Gynecology or Pregnancy Diagnosis or Consideration
Discussion Question – Gynecology Guidelines:
Discuss Etiology, Epidemiology, Pathophysiology, Clinical Manifestations, Workup, Nonpharmacological, and Pharmacological management, Education, and Follow-up for a gynecology or pregnancy diagnosis or consideration. Five hundred words or less for the initial post. Under the initial discussion board thread, add in second-and third-line treatments and additional considerations. Requirements: only evidence-based sources, such as The American Academy of Obstetrics and Gynecology or The American College of Obstetricians and Gynecologists. (Textbook resources and internet sites affiliated with medical associations are considered credible sources to obtain the information on the most up-to-date guidelines). Must include the link to the Latest Clinical Practice Guideline(s) within the last five years.
Length: Maximum 500 words or less, not including references, minimum 275 words.
Citations: At least three high-level scholarly references in APA 7 from within the last 5 years.
Sample Answer
Gynecology Or Pregnancy Diagnosis or Consideration
Etiology
Preeclampsia refers to pregnancy complication that shows signs of damaging another body organ system such as the kidney or liver or lead to hypertension. Preeclampsia affects the maternal immune system stopping the process of recognizing the fetoplacental unit. The illness is likely to happen after the first 20 weeks after pregnancy, but in some cases, the symptoms delay until birth, the first 48 hours of delivery (Amaral et al. 2017). Obesity, age, historical conditions of certain illnesses, new parenthood, history of preeclampsia, and in vitro fertilization are risk factors associated with this disorder (Cox et al. 2019). Preeclampsia is a deadly disorder that primarily causes mortality, maternal morbidity, perinatal death, and intrauterine growth restriction.
Epidemiology
Research shows that western countries have more cases of Pre-eclampsia as it affects about 3-8% of pregnancies. Preeclampsia is the recognized cause of significant mortality and morbidity globally because research shows the maternal deaths From Pre-Eclampsia are 10-15%. Ethnicity plays a role in determining preeclampsia incidences because the conditions in nulliparas range from 3-7% and 1-3% for multiparas.
Pathophysiology
Preeclampsia results from the placenta functionality failure; thus, the pathophysiology calls for fetal and maternal factors making it a two-stage disorder. Stage one involves reduced placental perfusion, observing defective invasions of the spiral arteries through the cytotrophoblast of cells. The process involves differentiation pathways that allow the fetal cells to absorb some features of the maternal endothelium usually replaced (Amaral et al. 2017). The differentiation will get awry as the pathophysiology of preeclampsia takes place. Relative placental hypoxia/under perfusion/ischemia can result from abnormalities realized in the development of placental vasculature. The condition can lead to antiangiogenic factors that are released, resulting in maternal circulation. The outcomes cause manifestations of the disease and hypertension which also makes changes in the maternal systematic endothelial (Amaral et al. 2017). The link between abnormal placentation and stage two of preeclampsia causes an imbalance in the angiogenic factors, simply creating a maternal response. At this stage, there are increased markers of oxidative stress, reduced immune functionality, insulin resistance, increased irritation, and maternal endothelial cell dysfunction.
Clinical Manifestations
The symptoms of preeclampsia include severe blood pressure, headaches, proteinuria with or without past systemic abnormalities in the kidney, liver, or blood. More symptoms involve low platelet count, fast weight gains, nausea and vomiting, and difficulties in urinating or vision challenges (Cox et al. 2019). Patients with eclampsia usually show symptoms associated with symptoms of preeclampsia.
Workups and Nonpharmacological
Physicians have no identified reliable and cost-effective tests or treatment techniques for preeclampsia. The primary prevention measures are not stated, but recommendations argue that management before the onset of labor is necessary to monitor both fetal and maternal status. Seizure prophylaxis with magnesium sulfate is recommended for use during delivery which can also include medical management of blood pressure (Awalia, Sukmawati & Witdiawati, 2020). The ultimate treatment for this condition is delivery. To reduce preeclampsia-related deaths, it is good to access prenatal care, go for early detection of the condition, adhere to monitoring pathways, and do appropriate management.
Pharmacological management
The primary way of managing severe emergency preeclampsia is done by maintaining tight and rapid blood pressure controls. The first-line agents of choice to manage blood pressure is to take oral nifedipine and intravenous labetalol (Awalia, Sukmawati & Witdiawati, 2020). To prevent eclampsia, the use of magnesium sulphate is recommended, which later will control blood pressure.
Education, and Follow-up
Maternal and prenatal care is necessary at the early stages of pregnancy because it helps in the early detection of preeclampsia symptoms. Early de-escalation of antenatal surveillance is a potential benefit that people gain after early detection of preeclampsia. High-risk populations are advised to stay under care for the physicians to monitor the severity of the condition. Early commencement of prophylaxis for people with high-risk conditions is necessary to prevent a recurrence.
Second-And Third-Line Treatments and Additional Considerations
The general rule for monitoring the degree and frequency of any disease for pregnant person shows that severity of the diseases increases with monitoring taken. Pre-eclampsia can be managed by application of other second-line and third-line treatments such as Venous thromboembolism prevention. The idea in this management strategy is that most of the women will be monitored on an inpatient-basis where they will be given fluid management and VTE prophylaxis. Some of the recommended pregnancy considerations include difficulties realized in intubation and aspiration, the take desaturation time, aortocaval compression.
