Lacerations, labor, and delivery Flashcards
1st degree tears
least severe
only skin around vaginal opeing
mild burning with urination
heal on their own in a few weeks
2nd degree tears
vaginal tissue and perineal mm
the mm btwn vagina and ansu that help support uterus, bladder, and rectum
typically require closure, but heal with in a few weeks
3rd degree tear
involve post vaginal tissues, perineal mm, and capsule of anal spinchter
4th degree tears
most severe perineal mm and anal sphincter tissue lining rectum surgical repair complications include fecal incontinence and painful intercourse
breastfeeding
bonding nutrition immunity benefits mothers health benefits society
30-50% of maternal deaths is d/t what
labor difficulties
morbidity in survivors of complicated delivery
fistulas
anaemia
infertility
antenatal risk factors
young and old nulliparas short previous difficult birth previous c-section previous stillbirth or neonatal death multiple pregnancy nutritional deficiency, severe anaemia LGA obvious pelvic deformity malpresentation high parity
when should you induce labor
41+ wks w/in 96hrs of ruptured membranes at term preeclampsia at term maternal DM or GD at term IUGR at term macrosomia ? multiple pregnancy? previous precipitate delivery? unstable lie? cholestasis of pregnancy?
how to induce labor for ruptured membranes
oxytocin by IV infusion
or vaginal PGs
to induce labor in other pts
vag PGs
amniotomy wtih oxy infusion 3-12 hours later
who do you NOT use PGs in
previous C-section pt
oxy infusion
single standard dilution in NS IV by infusion pump 1-2 mU/min increase at 30 min intervals review at 16-20mU/min discontinue after 5 units monitor fetus
evaluate Ps
powers
pasenger, presentation, position
passages
psychology
powers
uterine contractions
oxy augmentation?
