Reproductive System
Diseases
General Information
• The function of sexuality – reproduction
and enhancement of caring and pleasure
World Health Organization
Components of Sexual Health
• The enjoyment and control of sexual and
reproductive behavior according to personal and
social ethics
• Freedom from fear, shame, guilt and
psychological factors that impair sexual
relationships
• Freedom from organic disorders, diseases and
deficiencies that may interfere with either sexual
or reproductive functions
Stages of sexual response cycle
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Arousal - psychological
Plateau - psycho and physiological
Orgasm - psycho and physiological
Resolution - psycho and physiological
Also includes vasoconstriction and
myotonia which may arise if some physical
or mental condition arises
Sexual Dysfunction
• An important consideration in the treatment
of sexual dysfunction is a sensitivity to open
communication about the problem
• Physicians need to include detailed sexual
history as part of medical history
• Total health care must include human
sexual response and its function or
dysfunction
Dyspareunia
(Painful Intercourse)
• Dysparneunia is the occurrence of pain in
women during sexual intercourse
Etiology
• Anatomic – deformities of lesions in vagina, an
intact hymen, or retroversion of uterus
• Pathological – Scar tissue, genitourinary tract
infections, pelvic inflammatory disease, abnormal
growths, endometriosis, or allergic reactions to
contraceptive material
• Psychosomatic – Fear of pain, feelings of guilt or
shame, lack of arousal, fear of pregnancy
Signs and Symptoms
• Mild to severe discomfort during or after
intercourse
• Vaginal itching or burning
Diagnostic Procedures
• Physical examination
• Detailed sexual history
Treatment
• Creams or water-soluble jellies for
lubrication prior to intercourse
• Excision of scars
• Genital stretching
• Education
Prognosis
• Good with adequate treatment, proper
education and sensitivity from partner
Prevention
• Prompt treatment of any infections
Erectile Dysfunction
• Erectile dysfunction is the inability of the
man to achieve or sustain an erection
sufficient to complete sexual intercourse
Etiology
• Psychological causes include anxiety,
depression or feelings of inadequacy
• Physiological causes include pharmological
agents, drug and alcohol abuse, diabetes
mellitus, surgical complications, spinal cord
and disk injuries, and neurological,
endocrine, or urologic disorders
Signs and Symptoms
• Partial – unable to achieve full
• Intermittent – sometimes potent
• Selective – only with certain women
Diagnostic Procedures
• Differentiate between psychological and
physiological causes of impotence
• Physical examination
• Medical history review
• Detailed sexual history
Treatment
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Therapy
Counseling
Surgical implantation of prosthesis
Drug sildenafil (Viagra) – enhances the
effects of nitric oxide, which is released into
penis during sexual arousal, allowing
increased blood flow
Prognosis
• Variable – depends on duration and severity
• Viagra should only be taken while in
physician’s care
Arousal and Orgasmic
Dysfunction in Women
• Orgasmic dysfunction is the inability to
achieve orgasm
• Arousal dysfunction is the lack of desire for
sexual activity and arousal
Etiology
• Diseases that produce nerve damage, such
as diabetes mellitus or multiple sclerosis
• Drug reactions, pelvic infections, and
vascular diseases
• Anxiety, depression, stress and fatigue,
inadequate or ineffective stimulation, or
early traumatic experiences
Signs and Symptoms
• Loss of sexual desire or slow sexual arousal
• Lack of vaginal lubrication or
vasocongestive response
• Inability to achieve orgasm totally or under
certain circumstances
Diagnostic Procedures
• Physical examination
• Medical history
• Detailed sexual history
Treatment
• Sex therapy
• Eliminate involuntary inhibitions of
orgasmic reflex
• Experimental therapy
• Psychoanalysis
• Behavior modication
Prognosis
• Good is no nerve damage
• Psychological causes may require lengthy
treatment
Premature Ejaculation
• Premature ejaculation is the expulsion of
