PRE AND

CO-EXISTING
DISEASES OF
PREGNANCY

CARDIAC DISEASE
Involves a variety of heart conditions
both congenital and acquired that
complicate pregnancy

Risk factors:
Rheumatic fever (90% of all cases)
Congenital defects of the heart
Arteriosclerosis
Myocardial infarction
Heart surgery
Pulmonary diseases
Renal diseases

Classification of Heart diseases based on

functional capacity of the heart
CLASS 1
(Uncompromised)

No limitation of physical activity

ordinary/regular physical activities do not
produce symptoms of cardiac insufficiency or
angina pain

CLASS II
(Slightly
Compromised)

Slight limitation
asymptomatic at rest,
regular/ordinary physical activities produce
palpitations, fatigue, dyspnea and angina pain

CLASS III
(Markedly
Compromised)

Marked limitation of activities

during less than regular/ordinary activities woman
experiences fatigue, palpitations, dyspnea or anginal
pain

CLASS IV
(Severely
Compromised)

Marked limitation of activities; woman is unable to

carry out any physical activity without experiencing
discomfort.
Even at rest symptoms of cardiac insufficiency or

Complications in Pregnancy:
Congestive Heart Failure(Left sided
CHF)
Maternal dysrrhhytmia
Spontaneous abortion
Premature labor
IUGR

Assessment

Palpitations,tachycardia
Edema
Tachypnea
Fatigue
Dyspnea increasing with minimal
activity
Chest pain on exertion
Cyanosis
Persistent heart murmurs

Interventions
Monitor VS, FHR, condition of fetus
Encourage adequate nutrition
Maintain physical and mental rest
Monitor for signs of respiratory and other
infection
Encourage adequate nutrition
Compliance with Cardiac medications
Oxygen as needed
Frequent prenatal visit

Avoid constipation
Iron supplement to prevent anemia
Take daily fruits and vegetables:
regular bowel movement
regular exercise
medications

Care During labor:

Lateral position, semi fowlers
Oxygen as needed
observe strict asepsis to prevent
infection
Monitor I&O to prevent fluid
overload
Observe NPO

Provide psychological, emotional and

spiritual support
Continuous cardiac monitoring
Monitor blood loss, I&O and fluid
flow
Assess frequently for signs of
bleeding. sepsis

Diabetes Mellitus
Primary problem is controlling the
balance between insulin and blood
glucose levels to prevent
hyperglycemia and hypoglycemia

Insulin

hormone made by the

beta cells of pancreas
allows body to use sugar
(glucose) from
carbohydrates in the food
for energy or storage for
future use.
helps keeps blood sugar
level from getting too high
(hyperglycemia) or too low
(hypoglycemia).

Classification of DM:

TYPE 1 (Insulin-Dependent Diabetes

Mellitus)

Characterized by destruction of the beta cells in

the pancreas that leads to absolute insulin
deficiency

TYPE 2 (Non-Insulin-Dependent Diabetes

Mellitus)
Due to insulin resistance combined with
deficiency in production of insulin

GESTATIONAL DIABETES

Abnormal glucose metabolism that arises during

pregnancy