Question

Nursing care plan for this case study. Chapter 19: Nursing Management of Pregnancy at Risk: Pregnancy-Related Complications 1. Teresa is a 36-year-old primigravida who is expecting twins. She is 26 weeks pregnant. She stays after your “What to Expect with Twins” class to talk to you. Although Teresa is a nurse, she has many questions and concerns. Her twins are a result of years of trying to get pregnant and in vitro fertilization. She is nervous about whether she will have a vaginal delivery or a cesarean section. She is worried about having the babies prematurely. She wants you to tell her everything that could go wrong so she can be prepared. (Learning Objectives 1 and 2)

Answer 1

Twin pregnancy is considered as a high risk pregnancy and should be take extra care. The mother is also over 35 years of age and on fertility treatment. So the care should be even higher. As the mother is a nurse. I will use technical terms.

The following are the complications that could arise with this pregnancy.

• Malpresentations are common in twin pregnancies and other multiple pregnancies.
• Increases incidence of hyperemesis is seen in the first trimester.
• Increase in the pressure symptoms liken breathlessness and pedal oedema may occur.
• The high pressure may also manifest as varicosity is veins, constipation, palpitations, backache, difficulties in walking etc.
• Anemia is more common due to high increase in demand which may not be attained by the mother.
• The incidence of preeclampsia is increased by four fold.
• Antepartum hemorrhage may occur.
• Higher complications in labour.
• Increased likelihood of cesarean section Is seen in twin pregnancy.
• Spontaneous abortion and vanishing twin syndrome are high.
• congenital malformations like acardic twins, conjoint twins, thoracopagus twins, twin reversed arterial perfusion may occur.
• Premature labour, preterm prelabour rupture of membranes are possible.
• Disconjoint twins are also a complication.
• Congenital malformations

These are some of the common complications that are associated with this pregnancy along with other possible complication with any pregnancy. Hope this helps you out. All the very best. Please feel free to give your feedback and if you need further information. Thank you and have a great day.