NCLEX-PN

procedures like dilation and curettage (D&C) to remove pregnancy products or intravenous fluids, blood or blood products, and suction evacuation or D&C in certain cases. EE.​Premature rupture of the membranes occurs when the amniotic sac breaks 1 hour or more before labor starts. This condition poses risks, including infection and a prolapsed umbilical cord that can endanger the fetus. Symptoms may include pyrexia, fluid leakage or gushing from the vagina, foul-smelling vaginal discharge, maternal tachycardia, increased fetal heart rate, and positive findings on tests like ferning and nitrazine paper. FF.​Multiple gestations involve pregnancies with two or more fetuses. Proper prenatal care can significantly reduce associated risks. Signs of multiple gestations may include greater-than-expected weight gain, fatigue, abdominal expansion, nausea, vomiting, and feeling fetal movements earlier than usual. Ultrasound confirmation is necessary. ●​ Maternal complications can include anemia, hydramnios, hyperammonemia, hypoglycemia, hypertension, preeclampsia and eclampsia, gestational diabetes, pulmonary embolism, coagulopathy, and premature rupture of the membranes. ●​ Fetal complications in the first trimester can encompass infections, chromosomal anomalies, fetal growth restriction, an incompetent cervix, spontaneous abortion, and the "vanishing twin" phenomenon. The “vanishing twin” phenomenon commonly occurs in the first trimester in which one or more of the multiple fetuses are reabsorbed. ●​ These complex complications emphasize the importance of comprehensive prenatal care and timely interventions to ensure the health and well-being of both mother and fetus. GG.​Fetal growth restriction is characterized by a fetus being smaller than expected for its gestational age. It can result from genetic and non-genetic factors. ●​ Certain maternal risk factors are associated with restricted uterine growth, such as placental insufficiency, kidney disease, infections like cytomegalovirus, diabetes, hypertension, and substance abuse. ●​ Fetal complications related to growth restriction include perinatal asphyxia, polycythemia (excessive red blood cells leading to a ruddy complexion), tachypnea (rapid breathing), lethargy, meconium aspiration (ingestion of fetal stool), and hypoglycemia (low blood sugar). Among these, perinatal asphyxia is the most severe and life-threatening, occurring during labor when uterine contractions decrease maternal placental perfusion. An immediate delivery is indicated if fetal distress is observed. HH.​Oligohydramnios is the inadequate amount of amniotic fluid, with values below 5 considered low; the normal range is 5 to 25. ●​ Various causes can lead to oligohydramnios, including medications like NSAIDs and ACE inhibitors, placental abruption, premature rupture of the membranes, restricted fetal

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