T5: Dysfunctional Labor Flashcards
version
Þ Must be guided by ultrasound, and they will externally rotate the baby to vertex
if a version is successful
they will order an abdominal binder or induce the mother
if a version is unsuccessful
schedule a c-section
Castor oil
folk belief because it increases peristalsis, and it can cause uterine contractions due to the close proximity
labor inductions: prostaglandin
gel or CERVIDIL (looks like a tampon) and it goes by the cervix and stays in for 12 hours
o Causes cervix to ripen (soft and effaced) then they will use Pitocin
labor inductions: balloon catheters
Cook’s catheter; one goes in the cervix and other one is outside the cervix, this causes mechanical traction by pulling on it
o When this falls out, the mom will be 3-4 cm dilated
o This is the only induction method for a TOLAC
labor inductions: laminaria
insert sticks into the cervix
labor inductions: amniotomy
artificial rupture of membrane (using an amniotic hook)
when can an amniotomy not be used
if baby is -1-2 station
labor inductions: pitocin
stimulates uterine contractions must be on a pump, and it is increased slowly, licensed personnel must also check Pitocin
Augmentation
-Oxytocin
-Ambulation helps baby head move down and rotate
o Gravity helps
-Relaxation
Vacuum-assisted birth
An obstetric procedure used to assist in the birth of a fetus by applying suction to the fetal head with a soft suction cup attached to a suction bottle (pump) by tubing and placing the device against the occiput of the fetal head.
(baby head must be very low +2 station)
Vacuum-assisted birth: pop-off
vacuum becomes loose off baby head, after 3 pop off, they will have to do a c-section
cesarean birth
Birth of the fetus through a transabdominal incision of the uterus
Indications for C-Section
CPD (cephalic pelvic disproportion), malpresentations - Breech, face or brow, transverse, placental abnormalities, dysfunctional labor, umbilical cord prolapse, fetal distress, multiple births
Classical incision (up and down cut) must ALWAYS BE
C-SECTION BIRTH because risk for uterine rupture is increased
TOL
trial of labor
TOLAC
trial of labor after cesarean
VBAC
vaginal birth after cesarean
meconium aspiration syndrome
abnormal inhalation of meconium (first stool) produced by a fetus or newborn
meconium passage
passing of first stool
If baby is vigorous with a meconium aspiration
baby is okay
If baby is lethargic with a meconium aspiration
baby needs to be intubated with ET tube and deep suctioning is done
shoulder dystocia
head is delivered but body/shoulder is stuck, OBSTETRICAL EMERGENCY
Prolapsed cord
cord is in our outside vagina
prolapsed cord intervention
-Keep fingers inside to prevent presenting part from pushing on the cord
-Knee to chest or Trendelenburg
uterine rupture
- There is A LOT OF BLOOD
- You will not be able to palpate baby because bay is in abdomen you will not be able to feel contraction or find FHR
amniotic fluid embolus/anaphylactoid syndrome of pregnancy
Amniotic fluid containing particles of debris enter maternal circulation
o HAIR, VERNIX, AMNIOTIC FLUID WITH RUPTURE OF MEMBRANE AND CAN GET INTO MOM CIRCULATION
if mom survives amniotic fluid embolus/anaphylactoid syndrome of pregnancy …
she may have circulatory collapse, hemorrhage and DIC THIS MUST BE RECOGNIZED BECAUSE THEY CAN GOIN TO RESPIRATORY COLLAPSE
