Clinical nursing care for pregnancy complicated with hyperprolactinemia

What should be paid attention to in the clinical care of pregnancy complicated with hyperprolactinemia? Everyone knows that hyperprolactinemia is very harmful to female friends, especially in the case of pregnancy complicated with hyperprolactinemia. Daily care is very important. So, what are the nursing measures?

1. Care before delivery

(1) Understand the medical history

After the patient is admitted to the hospital, we will understand the medication history, pathological mechanism, drug mechanism, guide rational medication, explain the medication reactions, and precautions (adverse reactions).

(2) Fetal monitoring

Because the patient's fetus is relatively precious, she was given fetal heart rate monitoring, oxygen, and was taught to count fetal movements by herself.

(3) Psychological care

Because the patient had been married for many years without getting pregnant, she was worried about the development of the fetus after conception. Therefore, we provided her with good psychological care, communicated with her more, showed care and respect to her, and relieved and stabilized her nervousness and anxiety.

(4) Closely monitor changes in the condition

The patient had a brain CT scan, which showed that pituitary adenoma could be excluded. Visual field defects and pituitary adenoma are the most common causes of hyperprolactinemia. Therefore, PRL must be closely monitored during pregnancy and medication should be taken according to the doctor's instructions. The patient's PRL increased at 18 weeks of pregnancy and she continued to take oral bromocriptine until 38 weeks.

2. Post-delivery care

(1) Observe the patient’s vital signs

Blood pressure, heart rate, and respiration were closely monitored and no abnormalities were found. By day 3 after delivery, the patient's blood pressure returned to normal.

(2) Postpartum uterine bleeding and wound care

After the operation, oxytocin 20u was injected intramuscularly to promote uterine contraction and press the uterine fundus. Vaginal bleeding was about 20ml. The wound was observed on the second day after the operation. There was no redness, swelling, exudation, and dryness. The dressing was changed and the vulva was washed bid.

(3) Breast care

Galactorrhea is a typical clinical manifestation of hyperprolactinemia. However, the patient took bromocriptine during pregnancy, which can effectively inhibit the synthesis and secretion of PRL. The patient had slight breast pain, but no milk secretion. Because the patient took bromocriptine during pregnancy and did not want to breastfeed, she was given external application of Glauber's salt, twice a day, 500g each time, and milk stopped after 3 days.

(4) Health education

Patients who use bromocriptine during the postpartum period should pay attention to the effects of contraceptives. If contraception is required, estrogen contraceptives should not be used. Because a large amount of estrogen can cause the proliferation of pituitary secretory cells, the serum PRL value will also increase.