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107 Ch. 19 & 23

Labor and Birth at Risk

what is preterm labor preterm labor: 20-37wks preterm birth: up to 37 wks, length of gestation, not wt term: 38-42 postterm: past 42
what is considered low birth wt <2500g or less
What are two main predictors for preterm birth Fetal fibronectins - b/n 24-34wks salivary estriol Endocervical length
Causes of preterm labor infections (oral hygiene), turning(version), demographic factors
what is most important nursing prevention for preterm birth education about early symptoms
what are main early signs for preterm labor gestational age b/n 20-37wks uterine activity cervical changes: 80%/>2cm dilation
what are tocolytics used for and examples of common ones stop contractions Terbutaline(Brethine) Mg Sulfate(most common)
what do you give to mature young preterm lungs in preterm labor glucorticoids, not good for cord prolapse, chorioamnionitis, abruptio placentae
what is difference b/n PROM and PPROM PROM: premature rupture of membranes before 1 hr of labor PPROM: before 37 wks, can be inf.
what is dystocia long difficult, abnormal labor from dilation, effacement, descent
what is dysfunctional labor abnormal uterine contracitons prevent progress. Those at incr risk: body build,malposition (op), malpresentation(breech), CPD(diabetic), over on oxytocin, mom tired, epidural b4 time, hyper/hypotonic uterine tone
what is precipitous labor lasts less than 3 hrs from onset
what is version turn baby in utero to head down. Risks: labor, abrupt placentae(have C-section ready)
what is a prostaglandin do ripens cervix, Cytotec
what is an amniotomy artificial breaking of H2O
How should pitocin be given or never given always on pump, PB, never primary adn always with NS or LR
what are prerequisites for vacuum assisted birth vertex presentation, ruptured membranes, absence of CPD(diabetic big baby)
Which incision for c-section can't do a VBAC vertical thru uterus - classical
what are risks for postterm birth dysfx labor, birth canal trauma, more interventions, lg infant(macrosomia), shoulder dystocia, aging placenta
what is normal blood loss for vag/C-section? If more, what is that called vag: 500ml C-section: 1000ml PPH: postpartem hemorrhage: leading cause of mom death, VS q15min, fundal massage
what is the McRobert's maneuver open pelvis for shoulder dystocia
what are two kinds of prolapse cord occult(hidden): compressed up high, complete Cause variable compressions TX: Trendelenberg/knee-chest pos
Some OB emergencies Amniotic fluid embolism, rupture of uterus
Risk Factors for hemorrhage uterine atony: boggy soft uterus, hypotenia lacerations of genital, hematomas, retained placenta, inversion/subinvolution of uterus
What drug helps uterus to contract if oxytocin doesn't Methergine by IM only, not for HTN
what is tx for hemorrhaging replace fluids S/S: not show til 30-40% loss of blood, tachy then brady, clammy
What is idiopathic thrombocytopenic purpura low platelets, leads to DIC (disseminated intravascular coagulation) clotting then bleed out
what is puerperal sepsis and other infections postpartum infection in canal in 28 days of abortion or birth, endometritis, wound inf, UTI, mastitis
What are things that happen after childbirth incontinence cystocele: bladder goes into vag rectocele: rectum goes into vag wall..Tx: Pessary Fistulas: vesicovag, urethrovag, rectovag
Psychological postpartum complications baby blues, depression, psychosis(emergency)
Created by: palmerag