Category: Maternal Neonatal Nursing Postpartum hemorrhage is the most common complication of labor and delivery. Defined as hemorrhage of more than 500 mL after vaginal delivery, it affects 5% to 10% of all deliveries and accounts for up to 25% of obstetric deaths.
Category: Maternal Neonatal Nursing Loose umbilical cord knots pulled tight at delivery may cause fetal distress. As with cord prolapse, this situation must be resolved quickly to prevent fetal asphyxia. Rapid delivery with avoidance of further cord traction optimizes fetal outcome.
Category: Maternal Neonatal Nursing Umbilical cord prolapse may be overt or occult, requiring a pelvic examination to reveal the umbilical cord lying beside the presenting part. The diagnosis may also be made with Doppler ultrasonography.
Category: Maternal Neonatal Nursing Umbilical cord prolapse occurs when the umbilical cord precedes the fetal presenting part or when the presenting part doesn't fill the birth canal. Most cases of cord prolapse are unexpected and develop during the second stage of labor.
Category: Maternal Neonatal Nursing Umbilical cord-related complications can occur in normal and abnormal deliveries. The spectrum of cord-related emergencies includes prolapsed cord, nuchal loops of the umbilical cord, body coils, cord knots and entangled cords.
Category: Maternal Neonatal Nursing The presentation of twins is an important determinant for the safety of vaginal delivery. Twins who are vertex-vertex can be delivered vaginally, barring any other obstetric complications.
Category: Maternal Neonatal Nursing Face and brow presentations yield a larger engaging aspect of the fetal head and are predisposed to labor arrest. Although these presentations can be diagnosed with ultrasonography, most are discovered during labor by vaginal examination.
Category: Maternal Neonatal Nursing The consequences of shoulder dystocia can be devastating, with infant complications being common and severe. Traumatic brachial plexus injuries, clavicular fractures and hypoxic brain injury are all well-documented complications.
Category: Maternal Neonatal Nursing Shoulder dystocia is a common malpresentation, occurring in 1.4% of all deliveries. In contrast to a breech presentation, which may be diagnosed in the antepartum period, shoulder dystocia develops in the intrapartum period.
Category: Maternal Neonatal Nursing Three types of breech presentation exist - frank, incomplete and complete. The problem with breech presentations is that the buttocks and legs don't provide a sufficient wedge, hindering cervical accommodation of the relatively larger head.
Category: Maternal Neonatal Nursing Chorioamnionitis may result in prolonged first- and second-stage labor and decreased responsiveness to oxytocin. Early aggressive treatment, decreases neonatal morbidity and delays delivery, allowing more time for fetal maturation.
Category: Maternal Neonatal Nursing Chorioamnionitis occurs when vaginal or cervical bacteria ascend into the uterus, instigating an inflammation of the chorion and amnion layers of the amniotic sac. It occurs in 1% to 10% of all pregnancies.
Category: Maternal Neonatal Nursing Patients with premature rupture of membranes between 31 and 33 weeks gestation are usually managed expectantly and those at or > 34 weeks of gestation are generally delivered. All patients should be assessed for intraamniotic infection.
Category: Maternal Neonatal Nursing Examination of women with potential premature rupture of membranes is performed under sterile conditions to prevent ascending infection. Direct digital examination of the cervix is avoided. Culture specimens should be obtained.
Category: Maternal Neonatal Nursing Premature rupture of membranes is defined as rupture of the amniotic and chorionic membranes before the onset of labor. During pregnancy, the chorionic and amniotic membranes protect the fetus from infection and allow fetal growth and movement.
