Posted by Laura on March 14, 2010
Ruptured uterus – rare, can be caused by separation of c/s scar, congenital uterine, spontaneous UC, Meds, overextended uterus, malpresentation, external or internal version, difficult forceps-assisted birth. Classified as complete (extends entire U wall) or incomplete.
CPD – Cephalopelvic disproportion characterized by excessive fetal size 4G or > assoc. w/diabetes mellitus, obesity, multiparity or L size of parents.
Prolapsed cord – protrusion of the umbilical cord in advance of the presenting part – when cord lies below the presenting part of fetus. common to see frank prolapse directly after ROM. Contributing factors : long cord, malpresentation, transverse lie, unengaged presenting part from hydramnios resulting cord to be displaced downward.
Amniotic fluid embolism – AFE. Embolism resulting from amniotic fluid entering the maternal blood stream during labor and birth after ROM; often fatal to the woman if it is is a pulmonary embolism
Malposition – most common persistent occipitoposterior position (ROP or LOP). prolonged labor, severe back pain from occiput pressing against sacrum. Relief of back pain and facilitation of rotation to anterior position.
Malpresentation – Breech presentation (4 types: frank, complete, incomplete w knee extends below the buttocks, and incomplete with foot extends below buttocks). Associated with multifetal gestation, preterm birth,fetal & maternal anomalies, hydramnios, oligohydramnios. VB with manipulation ECV or CS if > than 3800 < 1500
Multifetal Pregnancy – > 1 infant. Complications: preterm, IUGR, cord prolapse, placental separation onset, cerebral palsy, dystocia, C/S, breech positioning, increased risk for HTN, anemia, PPM, Uterine atony, & abruptio placenae.
catecholamines – Hormones/neurotransmitters released in response to stress which may cause dystocia. Anxiety , confinement, pain and absence of support person can make these hormones act on the smooth muscles of the uterus increasing levels causing reduction of UCs.
amniotomy – Artificial Rupture of membranes. FHR assessed before and immediately after to detect any changes that may indicate cord compression or prolapse. T checked q 2 hrs./
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