seminal fluid prior to complete erection of
the penis or immediately following the
beginning of sexual intercourse
Etiology
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Anxiety
Guilt
Negative sexual relationships
Pathological factors are rare, but may be
linked to degenerative neurological
disorders, urethritis, prostatis
Signs and Symptoms
• Ejaculation during foreplay
• Prior to complete erection
• As soon as intromission
Diagnostic Procedures
• Physical examination
• Laboratory tests
• Detailed sexual history
Treatment
• Sex therapy
• Partners learning techniques to prevent
premature ejaculation
• Understand condition is reversible
Prognosis
• Excellent with proper treatment and
understanding from both partners
• Positive self image
Prevention
• No prevention is known
Male and Female Infertility
• Infertility is diagnosed as failure to become
pregnant after 1 year of regular, unprotected
intercourse
• 10 percent of couples are infertile
• Female fertility peaks at 24 and diminishes at 30,
pregnancy is rare after 50
• Most fertile within 24 hours of ovulation
• Male fetility peaks at 24 and declines at 40
• Greatest fertility occurs with sex 4 times per week
Etiology
• Women – hormonal, nutritional
deficiencies, infections, tumors, anomalies
• Men – sperm deficiencies, congenital
abnormalities, endocrine imbalance, chronic
inflammation of testes, epididymis, vas
deferens
Signs and Symptoms
• Typically no sexual dysfunction
• Inability to conceive
Diagnostic Procedures
• Women – complete medical, surgical and
gynecologic history and examination
• Serology test for syphilis
• Hysterosalpingography
• Analysis of cervical mucus after coitus – Huhner
test
• Men – sexual abstinence for 4 days and then
complete ejaculation and sperm count
• Testicular biopsy if azoospermia or oliospermia is
determined
Treatment
• Women – salpingostomy, Removal of
ovarian abnormalities, alleviation of
cervicitis, hormone therapy
• Men – correction of testicular hypofunction
secondary to hypothyroidism, Surgical
correction of varicocele or hydrocele,
hormone therapy
Prognosis
• About 50 percent of couples who are treated
for infertility achieve pregnancy
• Rest are untreatable and complicated
Prevention
• Avoid causative factors such as infections,
drugs and alcohol, trauma, and
environmental agents
• Need emotional support and information
Gonorrhea
• Gonorrhea is a contagious bacterial
infection of the epithelial surfaces of the
genitourinary tract for men and women.
• Currently one of the most prevalent
sexually transmitted (venereal) diseases in
the U.S.
Etiology
• Caused by the bacterium Neisseria
gonorrhoeae
• Infants born of infected mothers can get
gonorrhea during vaginal delivery and may
infect the conjunctivae, respiratory tract, or
anal canal
Signs and Symptoms
• Many cases, especially women, are
asymptomatic or produce only symptoms so
slight that they are ignored
• Infected men show signs of acute urethritis,
purulent urethral discharge, dysuria, and
urinary frequency.
• Discharge from pharynx or rectum with
pain among homosexuals
Diagnostic Procedures
• Bacterial cultures
Treatment
• Antibiotics, including penicillin or
tetracycline
• Clients should have 2nd culture in 1 to 2
weeks and the 6 months
Prognosis
• Good
• Systemic gonorrheal infections may
produce joint destruction or potentially lifethreatening complications such as
meningitis, or endocarditis
• Pelvic inflammatory disease among women
Prevention
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Condoms
Avoid multiple partners
Trace sexual contact with infected persons
1 percent silver nitrate solution in eyes of
newborns reduce gonococcal ophthalmia
neonatorum
Genital Herpes
• Genital, or venereal, herpes is a highly
contagious viral infection of the male and
female genitalia
• Unlike others, herpes recurs spontaneously
• Two stages
– Active – skin lesions
– Latent - asymptomatic
Etiology
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Caused by herpes simplex virus (HSV)
Two strains – HSV-1 and HSV-2
HSV-2 causes most
Direct contact with bodily secretions
Infections occur during sexual intecourse,
oral-genital sexual activity, kissing, handto-body contact
Signs and Symptoms
