OTHER INTRAPARTUM COMPLICATIONS Flashcards
- a clear, slightly yellowish
liquid that surrounds the
unborn baby (fetus)
during pregnancy
amniotic fluid
amniotic fluid is contained in the ___
amniotic sac
2 membranes of the amniotic sac
chorion and amnion
functions of amniotic fluid
- growth and development
- cushion and protection
- keeps the cord from being compressed
- constant temp
- lubricates the body
- excessive AF surrounding fetus
- more than 2000 ml
hydramnios / polyhydramnios
type of hydramnios: fluid volume gradually increases
chronic
type of hydramnios: volume increases rapidly over a period of a few days
acute
when is acute hydramnios usually diagnosed?
20-24 weeks
hydramnios is associated with maternal disorders:
DM
Rh sensitization
multiple gestation
true or false - in hydramnios, one may have difficulty palpating
fetus & auscultating FHR
true
When the amount of
amniotic fluid is 3000 ml or
more the woman
experiences:
SOB
edema on lower ex.
fetal implications of hydramnios:
- fetal malformation
- pre term birth
- prolapsed cord
- malpresentation
hydramnios: ___ can
occur when membranes
rupture
prolapsed cord
*If the fetus has been
diagnosed with a
congenital defect in utero
or is born with defect, the
family needs ___
psychologic support
- amount of amniotic fluid is
severely reduced & concentrated - less than 500 ml
oligohydramnios
oligohydramnios is found in cases of ___ with ___ secondary to placental insufficiency
postmaturity
IUGR
oligohydramnios etiology:
in fetal conditions associated with major renal malformations, including ____ absence of one or more kidneys ) , with ____ (malformation) &
____ of the lower urinary tract
renal aplasia
dysplastic kidneys
obstructive lesions
assessment of oligohydramnios
fetus easily palpated
fetus is not ballotable
in oligo, fetus can be assessed by:
BPP, nonstress, serial UTZ
fetal implication in oligo
- skin and skeletal abnormalities
- pulmonary hypoplasia
- cord compression
- fetal head compression
*If oligohydramnios
occurs in the first part of
pregnancy, there is
danger of ___
fetal adhesions
oligo: during labor fetus is monitored by continuous EFM to detect cord compression 🡪 ___
variable decelerations
oligo: ___ is done after
membranes have ruptured
to decrease the frequency &
severity of variable
decelerations in the FHR
during labor
amnioinfusion
*If variable decelerations are noted, ___ (to relieve pressure on the umbilical cord) & the physician is notified
the woman’s position can be changed
oligo: after birth, newborn is evaluation for signs of:
congenital abnormalities
pulmonary hypoplasia
postmaturity
- A small amount of
amniotic fluid leaks
into the chorionic
plate & enter the
maternal system - a rare but serious
condition - occurs during labor,
during birth or within 30
minutes after birth.
amniotic fluid embolism
what is the response of the mother’s body to AF embolism
inflammatory reaction: abnormal clotting in mother’s lungs and blood vessels
abnormal clotting in mother’s lungs and blood vessels can lead to a serious blood clotting disorder known as ___
DIC
s/sx of AF embolism
- respiratory distress
- circulatory collapse
- acute hemorrhage
- cor pulmonale
Sudden failure
of the heart to effectively pump blood
* Cyanosis
* Tachycardia
* Hypotension
circulatory collapse
alteration in the structure
& function of the RV of the heart caused by a primary disorder of the respiratory system
* dyspnea
* cyanosis
* hemorrhagic shock
cor pulmonale
care management for AF embolism:
- oxygenate
- administer IV fluids
- administer blood products
- insert IFO, measure hourly UO
- correct coagulation failure
- prepare for emergency birth
- emotional support
