Midterm Points Flashcards
(26 cards)
What is a uterine rupture?
It occurs when a weakened spot on your uterine wall tears due to strain put on it during labor and delivery.
What are the 5 symptoms of uterine rupture?
Abdominal pain Vaginal bleeding High pulse rate Signs of shock Chest pain
What is the most significant risk factor of uterine rupture?
A scar from a previous cesarean delivery
Assessment of complete uterine rupture?
Severe abdominal pain Halt in contractions Absent of FHR possible vaginal bleeding Falling blood pressure Rapid, weak pulse
What is uterine inversion??
Refers to the uterus’s turning inside out with either birth of the fetus or delivery of the placenta
It occurs when the placenta fails to detach from the uterus as it exits, pulls on the inside surface, and turns the organ inside out.
What happens when an inversion occurs??
- Loss of great amount of blood in the vagina
- fund us is not palpable in the abdomen
Risk factors of uterine inversion?
Fundal implantation or abnormal adherence of the placenta
Weakness of the uterus musculature or other uterine abnormalities
Excess traction on the umbilical cord or vigorous manual removal of the placenta
Nursing intervention of uterine inversion??
- Do not attempt to replace an inversion may enhance bleeding
- Do not remove placenta if it is still attached : larger surface area for bleeding
- no admin of oxytocin drug thus makes the it uterus more intense
- IVF starts
- oxygen starts by masks and asses v/s
- CPR if needed
- general anesthesia to relax muscles
- replaces the fundus manually
- admin of oxytocin after manual helps the uterus to contract
- advise of future cesarean birth
What are the 3 variations of uterine rupture??
A- complete rupture
B- incomplete rupture
C- dehiscence
What is a complete uterine rupture?
It is a rupture that is going through the endometrium, myometrium, and peritoneum
What is an incomplete uterine rupture??
A rupture into the peritoneum covering the uterus or into the ligament but no the peritoneal cavity
What is dehiscence?
A partial separation of an old uterine scar with little or no bleeding
No s/s may exist and the rupture window may be found incidentally during a subsequent CS birth or other abdominal surgery
What are the 5 complications associate with uterine rupture?
Depends on how quickly the doctor discovers the s/s
Maternal blood loss
Loss of placental function
Loss of oxygen of the mother and the baby
Why is there a chest pain, pain the scapula, or pain during inhalation during uterine rupture?
Pain is due to the irritation of blood below the woman’s diaphragm
What is the cause of hypovolemic shock in uterine rupture??
Hemorrhage
What are the 4 predisposing factors of uterine inversion??
Pulling on the umbilical cord before the placenta detaches from the uterine wall (vigorous manual removal of the placenta)
Fundal pressure during birth
Fundal implantation or abnormal adherence of the placenta
Weakness of the uterine musculature or other uterine abnormalities
What are the signs and symptoms of uterine inversion?
Uterus is absent from the abdomen or a depression in the fundal area is present
Interior of the uterus may be seen through the cervix or protruding into the vagina
Massive hemorrhage, shock, and pain quickly become evident
Therapeutic management of uterine inversion?
Monitor for hemorrhage and signs of shock and
to threat shock, continuous IV will be needed to allow rapid fluid and blood replacement
Prepare the client for the return of the uterus to the correct position
Hysterectomy may be required: tocolytic drug or gen anesthesia
After the uterus is replaced and placenta removed, oxytocin is given to contract the uterus and control blood loss
( oxytocin is not given until the uterus is repositioned to avoid trapping the inverted fundus in the cervix)
shapes of the pelvis?
Android pelvis
Anthropoid
Gynecoid
Platypelloid
Type of pelvis in which it is flattened, reverse oval shape. A smoothly curved, but the anteroposterior diameter is shallow. Fetal head may not be able to rotate to match the curves of the pelvis.
Platypelloid pelvis
A male pelvis; heart shaped. The pubic arc is in the pelvis. It forms an acute angle, making the lower dimensions of the pelvis extremely narrow. A fetus may have difficulty exiting.
Android pelvis
An “ape-like pelvis” oval shape. The transverse diameter is narrow and the anteroposterior diameter of the inlet is larger than normal. It does not accommodate a fetal head.
Anthropoid pelvis
A normal female pelvis round shape pelvic inlet. The inlet is well rounded forward and backward. The pubic arc is wide. Ideal for childbirth.
Gynecoid pelvis
A type of labor that last less than 3 hours. It is unexpected fast delivery.
Precipitous labor
