Complications of L&D Flashcards
Meds to stop preterm labor
Tocolytics CCB's NSAIDS Terbutamine Mag Sulfate
Corticosteroids can be used from
24 - 34 wks gestation to enhance maturity
Lung maturity
Group B strep
GU tract colonization in 15-40% of women
Universal screening btw 35 and 37 wks.
Group B strep meds
PCN G IV then q4 til delivery
If allergic:
Cefazolin, Clinda, Vanc
Dystocia
Failure to progress
Leading indication for c-section
Lack of dilation or fetal descent
No fetal descent after 1 hr of pushing =
2nd stage arrest
Meds for dystocia
Oxytocin (Pitocin)
Amniotomy
Manual rupture of the membranes
3 most common indications for c-section
Dystocia
Nonreassuring fetal status
Fetal malpresentation
Umbillical cord prolapse
Rare, serious complication
Umbilical cord palpable on PE
Causes fetal bradycardia
Cord prolapse mgmt
C-section
Tocolytics
Shoulder dystocia
1-3% of births
Anterior shoulder is impacted behind pubic symphysis
Cephalic presentation
Normal presentation
External Cephalic Version (ECV)
Turning baby from breech to vertex
50% success
Must have completed 36 wks
Retained placenta
Placenta that ha snot been expelled 30 - 60 mins post delivery.
Major cause of hemorrhage
Retained placenta tx
IV nitro to relax uterus
Intraumbillical oxytocin
Manual removal
Uterine inversion
Uterine fundus collapses into emdometrial cavity
Manual correction, IV, fluids, relaxants
Post-partum hemorrhage
4% of deliveries
Multiple etiologies
Post partum hemorrhage tx
Fundal massage
IV access
Oxytocin and other uterotonic drugs
Tamponade balloon catheter
Number one cause of postpartum bleed?
Uterine Atony
