Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
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- Pregnancy is not a disease process but rather a physiologic state. It involves severe metabolic stresses on the mother to facilitate the growth and development of the fetus.
- All women of reproductive age with abdominal pain are considered pregnant until proven otherwise even with history of sterilization.
- The changes in pregnancy occur from the production of large amounts of placental hormones:
- Placental progesterone and estrogen
- Range for menarche in US is 11–15 yr old
- Pregnant adolescents who present to the ED may be either unaware of the pregnancy or reluctant to admit it:
- Assume pregnancy in adolescents, regardless of the chief complaint
- Pediatric pregnancies have an increased risk of obstructive labor
- Preceding signs and symptoms can be explained by elevations in various hormone levels or changes in anatomy that are a function of the progression of the pregnancy.
- Placental human chorionic gonadotropin (hCG):
- Prevents the normal involution of the corpus luteum at the end of the menstrual cycle
- Causes the corpus luteum to secrete even larger quantities of estrogen and progesterone
- Elevated hCG levels are responsible for nausea and vomiting.
- Placental progesterone:
- Causes decidual cells in the endometrium to develop and provide nutrition for the early embryo
- Decreases contractility of the gravid uterus and risk of spontaneous abortion
- Helps estrogen prepare the breasts for lactation
- Placental estrogen:
- Responsible for enlargement of uterus, breasts, and mammary ducts
- Enlargement of female external genitalia, relaxation of pelvic ligaments, symphysis pubis, and sacroiliac joints