Gynecological Surgery, Cancer Care, Pregnancy and Childbirth

Posted on Feb 27, 2026 in Medicine & Health

Gynecological Surgery Effects

Gynecological surgery can affect: femininity, body image, relationships, sexuality, the pelvic floor muscles, hormonal balance, quality of life and mobility habits. Cancers include:

  • Vulvar cancer
  • Vaginal cancer
  • Cervical cancer
  • Endometrial cancer
  • Ovarian and tubal cancer
  • Breast cancer (highest 31%)

Preoperative Nursing Care

Begins from the outpatient department. Key elements:

  • Provide information about the procedure and preoperative preparation.
  • Organize preparation for the operating theatre and reporting.

Intraoperative Nursing Care

During surgery, nursing care includes:

  • Receive the woman into the operating room and provide reporting.
  • Assist during surgery and transfer to the recovery room.
  • Transfer the patient to the ward and complete reporting.

Postoperative Nursing Care

Postoperative care includes:

  • Intensive care unit (ICU) when needed.
  • Care in a basic ward.
  • Follow-up treatment and monitoring.

Hysterectomy: Indications and Definition

A hysterectomy is an operation to remove a woman’s uterus. A woman may have a hysterectomy for different reasons, including:

  • Uterine fibroids that cause pain, bleeding or other problems
  • Uterine prolapse (sliding of the uterus into the vaginal canal)
  • Cancer of the uterus, cervix or ovaries
  • Abnormal vaginal bleeding
  • Chronic pelvic pain
  • Thickening of the uterus

Preoperative Instructions and Tests

Patients are interviewed the previous day and complete the anesthesia form. Instructions and preparations include:

  • No eating and no smoking before the procedure; take a shower on the morning of surgery.
  • Klexane prophylaxis; suppositories Metalax- (as prescribed).
  • Laboratory tests and radiography when indicated.
  • Provide written and spoken instructions.
  • Surgery preparation: shaving in the genital area, cleaning the navel and identification of Avopaita.

Role of the Nurse

The nurse provides:

  • Information about treatments, surgery, chemotherapy and radiotherapy.
  • Explanation of side effects, their prevention and treatment.
  • Advice on healthy lifestyles and information about cancer societies and social insurance benefits.

Side Effects

Common side effects may include fatigue, nausea, loss of appetite, urinary problems, flatulence and diarrhea.

Radiotherapy

Effects of radiotherapy:

  • Skin in the treated area becomes more sensitive to heat.
  • Vaginal radiation therapy can cause mild bleeding (use Ovestin cream for 1 month as advised).
  • Hair can be lost from the radiotherapy area.

Chemotherapy

Chemotherapy can damage healthy tissue. Symptoms and severity vary depending on the drugs, dose, the patient’s general health and individual tolerability. Key points:

  • Blood values are monitored because treatment can lower white blood cells, red blood cells and platelets.
  • Susceptibility to infections increases when leukocytes decrease; avoid places with circulating flu. If temperature rises above 38.5°C, this can be a sign of infection.
  • Dry mouth and loss of hair; avoid combing or washing hair for a few days after certain treatments; consider an ice cap and wigs.
  • Palms and soles may become red, swollen and flaky. Nails may discolor or come loose.
  • Reduced sexual desire and drying of mucous membranes.
  • Weight loss may affect drug dosing; ensure patient has taken premedication before chemo when prescribed.
  • Monitor the patient during chemotherapy; be prepared for first aid in case of an anaphylactic reaction.

Hypersensitivity reactions usually occur during the first 10 minutes of infusion and may include: redness of the face, skin reactions, itching, chest tightness, back pain and breathing difficulties.

Family is often the most important means of support. Spirituality, expressing feelings and hope, trust in treatments and care staff, and informational support increase hope. Provide psychological support, discussion and listening, and individual support.

Breast Cancer: Screening and Risk Factors

Recommendations and risk factors:

  • Self-examination and mammography; for women over 50, mammography every two years.
  • Risk factors: early onset of menstruation, late menopause, nulliparity, high age at first birth, prolonged menopausal hormone treatment, overweight, heavy alcohol use, hereditary predisposition.
  • Treatment options may include mastectomy when indicated.

