| Abstract | Trudnoća je prirodan proces koji započinje oplodnjom jajne stanice spermijem. Uredno traje oko 40 tjedana ili devet mjeseci. Tijekom tog razdoblja, žensko tijelo prolazi kroz brojne anatomske, fiziološke, mehaničke i hormonalne promjene, koje osiguravaju razvoj ploda i napredak trudnoće.
Uz pojam trudnoća vežu se brojni pojmovi poput željena trudnoća, neželjena, visoko rizična, patološka itd. Osim planiranih i željenih trudnoća, u svakodnevnom životu susrećemo se i s onima koje nisu bile planirane i željene. Prema definiciji, neželjena trudnoća je ona trudnoća koja nije bila planirana ili željena u trenutku začeća. Posljedica je različitih životnih stanja i situacija, poput silovanja, neadekvatne kontracepcije, neispravnog korištenja ili potpunog izostanka zaštite. Često ima za posljedicu namjerni prekid trudnoće.
Neke trudnoće popraćene su komplikacijama i komorbiditetima, što ih svrstava u skupinu tzv. visokorizičnih trudnoća. Kod takvih trudnoća postoji povećan rizik za razvoj komplikacija, bilo zbog zdravstvenog stanja majke ili problema u razvoju ploda. Kod takvih slučajeva, potreban je intenzivniji nadzor i medicinska skrb. Osim navedenih pojmova, željene i neželjene te visokorizične trudnoće, važno je spomenuti i pojam patološke trudnoće. Patološka trudnoća je trudnoća s komplikacijama ili abnormalnostima koje mogu ugroziti zdravlje majke, ploda ili oboje. U takvim slučajevima dolazi do odstupanja od normalnog tijeka trudnoće zbog problema sa zdravljem majke ili razvojem ploda. Kako bi se spriječile komplikacije i/ili ugrožavanje zdravlja majke ponekad je potrebno učiniti prekid trudnoće iz medicinski opravdanog razloga.
Kako smo već ranije naveli, prekid trudnoće može biti medicinski indiciran zbog negog patološkog stanja ili rezultat osobne odluke. U današnje vrijeme najviše su se u kliničkoj praksi uvriježila dva načina, kirurški ili medikamentozni. Medikamentozni prekid trudnoće koristi se najčešće u ranijim stadijima trudnoće i najčešće se provodi se primjenom dva lijeka, mifepristona i misoprostola.
Mifepriston blokira djelovanje progesterona, hormona neophodnog za održavanje trudnoće, dok misoprostol potiče kontrakcije maternice, što dovodi do izbacivanja/istiskivanja sadržaja iz maternične šupljine. Ovaj postupak se primjenjuje ne samo u slučajevima neželjene trudnoće, već i kod medicinskih indiciranih prekida trudnoće.
Upravo u postupku prekida trudnoće lijekovima, medicinske sestre imaju ključnu ulogu. Njihova odgovornost uključuje edukaciju pacijentice o postupku, praćenje fizičkog stanja i potencijalnih komplikacija, te pružanje emocionalne i psihološke podrške. Izazovi s kojima se medicinske sestre susreću u ovom procesu uključuju ne samo kliničke aspekte, već i etičke dileme te emocionalni stres zbog čestog suočavanja s pacijenticama koje prolaze kroz emocionalno zahtjevne situacije. |
| Abstract (english) | Pregnancy is a natural process that begins with the fertilization of an egg by a sperm. It regularly lasts about 40 weeks or nine months. During this period, the female body goes through numerous anatomical, physiological, mechanical and hormonal changes, which ensure the development of the fetus and the progress of the pregnancy.
Many terms are associated with the term pregnancy, such as wanted pregnancy, unwanted, high-risk, pathological, etc. In addition to planned and desired pregnancies, in everyday life we also encounter those that were not planned and desired. By definition, an unwanted pregnancy is a pregnancy that was not planned or wanted at the time of conception. It is the result of different life conditions and situations, such as rape, inadequate contraception, incorrect use or complete lack of protection. It often results in intentional termination of pregnancy.
Some pregnancies are accompanied by complications and comorbidities, which puts them in the group of so-called high-risk pregnancies. In such pregnancies, there is an increased risk of developing complications, either due to the health condition of the mother or problems in the development of the fetus. In such cases, more intensive supervision and medical care is required. In addition to the mentioned concepts, wanted and unwanted and high-risk pregnancies, it is important to mention the concept of pathological pregnancy. A pathological pregnancy is a pregnancy with complications or abnormalities that may endanger the health of the mother, the fetus, or both. In such cases, there is a deviation from the normal course of pregnancy due to problems with the health of the mother or the development of the fetus. In order to prevent complications and/or endangering the health of the mother, it is sometimes necessary to terminate the pregnancy for a medically justified reason.
As we mentioned earlier, termination of pregnancy may be medically indicated due to a pathological condition or the result of a personal decision. Nowadays, two methods, surgical or medicinal, are the most common in clinical practice. Medical termination of pregnancy is most often used in the earlier stages of pregnancy and is most often carried out using two drugs, mifepristone and misoprostol.
Mifepristone blocks the action of progesterone, a hormone necessary to maintain pregnancy, while misoprostol stimulates uterine contractions, which leads to expulsion/extrusion of contents from the uterine cavity. This procedure is applied not only in cases of unwanted pregnancy, but also in cases of medically indicated termination of pregnancy.
Nurses play a key role in the process of medical termination of pregnancy.
Their responsibility includes educating the patient about the procedure, monitoring her physical condition and potential complications, and providing emotional and psychological support. The challenges that nurses face in this process include not only clinical aspects, but also ethical dilemmas and emotional stress due to frequently dealing with patients who are going through emotionally demanding situations. |
