies.

The most common time for miscarriage to occur is during the first trimester, between 8 and 12 weeks. This may even occur before an individual is aware that they are pregnant. Chromosomal abnormalities are identified in approximately 50% of first trimester miscarriages, while later miscarriages may be more likely in individuals with uterine malformations or cervical incompetence.

Endometriosis will increases risk of both infertility and of miscarriage. This may be due to a paracrine effect as hormones are released locally by ectopic endometrial tissue, causing disruptions in hormone levels required for implantation and for sustaining an implanted embryo before the formation of the placenta.

In a study surveying 120 women with endometriosis, the prevalence of celiac disease, an autoimmune condition triggered by ingestion of gluten, was nearly four times higher than the general population. No association has been made between the presence of endometriosis and lactose intolerance or incidence of anaphylaxis.

The basal body temperature is a method many women use to determine when ovulation occurs. To take a basal body temperature, one must use a basal thermometer (which is more sensitive) and take their body temperature before getting out of bed (or even sitting up) each morning. This method is utilized the best if a woman wakes up and takes her temperature at the same time daily.

Yoga once per week (light exercise) is the least likely of the above to cause a change in regular menstruation. Cross country or long distance running (vigorous exercise) is more likely to cause changes to a woman's cycle. Poor lifestyle choices such as eating habits and health issues such as kidney disease can also cause irregular menstruation. Likewise, pharmaceuticals can have the same effect.