Managing Nausea, Diarrhea and Constipation

  • Reduce nausea: eat small meals often, eat slowly and chew properly; acidic foods often reduce nausea. Rest before and after meals.
  • Diarrhea: maintain fluid intake, avoid gas-forming foods; recommended foods include blueberries, banana, toast, rice.
  • Constipation: increase fiber, drink fluids, exercise and use laxatives when needed.

Pregnancy: Signs and Symptoms

Subjective symptoms and signs may include:

  • A missed period
  • Morning sickness
  • Appetite changes and special cravings (pica)
  • Fatigue and a feeling of tightness or abdominal growth
  • Frequent urination (hormonal)
  • Fetal movements
  • Breast enlargement and tenderness
  • Positive hCG in urine or blood
  • Ultrasound is the earliest way to detect pregnancy; fetal heart sounds are used clinically

Pregnancy Duration and Trimesters

It takes an average of 280 days, or 40 weeks, from the last menstrual period. Full-term weeks are usually considered approximately 38–42 weeks, with biological variation. Important timing notes:

  • Ultrasound: performed for almost everyone, commonly around week 12.
  • I trimester: last period to week 13.
  • II trimester: week 14 to week 28.
  • III trimester: week 29 to birth.

Pregnancy Symptoms and Changes

Common symptoms and bodily changes include:

  • Increased skin pigmentation (melasma, abdominal and nipple pigmentation, perineum) due to steroid hormones.
  • Stretch marks (striae gravidarum), possible collagen changes.
  • Early pregnancy nausea and heartburn.
  • Constipation, hemorrhoids, varicose veins, leg cramps, swelling.
  • Fatigue and increased need for sleep (particularly in the first trimester), emotional sensitivity and crying.
  • Lower abdominal heaviness and irregular contractions, frequent urination.

Placenta Functions

The placenta is responsible for:

  • Carrying oxygen to the fetus (acts as fetal lungs)
  • Acting like the fetal liver and filtering some substances
  • Transferring nourishment from mother to fetus
  • Acting as a barrier between mother and fetus, protecting the unborn child from some harmful substances

Clinic: Periodic Health Checks and Services

Periodic health checks are performed in accordance with recommendations to:

  • Identify early pregnancy disorders and their risk factors for early intervention and control
  • Identify special needs of families and provide targeted support
  • Strengthen health resources and parenting support
  • Support partnership and promote parents’ sexual and reproductive health
  • Provide multi-professional family coaching, home visits and cooperation with municipal and specialized care actors
  • Ensure that children of expectant families receive appropriate services and guidance

Birth Risk Factors

Risk factors for childbirth complications include:

  • Stress, single custody, lower socio-economic class
  • Depression, stressful life events
  • Excessive uterine growth, multiple pregnancy
  • Cervical problems, previous second-trimester miscarriage
  • Gestational diabetes mellitus (GDM)
  • Abnormal fetal heart rate or abnormal fetal movement

Birth and Labour: Signs and Timing

Before and during labour:

  • Mood swings are common; many women experience a surge of energy 2–3 weeks before labour.
  • The lower uterine segment expands and the fetal head may sink lower (engagement), especially in first-time mothers. The fundus may descend, creating more room for breathing and digestion.
  • Under hormonal influence the symphysis pubis widens and the pelvic floor becomes more relaxed and softened.
  • Normal full-time labour is approximately week 38–42.
  • Childbirth before 37 weeks is considered premature (<37), after 42 weeks postmature (>42).

Signs and symptoms of labour include contractions and rupture of membranes (amniotic fluid, “water broke”). Random factors that may trigger onset include diarrhoea, sexual intercourse and physical stress. Typical labour contractions may occur about every 5 minutes and, when active, labour may last at least 2–3 hours in some cases. Individual situations vary, especially if previous labour was quick. Watch for vaginal bleeding and the rupture of membranes.