QUIZ 2 - PREGNANCY COMPLICATIONS Flashcards
a difficult labor
dystocia
three components of labor (3P)
power, passenger, passageway
2 types of dysfunctional labor
primary and secondary
women with prolonged labor are at risk of…
maternal postpartal infection, hemorrhage and fetal death
contractions are low or infrequent
hypotonic
normal dilatation per hour
1cm per hour
may occur after administration of analgesia
hypotonic contractions
causes of overstretched uterus
multiple gestation, large fetus, hydramnios and grand multiparity
managament for hypotonic contractions
oxytocin infusion, amniotomy, palpate uterus and assess lochial discharge
increased resting tone to more than 15mmHg, myometrium does not relax after contraction
hypertonic contractions
occur due to more than one pacemaker, may cause fetal anoxia
hypertonic
management for hypertonic contractions
pain relief, rest and fetal monitoring
strong contractions, labor fewer than 3 hours
precipitate labor
precipitate labor can lead to..
premature separation of placenta (hemorrhage)
precipitate labor can cause…
subdural hematoma to fetus and lacerations to mother
precipitate labor is common to…
grand multiparas, induced labor, amniotomy
precipitate labor management
tocolytic agent
uterus undergoes more strain
uterine rupture
uterine rupture is common for women with…
vertical CS and hysterectomy
contributing factors to uterine rupture
abnormal presentation, multiple gestation, forceps and traction, prolonged labor, unwise use of oxytocin
uterine rupture management
emergency fluid replacement, IV oxytocin, CS hysterectomy and tubal ligation
uterus turning inside out
inversion of uterus
inversion of uterus management
IV fluid line, O2 by mask, VS assessment and CPR
amniotic fluid forced into open maternal uterine blood sinus
amniotic fluid embolism
women with amniotic fluid embolism can feel…
sharp pain on chest and inability to breath
embolism management
O2 by mask or cannula, fibrinogen therapy and ICU
umbilical cord slips down
prolapsed umbilical cord
prolpased umbilical cord can lead to..
compression of cord and fetal anoxia
prolapsed umbilical cord management
O2 by facemask, tocolytic agent and cover exposed cord with sterile moist cloth or sterile saline compress
risk factors of PUC
PROM, non cephalic presentation, placenta previa, intrauterine tumors, small fetus, CPD, hydramnios, multiple gestation
position if PUC
knee chest position or hips elevated using two pillows with Trendelenburg position
how to determine position of second fetus in multiple gestation
external abdominal palpation and sonography
fetus weighing 4k to 5k grams
macrosomia
macrosomia is common with women who..
have diabetes or developed gestational diabetes
fetal head is born but shoulders are too broad
shoulder dystocia
shoulder dystocia can cause..
fractured clavicle and brachial plexus injury for fetus
indications for forceps birth
woman unable to push w contractions, cessation of descent, abnormally positioned fetus, fetal distress
forceps birth guidelines
ruptured membranes, CPD not present,cervix fully dilated, empty bladder
abdominal incision into the uterus
CS
2 types of CS
low segment cs and classical cs
indications for cs
severe toxemia, cpd, previous classic cs
advantages of lscs
minimal blood loss, incision is easier to repair, low incidence of postpartum infection, no possibility of uterine rupture
reasons for emergent cesarean birth
abruptio placentae, placenta previa, unable to progress in labor and fetal distress
