maternal and neonatal resus part 2 Flashcards
what is amniotic fluid embolism (AFE)
when amniotic fluid or fetal material enters the mothers blood stream via ruptured uterine or placental vessels
what are symptoms of AFE?
- sudden onset of SOB
- hypotension/shock
- seizure / altered LOA
- bleeding due to DIC
- cardiac arrest
what are risk factors for AFE?
- rapid delivery
- c section
- advanced maternal age
- placental abnormalities
what are cardiac arrythmias associated with AFE?
tachycardia and atrial fibrillation
what is peripartum depression?
the onset of depressive symptoms around the time of child birth around 4 weeks beofr childbirth
what is uterine inversion?
the uterus turns inside out after delivery
what are the causes of uterine inversion?
improper hadling of third stage of labour
- adherent placenta
- mismanagment of cord traction
what is an adherent placenta?
the placenta fails to detach properly
types of uterine inversion: incomplete
no visible protrusion outside the vagina
types ofuterine inversion: prolapsed
fundus of the uterus protrudes through the cervix/Vagina
types of uterine inversion: total inversion
the uterusand vagina are completely inside out with the placenta still attached
how can you treat uterin inversion
- position patient supine with legs elevated
- establish IV bolus
- administer O2
- moist sterile dressing
- rapid transport
during maternal cardiac arrest, why is priority given to the mother?
because the fetus sruvival is directly dependent on the mothers survival
why is fundal (left uterine) displacement a method used during maternal cardiac arrest?
this is done to adress the compression by the gravid uterus on the aorta and inferior venacava. it inhances maternal cardiac output and circulation
BOCHOPS mnemonic for maternal mortality risk factors
B - Bleeding/ DIC
O - obstuction (AFE, PE, coronary embolism
C - Cardiac conditions
H - Hypertension
O - other medical conditions
P - Placental problems
S - Sepsis
what are intrapartum risk factors that might signal you that the baby will probably need resus?
- meconium staining
- previous complications
- lack of prenatal care
- multiple births
- substance abuse
what respiratory physiological change occurs at birth?
new borns lungs were previously filled with fluid. as the lungs begin to function, the fluid is absorbed into the pulmonary circulation allowing air to fill the alveoli
what are cardiovascular physiological changes at birth?
the closue of ductus arteriosis
what are pulmonary adaptations of a neonate?
when neonates start to breath the pulmonary blood vessels dilate and enhances blood flow to the lungs for effective gas exchange
primary apnea vs secondary apnea
primary apnea is when the baby just needs some stimulation to encourage breathing and secondary apnea is more severe requiring resus
why do you initally use room air during neonatal resus?
to avoid oxygen toxicity and retinopathy
what is a proper mask fit for a neonate?
only covering nose and mouth
what flow rate should you use for neonate ppv?
10 lpm
