PROBLEMS OF THE PASSENGER PART 2 Flashcards
- Non-reassuring fetal heart tracing, non-reassuring heart
tones or non-reassuring fetal status - Signs before & during childbirth indicating that the fetus
is not well
fetal distress
fetal distress may result to ?
cerebral palsy, seizures, mental retardation
causes of fetal distress
BLUUP SOAN CAMP
breathing problems
low blood pressure
uterine infection
uterine rupture
premature closure of fetal ductus arteriosus
shoulder dystocia
oligohydramnios
abnormal fetal position and presentation
nuchal cord
cord prolapse
abruptio placenta
multiple births
postmaturity
s/sx of fetal distress
- decreased movement
- meconium stain
- biochemical signs
- nonreassuring patterns
Results when the umbilical
cord precedes the fetal
presenting part
prolapsed umbilical cord
the cord dropping alongside the baby, but may not be seen in advance
occult cord prolapse
the cord coming before the baby’s head can come out
over cord prolapse
risk factors of prolapse umbilical cord
- malpresentation
- LBW
- multipara
- multiple gestation
- presence of long cord
- CPD, hydramnios
- PROM, placenta previa
fetal risks for prolapsed cord
cord compression
bradycardia
persistent variable deceleration
death
s/sx of prolapsed cord
prolonged deceleration
cord is seen or felt
If a loop of cord is discovered, examiner’s fingers must remain
in the vagina and ??
manually elevate the fetal head off the cord
prolapsed cord - position the mother in ??
trendelenburg, modified sim’s, or knee chest
prolapsed cord - Place a ___ under the woman’s right or left hip
rolled towel
if cord is protruding from vagina = ??
wrap loosely in sterile towel saturated with warm sterile saline solution
defined as difficulty in the birth of the shoulder, or impaction of the shoulders
* may occur in 0.15% to 2.0% of all births
shoulder dystocia
- If the fetus weighs more than ___ gm, the incidence of shoulder dystocia may be as high as 35.7%
4500
risk factors or shoulder dystocia
- DM, obesity
- multipara
- small pelvis
- hx of large infant
- hx of shoulder dystocia
- post-date pregnancies
shoulder dystocia - intrapartum risk factors:
slow descent and prolonged 2nd stage
what is this sign called?
if the head appears on the perineum (crowning), it retracts instead of protruding with each contraction
turtle sign
fetal risks of shoulder dystocia
- asphyxia
- brachial plexus injury
- apgar 5
- fractured clavicles or humerus
maternal risks of shoulder dystocia
- postpartum hemorrhage
- rectal injuries
what maneuver?
- If difficulty of extracting the
shoulders occurs during the
birth, the OB/CNM may
direct the woman to sharply
flex her thigh up against her
abdomen
mcrobert’s maneuver
interventions for shoulder dystocia
- enlarging the episiotomy
- apply suprapubic pressure
- woods screw maneuver
