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14 Cards in this Set
- Front
- Back
- 3rd side (hint)
Hypotonic Dysfunction
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Contractions:
Coordinated but weak become less frequent and shorter in duration Easily indented at peak, minimal discomfort because the cotractions are weak Uterine Resting Tone: Not elevated Phase of Labor: Active - typically occurs after 4cm dilation, more common than hypertonic dysfuntion Therapeutic Mngmnt: Amniotomy, oxytocin augmentation, C-section |
None
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Hypertonic Dysfunction
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Contractions:
Uncoordinated Irregular Short and poor intensity but painfula nd cramplike Uterine Resting Tone: Higher than normal Important to distinguish from abruptio placentae Phase of Labor: Latent - usually occurs before 4cm dilation Less common than hypotonic dysfunction Therapeutic Mngmnt: Correct cause if identified, Light sedation to promote rest Hydration Tocolytics to reduce high uterine tone & promote placental perfusion |
None
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Dystocia
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General term that describes any difficult labor or birth
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Possible Causes of Hypotonic Dysfunction
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Maternal fatigue
Maternal Inactivity Fluid & Electrolyte Imbalance Ecvessive Analgesia or anesthesia Maternal catecholamines secreted in response to stress or pain Disporportion between the maternal pelvis and fetal presenting part Uterine overdistenetion |
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Macrosomic
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Large Baby
8.8lb or more at birth |
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Shoulder Dystocia
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Impactation of the shoulder above the maternal symphysis pubis
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Rotation Abnormalities
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Occiput posterior or occiput transverse
Solution: Pt on Hands & Knees |
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Mutlifetal Pregnancy
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Uterine overdistention resulting:
Hypotonic dysfunction Hypertonic dysfunction Abnormal presentation of fetus |
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Premature Rupture of Membranes
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Associated Conditiosn:
Infections of Vagina Chorioamnionitis (related to Strep B) Incompetent cervix or short cervical length Fetal abnormalities Malpresentation Hydramnios Weak Amniotic Sac Recent Amniocentesis or cerclage Recent sexual intercourse Nutritional deficiencies Previous preterm birth related to PROM + fetal fibronection results |
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Preterm Labor
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Define: labor begins between weeks 20 to 37
Signs and Symptoms: Uterine contractions that may or may not be painful Sensation that the baby is freq "balling up" Cramps Constant low backache Pelvic pressure or feeling that baby is pushing down Pain, discomfort or pressure in the vagina or thighs Change or increase in vaginal discharge "just feeling bad" or "coming down with something" |
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Predicting Preterm Birth
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Cervical Lenght:
Short Cervix (<25mm) allowing vaginal organisms into uterus weakening membranes Fetal Fibronection: Normally found in cervial and vaginal secretions until 16 to 20wks gestation & again at or near term |
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Magnesium Sulfate
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is used to inhibit preterm labor
Criteria for continuation: Urine output of atleast 30ml/hr Presence of deep tendon reflexes Respirations of 12 per minutes Antidote: Calcim gluconate 1g IV push over 3min |
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Accelerating Fetal Lung Maturity
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Corticosteriods to speed up development if birth before 34wks seems inevitable
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Prolonged Pregnancy
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lasts longer than 42 weeks
Complications: reduced amniotic fluid volumne (oligohydramnios) results in umbilical cord compression |
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