Pregnancy, Uncomplicated
Pregnancy, Uncomplicated is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- 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
Pediatric Considerations
- 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
Etiology
Etiology
- 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
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Citation
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TY - ELEC
T1 - Pregnancy, Uncomplicated
ID - 307333
ED - Barkin,Adam Z,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Shayne,Philip,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307333/all/Pregnancy__Uncomplicated
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -