PRECIPITATE LABOR TO UTERINE INVERSION Flashcards
- occur when labor lasts less
than 3 hours & results in
rapid birth - uterine contractions are so
strong
precipitate labor and birth
causes of precipitate labor
- low resistance in maternal soft tissues
- strong uterine contractions
contributing factors
- multiparity
- large pelvis
- previous precipitate labor
- small baby in favorable position
s/sx of precipitate labor
- pain
- increased HR, temp, and BP
- diaphoresis
- restlessness
- hypertonic contractions
precipitate labor - maternal risks:
- uterine r___
- L___ of the cervix, vagina, and perineum
- postpartum h___
rupture
lacerations
hemorrhage
hypoxia
trauma
pneumothorax
precipitate labor - fetal neonatal risks:
- h___
- cerebral t___
- p___
hypoxia
trauma
pneumothorax
criteria for assessment
cervical dilatation - more than 2 cm/hr in multigravida, and more than 1.2 cm/hr in primi
intense uterine contractions with little relaxations between contractions
uterus has descended from its normal position
in the pelvis farther down
into the vagina
uterine prolapse
causes of uterine prolapse
- Pregnancy & t___ incurred during childbirth
- Loss of m___ t___
- t___ in the pelvic cavity
- g___
trauma
muscle tone
tumor
genetics
risk factors or uterine prolapse
- One or more pregnancies & v___ births
- Giving birth to a l___ b___
- Increasing a___
- Frequent h___ l___
- Chronic c___
- Frequent s___ during bowel movements
- Some conditions, such as o___, chronic c___ & ___
vaginal
large baby
age
heavy lifting
coughing
straining
obesity, constipation, COPD
3 type of uterine prolapse
first degree - mild
second degree - moderate
third degree - severe
s/sx of uterine prolapse
- Sensation of h___ or p___ in the pelvis
- t___ p___ from the vagina
- Urinary difficulties, such as urine l___ or urge i___
- Trouble having a b___ m___
- L___ b___ pain
- Feeling as if sitting on a s___ b___ or as if something is falling out of vagina
- Painful s___ i___
heavy or pulling
tissue protruding
leaking or incontinence
bowel movement
low back
small ball
sexual intercourse
management for uterine prolapse
- use of lubricants
- avoid lifting or straining
- prenatal and postnatal kegel
A tear in the wall of the uterus
uterine rupture
true or false - Rupture of the uterus during labor is common
false - rare
causes of uterine rupture
- uterine o___
- e___ or i___ version
- i___ perforation
- excessive use of u___
- failure to recognize l___ d___ with excessive uterine contractions against a lower uterine r___ r___
overdistention
external or internal
iatrogenic
uterotonics
labor dystocia; retraction ring
risk factors of uterine rupture
- prior u___ s___ including CS
- fetal m___
- G___ m___
- o___ vaginal birth
- o___ induction of labor
uterine surgery
malpresentation
grand multiparity
operative
oxytocic
2 classification of uterine rupture
complete
incomplete
s/sx of uterine rupture:
- sudden, severe a___ p___ during strong labor contraction - reported as t___
- minimal to diffuse v___ b___
- s___
- d___ of FHS
- fetal o___ - late decelerations, reduced viability, tachy and bradycardia
- cessation of u___ c____
abdominal pain; tearing
vaginal bleeding
shock
deterioration
oxygenation
uterine contractions
therapeutic management for uterin rupture:
- fluid replacement therapy
- oxytocin
- laparotomy
- blood transfusion
- repair or remove uterus
uterus turns inside out
with either birth of the
fetus or delivery of the
placenta
uterine inversion
risk factors for uterine inversion:
- Short u___ c___
- Excessive t___ on the umbilical cord
- Excessive fundal p___
- Fundal i___ of the placenta
- Retained p___ & abnormal adherence of the placenta
- v___ b___ after previous CS
- Rapid or long l___
- Previous u___ i___
- Certain drugs such as m___ s___
- Vigorous manual r___ of the placenta
- w___ of the uterine musculature
- Uterine a___
umbilical cord
traction
implantation
placenta
vaginal birth
labor
uterine inversion
mag sulfate
removal
weakness
abnormalities
4 classification of uterine inversion
incomplete
complete
prolapse
total
s/sx of uterine inversion
- hemorrhage
- appearance of vaginal mass
- fundus not palpable
- signs of blood loss - dizziness, pallor, diaphoresis
therapeutic management of uterine inversion
- drugs to soften uterus
- manual reinsertion of uterus
- abd surgery
- antibiotics
- IV fluids
- blood transfusion
- oxytocin
- hysterectomy
