Chapter 23 & 24 - Complications Of Labor & Delivery Flashcards
What is a precipitous birth and labor?
Lasts less than 3 hours, from the 1st contraction to birth.
What are maternal risks of precipitous birth?
Cervical, vaginal and rectal lacerations (doesn’t have time to stretch) as well as hemorrhage.
What are fetal risk from precipitous birth?
Hypoxia
Injury during birth
Intracranial hemorrhage
What is preterm labor?
Delivery that occur is between 20-38 weeks.
What is prolonged pregnancy?
Pregnancy that reaches or goes beyond 42 weeks.
Risk factors for fetus with a prolonged pregnancy:
Meconium aspiration Growth restrictions Intrapartum asphyxia (not enough 02) Macrosomia (big baby) Shoulder dystocia Brachial plexus injury (paralysis) Still birth
Risk factors for mom with a prolonged pregnancy:
Induction C-section Infection Hemorrhage Emotional trauma Injury to pelvic floor
What is dysfunctional labor?
Sluggishness of contractions or the force of labor.
What are causes of a dysfunctional labor?
Large fetus
Hypotonic, hypertonic or uncoordinated contractions occur
What are risks of a dysfunctional labor?
Maternal postpartum infection
Hemorrhage
Infant mortality
What occurs in the 1st stage of dysfunctional labor?
Prolonged latent stage
Protracted active stage (4cm then stops)
Prolonged deceleration (HR below 120 for 2+mins)
Secondary arrest of dilation (nice progression then stops)
What are reasons for induction of labor?
Placenta previa (placenta over cervix)
Pre-eclampsia (C-Section if L&D not tolerated)
Diabetic (baby is too big)
Premature ROM (needs to be born within 36h after rupture)
CVD (baby cannot fit)
Post-term
What are methods of induction?
Cervical ripening- prostaglandins and laminaria
Amniotomy- AROM (artificially rupture)
Misoprostol/Cytotec- stimulates UC’s (pill on cervix- POTENT [rectally when hemorrhaging])
Pitocin/Oxytocin- increases intensity of UC’s and may prolong them [give epidural 1st]
What are two substances that ripen the cervix using prostaglandins?
Sperm
Cervadil
Types of malpositions malpresentations:
OP: sunny side up (hard to get out) 25% of term deliveries
OT: face down
Breech presentation
Shoulder presentation
What is a forcep delivery?
Metal instrument used to help facilitate delivery - helps rotate fetal head.
What are risks of a forcep delivery?
Bruising and edema to fetal face
Maternal lacerations
Episiotomy extension
What is a vacuum extraction?
A suction cup applied to the fetal head to facilitate delivery.
What is an external version?
Manually trying to turn the fetus
Administer trabutelene to relax smooth muscle
What is fetal distress
Insufficient 02 supply to the fetus.
What are signs and symptoms of fetal distress?
Meconium stained amniotic fluid (green)
Changes in fetal heart rate
Changes in FHT pattern (variability)