• Skin lesions on genitals, mouth, and/or anus
• Shallow ulcerations, pustules, or
erythmatous vesicles
• Acute pain and itching
• Fever, headache, malaise, muscle pain,
anorexia, dysuria
• Leukorrhea in women
Diagnostic Procedures
• Physical examination
• Scraping and biopsy of ulceration
Treatment
• Topical medications to reduce edema
• Clean and dry
• Antiviral drugs - acyclovir
Prognosis
• Genital herpes cannot be cured
• 80 percent of individuals will experience a
recurrence within 12 months
• May produce cervical cancer
Prevention
• No proven method of prevention
• Avoid sexual intercourse with infected
individuals
• Condoms
• Cesarean birth
Genital Warts
• Genital warts are circumscribed, elevated
skin lesions near genitalia or anus
• Papillomas have fibrous tissue outgrowth
Etiology
• Papillomaviruses
• Spread during intimate sexual contact
• Incubation period of 6 months
Signs and Symptoms
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Asymptomatic or tenderness in area
End of penis
Perianal area
Opening of vagina
Warts are 3 to 4 inches in diameter
Diagnostic Procedures
• Scrapings from wart cells are diagnosed
Treatment
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Topical medication
Cryosurgery
Electrocautery
Debribement
Prognosis
• Spontaneous “cures” are rare
• Some are unresponsive
Prevention
• Avoid sexual intercourse with infected
individuals and regularly washing genitalia
area
Syphilis
• Syphilis is a highly infectious, chronic,
sexually transmitted disease characterized
by lesions that may involve any organ or
tissue
Etiology
• Bacterium Treponema pallidum
• Direct contact with infected lesions
• Sexual intercourse or contact with bodily
fluids
• Transfusion of blood
• T. pallidum may cross placenta and infect
fetus, causing serious fetal damage
• Spread to lymphatic system and blood
Signs and Symptoms
• Three stages if left untreated
– Primary syphilis – 3 wks incubation,
appearance of distinctive, painless lesions,
called a chancre, appears on penis or anus or
labia of vagina, cervix, lips, tongue, fingers,
accompanied by lymphadenopathy – highly
contagious
Signs and Symptoms
• Secondary syphilis – rash with uniform
macular, papular, pustular or nodular
lesions on soles or palms
• Lesions erode and become contagious
• Headache, malaise, gastrointestinal upset,
sore throat, fever, alopecia, and brittle nails
Signs and Symptoms
• Latent syphilis – begins asymptomatic
• Final or tertiary stage appears 2 to 7 years
later and may cause damage to aorta of
heart, central nervous system, or
musculoskeletal system
Diagnostic Procedures
• Fluorescent treponemal antibody-absorption
(FTA-ABS) test
• Venereal Disease Research Lab (VDRL)
and cerebrospinal fluid (CSF) examination
Treatment
• Penicillin, intramuscularly
• Tetracycline or erythromycin may be used
if allergic to penicillin
Prognosis
• Varies
• Any organ damage is irreversible
• Poor for fetus
Prevention
• Condoms
Trichomoniasis
• Trichomoniasis is a protozoal infestation of
the vagina, urethra, or prostate.
Etiology
• Affects 10 to 15 percent of sexually active
persons
• Increased susceptibility to Trichomonas
infection by using vaginal sprays and overthe-counter douches
• May change natural flora of vagina
Signs and Symptoms
• 50% of women are asymptomatic for 6 mths
• Acute vaginitis – a strong smelling,
greenish yellow, frothy vaginal discharge,
accompanied by itching, swelling,
dyspareunia, and dysuria
• May persist for months if untreated
Diagnostic Procedures
• Microscopic examination of seminal or
vaginal discharge
• Urinalysis
Treatment
• Antiparasitic drugs
• Should have follow-up examination
Prognosis
• Good with proper treatment
• Re-infection may occur
Prevention
• Over-the-counter douches and vaginal
sprays should be avoided
• Abstinence
• Condoms
• Wear cotton or loose-fitting underwear
• Cleanliness
Chlamydial Infections
• Sexually transmitted that causes
inflammation of urethra and epidymis in
men and inflammation of cervix in women
• Most potentially damaging of all STD’s
Etiology
• Silent STD
• Resembles gonorrhea in may women
• Itching and burning, vaginal discharge, and
cervicitis
• Urethritis and epididymitis may result
Diagnostic Procedures
