Maternity Final

Maternity Final - MaternityNewContentforFINAL...

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Maternity New Content for FINAL Intrapartal Complications Precipitous Labor: rapid labor less than 3 hours  Occurs with strong contractions with little tissue resistance in mother Risk of lacerations and hemorrhage Might result in precipitate birth Precipitate Birth Rapid, unattended birth inside or outside the hospital May result in failure to watch- parents Maternal implications o Lacerations and/or PP hemorrhage  Fetal/Neonatal implications o Asphyxia: meconium aspiration o Cerebral trauma or other injury NI Identify women at risk- easy cervix stretching on vaginal exam Careful monitoring Be prepared for rapid birth Never prevent birth Preterm Labor: labor that occurs between 20-37 weeks Viability- fetus can survive outside of the uterus o Currently between 23-24 weeks o Lung maturity reached at 37 weeks Maternal cause  o Often unknown in 70-80% o PROM (30-35%)- heart of renal, infection, htn, cervical incompetence, diabetes, stress,  low income, trauma, surgery, uterine anomalies, past history of smoking, nutrition  Fetal cause o Multiples, fetal anomalies, infection, hydramnios Placental Cause o Placenta previa or abruptio placenta Significance o Incidence is 11-12% in general population o Accounts for 75% of all perinatal deaths and 90% of all fetal deaths Current Trends o No decrease in incidence o Dramatic improvement in technology and care o Very costly $$$$ “million dollar babies” o Emotion and family burden o Infants survive with major problems o Big challenge for healthcare providers o PREVENTION is KEY Prevention o Identify women at risk
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o Good nutrition and hydration- dehydration can cause preterm labor o Early and adequate prenatal care o Avoid strenuous activity – work or exercise o DC smoking and use of drugs o Avoid sexual stimulation if at risk- can cause uterus to contract o Treatment of bacterial infections (UTI, cervix, vagina) Bacterial vaginosis, Chlamydia, GBS, periodontal disease o Patient education about s/s of preterm labor Diagnostic Test for Preterm Labor o Fetal Fibronectin Test Protein produced by fetal membranes  Normally present in cervical fluid early and late in pregnancy Presence of fFN is abnormal after 20 weeks Thought to hold membranes and placenta deciduas: lining of uterus Predicts preterm labor risk 15-25% Better predictor of who will not have preterm labor 99% Fairly expensive test Signs and Symptoms of preterm labor o Can be symptoms that normal women can experience during pregnancy Backache, cramping, pelvic pressure Urinary frequency Increase in vaginal discharge Diarrhea, PROM
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This note was uploaded on 04/14/2011 for the course NURS 101 taught by Professor Carlson during the Spring '11 term at Saint Louis.

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Maternity Final - MaternityNewContentforFINAL...

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