Giving Birth Fall2013updated(1).ppt - Chapter 16 Giving...

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Unformatted text preview: Chapter 16 Giving Birth 1 Uterine Contractions: Opposing Characteristics Fig. 17-2 2 Components of the Birthing Process Powers Uterine contractions • • • Frequency (beginning of one to beginning of next) Duration (length in secs) Intensity (strength) Cervical changes (dilation & effacement) Passageway- maternal pelvis (gynecoid) Passenger-fetus, placenta, cord Psyche- Mind-body connection---Anxiety, fear, fatigue, or relaxation effects labor progress. 3 Cervical Changes (Powers) Cervical dilation- opening of cervix allows passage of fetus; measured in cms (0-10 cms) Cervical effacement- thinning of cervix; effacement measured percent (0-100%). Dilation & Effacement of cervix- components of labor. true 4 Plus 3 Patience - procession of labor at its own pace- 1st delivery will take atleast 24 hr Presence - skilled support person Protection - creation of “Safe Nest” for birthing Only intervention consistently reduced rates of C/Ss is one-to-one support of woman by nurse, nurse-midwife, or doula. (research) Giving reassurance 5 Cervical Dilation and Effacement 6 Dilation & Effacement Video Of0NE 7 Lie Fig. 17-6 8 Attitude Fig. 17-7 9 Passenger/Fetus Fetal presentation- part of fetus enters pelvis first. Cephalic (VERTEX)-head is presenting: reference points include vertex or occipital bone, brow, and mentum (chin). Breech-sacrum is reference point. Transverse lie-AKA shoulder presentation; scapula is reference point Fetal position- relationship of reference point of fetal presenting part to one of 4 quadrants of mother ’s pelvisleft or right & anterior or posterior. Fetal station-relationship of presenting part of fetus to ischial spines of maternal pelvis. When presenting part is at same level of ischial spines, the station is “0” (zero) 10 Types of Cephalic Presentation 11 Left Occiput Transverse L.O.T. spinningbabies.com 12 Fetal Head: Bones, Sutures, Fontanels Fig. 17-5a 13 Variations of a Breech Presentation Fig. 17-9a 14 Station Fig. 17-12a 15 Stations Video p-gwBQ 16 Maternal Pelvis 17 Application of low-profile cup to fetal head in occiput posterior (OP) position. 18 19 Leopold's Maneuvers (1 of 4) Unn Fig. 17-1 Procedure 17-1 20 Leopold's Maneuvers (2 of 4) 21 Leopold's Maneuvers (3 of 4) Unn Fig. 17-3 Procedure 17-1 22 Leopold's Maneuvers (4 of 4) 23 Premonitory Signs of Labor Braxton Hicks contractions Lightening (descent of fetus)(“dropped”) Increase in clear and nonirritating vaginal secretions "Bloody show” Energy spurt Small weight loss 24 Conditions Associated with Fetal Compromise Fetal heart rate (FHR) outside normal range Little or no variability in FHR Persistent slowing of FHR after UCs Meconium-stained amniotic fluid Cloudy, yellowish, or foul odor to amniotic fluid 25 Conditions Associated with Fetal Compromise Contractions > 90 secs Incomplete uterine relaxation, intervals between contractions < 60 secs Maternal hypotension Maternal hypertension Maternal fever 26 Shoulder Dystocia Shoulder Dystocia d0pXc McRoberts Manuever WJPhF4 27 28 Prolapsed Cord 29 Prolapsed Cord Prolapsed Cord Animation oDBv-k 31 32 ...
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