• Cytological and serological studies reveal
C. trachomatis in infected body fluids
Treatment
• Tetracycline and erythromycin
• Both partners must be treated
simultaneously
Prognosis
• If untreated, disease in fallopian tubes,
pelvic inflammation, infertility in women
• Men may suffer epididymitis and become
sterile
Prevention
• Condoms
Prostatitis
• Inflammation of prostate gland
• Acute or chronic
• Common in men over 50
Etiology
• Bacterial or non-bacterial
• Causes
– E. coli
– Klebsiella
– Streptococcus
• May be in urethra or bloodstream
Signs and Symptoms
• Low back pain, myalgia, perineal fullness,
urinary frequency and urgency
• Prostate may be enlarged, tender, and boggy
Diagnostic Procedures
• Abnormally high leukocyte counts in the
absence of detectable bacteria
Treatment
• Rest and increased fluid intake
• Analgesics, antipyretics, and stool softeners
• Stitz baths
Prognosis
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Acute prostatitis responds well to treatment
Chronic prostatitis does not
Cystitis
Urethritis
Prevention
• Early treatment of urinary tract infections
Epididymitis
• Inflammation of the epididymis due to
infection
• Unilateral condition
• Most common infections of male
reproductive system
Etiology
• Chlamydia trachomatis and Neisseria
gonorrhea
• E. coli, Staphylococcus and Streptococcus
• Can occur as result of prostatits, urinary
tract infection, mumps, tuberculosis, or
gonorrhea and syphilis
Signs and Symptoms
• Epididymis may become enlarged, hard,
tender, causing pain
• Scrotal and groin tenderness
• Fever
• Patients may waddle as they walk
Diagnostic Procedures
• Urinalysis
• Urine cultures
• Increased leukocyte count
Treatment
• Antimicrobial therapy
• Scrotal support
• analgesics
Prognosis
• Inflammation responds well
• Sterility may result if treatment is delayed
• Orchitis may develop
Prevention
• Inflammation of testes due to infection and
is a serious complication of epididymis
• Condition may be unilateral or bilateral
Etiology
• May arise from mumps virus
• Scrotal trauma
Orchitis
Signs and Symptoms
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Testicular swelling
Acute pain
Chills
Fever
Malaise
Nausea and vomiting
Diagnostic Procedures
• Testicular examination
Treatment
• Analgesics
• Antipyretics
• Scrotal support
Prognosis
• Good
• Atrophy of affected testicle
• Sterile
Prevention
• Mumps vaccine
Benign Prostatic Hyperplasia
• Overproliferation of cells within inner
portion of prostate
• Common in men over 50
Etiology
• Metabolic and hormonal changes associated
with aging
• Enlarged prostate may press against rectum,
causing constipation
Signs and Symptoms
• Urinary obstruction
• Difficulty in initiating urination or
incomplete emptying of bladder
• Dysuria, nocturia, dribbling, urinary
frequency, weak urine
• Hydronephrosis or pyelonephritis
Diagnostic Procedures
• Rectal examination
• IVP – intravenous pyelogram
• Prostatic biopsy to ensure that prostatic
carcinoma is not causing enlargement
Treatment
• Prostatic massage, catherization, stitz baths
• Medications to shrink prostate
• Transurethral thermo-ablation therapy (T3)
Prognosis
• Good with proper intervention
• If untreated, infections ma ascend to kidney
Prevention
• none
Prostatic Cancer
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Malignant neoplasm of prostate tissue
Classified as adenocarcinomas
3rd leading cause of cancer deaths in men
Tends to metastasize and spreading to bones
Rare before age 50
Etiology
• Cause is not known
• Increased incidence with age
Signs and Symptoms
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Asymptomatic
Dysuria
Difficulty in voiding
Urinary frequency
Urinary retention
Diagnostic Procedures
• CT scan
• Prostate-specific antigen (PSA) blood test
Treatment
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Surgery
Orchidectomy and estrogen therapy
Radiation therapy
Chemotherapy
Prognosis
• Earlier the cancer is detected, the better
• Survival rates 50 to 76 percent
Testicular Cancer
• Malignant neoplasm of testis
• Affects young to middle-aged men
Etiology
• Cause is unknown
• Predisposing factors such as cryptorchidism
• History of mumps or inguinal hernia during
