Adolescent pregnancy
Adolescent pregnancy can pose a major health risk to both the mother and the child because up to 70% of adolescents who become pregnant don’t receive adequate prenatal care. Pregnant adolescents develop special problems and are known to have a significantly higher incidence of anemia, pregnancy-induced hypertension, and perinatal mortality. For example, they’re more likely to have babies who are premature or of low birth weight, with a higher neonatal mortality, and who are predisposed to injury at birth, childhood illness, and retardation or other neurologic defects. These risks are aggravated if the mother has abused drugs during the pregnancy. (See How maternal drug use affects infants.)
As a rule, the younger the mother, the greater the health risk for both mother and infant. Adolescents account for one-third of all abortions performed in the United States.
Causes and incidence
Adolescent pregnancy is prevalent in all socioeconomic levels, and its contributing factors vary. Such factors may include ignorance about sexuality and contraception, increasing sexual activity at a young age, rebellion against parental influence, and a desire to escape an unhappy family situation and to fulfill emotional needs unmet by the family.
In the United States, an estimated 1 million adolescents become pregnant each year.
Signs and symptoms
Clinical manifestations of adolescent pregnancy are the same as those of adult pregnancy (amenorrhea, nausea, vomiting, breast tenderness, fatigue). However, the pregnant adolescent is much more likely to develop complications, such as poor weight gain during pregnancy, premature labor, and pregnancy-induced hypertension. In addition, the neonate is more likely to be of low birth weight. Some of these complications are related to the pregnant adolescent’s physical immaturity, rapid growth, interest in fad diets, and generally poor nutrition; other complications may stem from the adolescent’s need to deny her condition or to her ignorance of early signs of pregnancy, which often delays initiation of prenatal care.
Diagnosis
Confirming diagnosis A positive pregnancy test that shows human chorionic gonadotropin in the blood or urine and a pelvic examination confirm pregnancy.
Auscultation of fetal heart sounds with a Doppler ultrasonic flowmeter or fetoscope and ultrasonography assess fetal gestational age.
Treatment
The pregnant adolescent requires the standard prenatal care that’s appropriate for an adult. However, she also needs psychological support and close observation for signs of complications.
Special considerations
❑ Because you may be the first health care professional the pregnant adolescent encounters, you must help motivate her to follow sound medical advice without being judgmental, condescending, or threatening. Emphasize the importance of adhering to the prescribed diet, getting plenty of rest, and taking prescribed vitamin and iron supplements. Your understanding and support can ensure proper health care during the pregnancy for both mother and infant. Encourage her to ask questions and to express her feelings about the pregnancy. Answer her questions fully. It’s also important to ascertain if the patient wishes to place the child up for adoption or is considering abortion. Any decision should be accepted in a nonjudgmental way.
❑ Try to help the pregnant adolescent identify her own strengths and support systems for coping with pregnancy, birth, and parenting.
❑ Prepare the patient and her partner for the physical and psychological process of labor and birth. Encourage attendance at prenatal classes: The use of educational films, tours of the health care facility, and role-playing techniques will facilitate her cooperation with care providers.
❑ Following birth, encourage the patient to set realistic goals for the future. If she opts for adoption, make sure she clearly understands her legal rights and responsibilities. Allow the patient to care for the infant, as she desires.
❑ If the patient decides to raise the infant, help her make the transition from pregnancy to parenthood during the postpartum period. Facilitate bonding. Help her establish a realistic plan regarding childcare, parenting, returning to school or work, and her relationship with the infant’s father.
❑ In the event of stillbirth or the neonate’s death, help the patient through the grieving process.
❑ Before the patient is discharged, provide information on contraception.
Pictures
Book Source Details
- Book Title: Professional Guide to Diseases (Eighth Edition)
- Author(s): Springhouse
- Year of Publication: 2005
- Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.
Other Book Chapters Related to Pregnancy symptoms
Read excerpts from these other book chapters related to Pregnancy symptoms:
Medical Books Excerpts
- AMENORRHEA
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
- Amenorrhea
- "Handbook of Signs & Symptoms (Third Edition)" (2006)
- [ read ]
- Amenorrhea
- "A Pocket Manual of Differential Diagnosis" (1999)
- [ read ]
- Amenorrhea
- "Professional Guide to Diseases (Eighth Edition)" (2005)
- [ read ]
- Amenorrhea
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Amenorrhea
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- Amenorrhea
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
- [ read ]
Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2008 Williams & Wilkins.
More About Causes of Pregnancy symptoms
» Next page: Cardiovascular disease in pregnancy (Professional Guide to Diseases (Eighth Edition))
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