childhood
Signs and Symptoms
• Smooth, firm, painless mass in testicles
• Later symptoms may include breast
enlargement or nipple tenderness
Diagnostic Procedures
• Palpatation of testes
• CT scan
• MRI
Treatment
• Surgery
• Radiation
• Chemotherapy
Prognosis
• Cure rates of 90 percent
Prevention
• Early detection is crucial to successful
treatment
• Perform monthly testicular examinations
Female Productive Diseases
Premenstrual Syndrome (PMS)
• A cluster of symptoms that regularly occur
several days prior to onset of menstruation
• More frequently in thirties and forties
Etiology
• Cause is not clearly understood
• Attributable to water retention, estrogen –
progesterone imbalance, psychological
factors or dietary deficiencies
Signs and Symptoms
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Irritability
Sleeplessness
Fatigue
Depression
Headaches
Vertigo
Abdominal bloating or weight gain
Diagnostic Procedures
• Keep a journal recording
• Evaluation of estrogen and progesterone
levels
• Blood tests to rule out anemia
Treatment
• A reduction of salt intake for 2 weeks prior
to menses to minimize water retention
• Avoid coffee, nicotine, and alcohol
• Proper diet and exercise and rest
• Reduction of stress and relaxation
techniques
Prognosis
• Variable
Prevention
• No known prevention
Amenorrhea
• Absence of menarche beyond age 16 or
absence of menstruation for 6 months
Etiology
• Hormonal imbalance capable of preventing
ovulation
• Absence of uterus
• Endometrial problems, ovarian or pituitary
tumors, malnutrition, psychological stress,
or too much physical exercise
Signs and Symptoms
• Delayed menarche for youth
• Absence of menstruation in adults
Diagnostic Procedures
• Pelvic exam to rule out pregnancy or
anatomic abnormalities
• Blood and urine samples
• X-rays or laparoscopy
Treatment
• Hormone therapy
• surgery
Prognosis
• Good
Prevention
• Adequate diet
• Reduction of psychological stress
• Balanced exercise
Dysmenorrhea
• Pain associated with menstruation
• Frequently gynecologic disorders
• Two categories
– Primary – no identifiable pathological disorders
– Secondary – underlying disease condition
Etiology
• Hormonal imbalance such as prostaglandin
• Endometriosis, cervical stenosis, or pelvic
inflammatory disease
• Uterine polyps or benign tumors
Signs and Symptoms
• Sharp, cramping pains
• Starts prior to menses
• Subside within 18 to 24 hours
Diagnostic Procedures
• Laparoscopy and dilation and curettage
(D&C) may be attempted
Treatment
• Analgesics and non steroid antiinflammatory drugs
• Heat
• Uterine leiomyomas may require surgery
Prognosis
• Good
Prevention
• Correction of hormonal imbalance
Ovarian Cysts and Tumors
• Derived from ovarian follicles and corpus
luteum
• Nonneoplastic cysts (tumors) are small
• Neoplasms may be benign, malignant,
cystic, or solid
• Tissues colors change
Etiology
• Not known
Signs and Symptoms
• Pelvic pain
• Lower back pain
• dyspareunia
Diagnostic Procedures
• Laparoscopy
• Sonography
Treatment
• Surgery only if malignant
Prognosis
• varies
Prevention
• No known prevention
Endometriosis
• Appearance and growth of endometrial
tissue in areas outside endometrium, the
uterine cavity’s lining
• Misplaced endometrial tisse in pelvic area
Etiology
• Cause is not known
Signs and Symptoms
• Dysmenorrhea occurs, with pain in lower
back and vagina
Diagnostic Procedures
• Laparoscopy
Treatment
• Hormone therapy
• Surgery to include uterus, cervix, ovaries,
and fallopian tubes
Prognosis
• Varies
• Primary complication is infertility
Prevention
• Use sanitary napkins rather than tampons
Uterine Leimyomas
• Often mislabeled as fibroids or fibroid
tumors
• Smooth muscle tissue
• Tend to calcify after menopause
Etiology
• Stimulated by estrogen
Signs and Symptoms
• Pelvic pressure, urinary frequency,
constipation and meorrhagia
Diagnostic Procedures
• Ultrasonography and D & C
Treatment
• Dependent on age, parity, desire to have
children
• Tumor status
• Surgical removal of tumors
Prognosis
• good
Pelvic Inflammatory Disease
• Acute, or subacute, or a recurrent or chronic
infection of the fallopian tubes, ovaries, and
adjacent tissues
Etiology
• Parturition
• Infections from N. gonorrhoeae, C.
trachomatis, Pseudomonas, and E. coli
• Iatrogenic
• Conization
• Most common in young nulliparous women
Signs and Symptoms
• Sudden pelvic pain
• Purulent and foul-smelling vaginal
discharge
• Fever
• Sexual dysfunction
Diagnostic Procedures
• Ultrasonography used to identify a uterine
mass
Treatment
• Antibiotics
• Surgery may be necessary to prevent
septicemia
Prognosis
• Good when treated early
Menopause
• The cessation of menses and ovarian
function
• Decrease in estrogen levels
• Not a disease
Etiology
• Occurs naturally in women between ages 40
and 50
Signs and Symptoms
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Menstrual irregularities
Decrease in flow
Hot flashes
Night sweats
Tachycardia
Loss of elasticity in skin
Reduction in size and firmness of breast
Diagnostic Procedures
• Blood serum levels checked for increased
production of follicle-stimulating hormone
(FSH) and luteinizing hormone (LH)
Treatment
• Hormonal replacement therapy if needed
Prognosis
• Good
Prevention
• Cannot be prevented but emotional swings
occur
Diseases of the Breasts
Mammary Dysplasia or Fibrocystic
Disease
• Generalized diagnosis of palpable lumps or
cysts in breasts
• Papillomatosis
• Fibrosis
• Hyperplasia
• Chronic cystic mastitis
• More frequently in women 30 to 50
Signs and Symptoms
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The upper, outer quadrant of the breast
Widespread lumpiness
Localized mass
Pain, tenderness, and nipple discharge
Treatment
• Caffeine intake may be restricted
Prognosis
• Good
• Cancer is more common in women who
also have mammary dysplasia
Benign Fibroadenoma
• Benign, well-circumscribed tumor
• Occurs usually 20 years after puberty
Signs and Symptoms
• Round, firm, discrete, and relatively
movable
• nontender
Prognosis
• Good
Carcinoma of Breast
• Encompasses a variety of malignant
neoplams
• Most common site of cancer in women
• Replaced by lung cancer as number 1
Etiology
• Hereditary patterns
• Greatest risk in women over 40 who have
not had children or until after age 35
Signs and Symptoms
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Lump
Thickening
Dimpling
Swelling
Distortion
Retraction or scaliness
edema
redness
nodularity
ulceration
Diagnostic Procedures
• Monthly self-examination
• Mammography
• ultrasonography
Treatment
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Curative or palliative
Total mastectomy
Lumpectomy
Radiation to shrink tumors
Breast reconstruction
Hormone receptors
Prognosis
• Depends on stage of cancer
• 5-year survival rate for localized breast has
risen to 97 percent
• If spread regionally, 76 percent survival rate
Disorders of Pregnancy and
Delivery
Spontaneous Abortion
• Also called miscarriage, and is the
expulsion of the conceptus before viability
Signs and Symptoms
• Pink or brown discharge may precede onset
of cramping and increased vaginal bleeding
• Clotty menstrual flow
• Pulse rate increased
• Blood pressure is lowered
Ectopic Pregnancy
• Occurs when the fertilized ovum implants
and grows somewhere other than the uterine
cavity
• Most common in fallopian tubes
Etiology
• Scarring or inflammation of the fallopian
tubes as result of infection or congenital
malformations
Signs and Symptoms
• Abdominal pain and tenderness
• If life threatening, severe abdominal pain
Treatment
• Laparotomy
• Transfusions of blood in the event of severe
intra-abdominal bleedding or hypovolemic
shock
Toxemias of Pregnancy
• Hypersensitive disorder that may develop
during the third trimester.
• Preeclampsia – edema or proteinuria
• Eclampsia – convulsions or coma
Etiology
• Related to malnutrition, especially lack of
protein
Signs and Symptoms
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Sudden weight gain
High sodium ingestion may contribute
Headaches, vertigo, malaise, irritability
Egigastric pain and nausea
Treatment
• Goal is prevent eclampsia and to deliver a
normal baby
• Bed rest is advised
• Sedatives
• Antihypertensives
Prognosis
• Good
• In eclampsia, maternal mortality rate is 15
percent
Placenta Previa
• Placenta is implanted abnormally low in the
uterus so that it covers all or part of the
internal cervical os, or opening
• Dangerous because placenta may
prematurely separate from uterus
Etiology
• Predisposing factors
– Multiparity
– Advanced maternal age
– Uterine surgery
Signs and Symptoms
• Slight, painless bleeding
• Ok as long as fetal heart tones remain
strong
Prognosis
• Depends on amount of bleeding
• Age
• Blood loss
Abruptio Placentae
• Premature separation of a normally
implanted placenta from the uterine wall
about the 20th week of gestation
• Most common condition is multigravidae
Etiology
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Trauma
Chronic hypertension
Preeclampsia
eclampsia
Signs and Symptoms
• Sudden, severe abdominal pain with
boardlike rigidity, tenderness of the uterus,
hemorrhage and the onset of shock
Prognosis
• Good if bleeding is controlled
• Complications of blood loss include
disseminated intravascular coagulation
(DIC) and renal failure
Premature Labor/ Premature
Rupture of Membranes (PROM)
• Early rupture of amniotic sac
• Early onset of rhythmic uterine contractions
Etiology
• Incompetent cervix
• Multiple pregnancy
• Infections
Signs and Symptoms
• Blood-tinged flow from the vagina
• effacement
Common Disorders of Pregnancy
and Delivery
• Abdominal pain, tenderness or cramping
• Unusual discharge, pink or brown in color,
or clotted
• Hypertension, rapid weight gain, edema,
and malaise, which indicates possible
toxemia
