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Back Again. http://www.youtube.com/watch?v=x5kisPBwZOM. High Risk Intrapartum Nursing –Part II. Developed by D. Ann Currie RN, MSN 2012. Birth Related Procedures. Version Cervical Ripening Induction / Augmentation Amniotomy Amnioinfusion Episiotomy Assisted Vaginal Birth: - PowerPoint PPT PresentationTRANSCRIPT
http://www.youtube.com/watch?v=x5kisPBwZOM
Version Cervical Ripening Induction / Augmentation Amniotomy Amnioinfusion Episiotomy Assisted Vaginal Birth: Forceps-assisted birth Vacuum Extraction Cesarean Section VBAC
External Cephalic Version is the changing of the fetal presentation from breech, transverse lie or oblique lie to a cephalic presentation.
Podalic Version is used only with the second twin during a vaginal birth.
May be attempted after 36-37 weeks gestation.
Criteria: Single fetus Not engaged Adequate amount of amniotic fluid A Reactive NST
Suspected IUGR Fetal Anomalies Abnormal FHR Pattern Rupture of Membranes Cesarean birth indications Maternal Problems-GDM,
Preeclampsia/eclampsia cardiac disease etc.
Amniotic Fluid abnormalities Other
Done in Labor UnitClient is NPO for least 8 hoursUltrasound for : single fetus, AFI, location of placenta,
position and presentation of fetus and cordVital signsNSTBlood type and Rh and antibody screenInformed consentIV started with LRPossible Tocolytic medications
Softening and effacing of the cervix Can be done with several agents: Prostaglandin E2( PGE2) gel Dinoprostone ( Cervidil)- vaginal insert Dinoprostone ( Prepidil) Misoprostol ( Cytotec) Can be done prior to induction with Pitocin
Labor Induction is the stimulation of uterine contractions before the spontaneous onset of labor.
Labor Augmentation is the stimulation of uterine contractions after labors onset and there is failure in progression of cervical dilation or descent of fetus.
Diabetes mellitus Postterm gestation Fetal Demise PROM Hx of precipitous labor and birth Other indications see text
Prematurity Abnormal Presentation Multiple Gestation Severe Hypertension Maternal Heart Disease Abnormal FHR Pattern Polyhydramnios Presenting part not
engaged
Severe Preeclampsia/ eclampsia
CPD Macrosomic fetus Cord prolapse Placenta previa Previous Classical
Incision C/S See text for other
contraindications
It is the artificial rupture of the amniotic membranes. (AROM)
Before procedure : Do pericare Assess for contraindications or risk factors. Assess the fetus for presentation, position,
station, and FHR Prep bed for fluid Immediately after: Assess FHR Check fluid color and amount
It is a procedure by which warm, sterile saline is put into the uterus via an IUPC. It can be used to increase volume of fluid in oligohydramnios, decrease pressure on cord ,or dilute meconium.
First place IUPC Assess FHR Bolus 150-250 ml of saline using infusion pump
over20-30 minutes Monitor vital signs, FHR ,and contraction status
and resting tone
It is a surgical incision into the perinium. Types: Midline Mediolateral Episiorrhaphy is a repair of the episiotomy
or any lacerations.
Cesarean birth is the birth of the baby through abdominal and uterine incision. Hsyterotomy
Indications: CPD, placenta previa, Abruptio placenta,
Umbilical cord prolapse, nonreassuring FHR pattern, previous section, breech presentation, fetal congenitial anomalies and others.
Preoperative Prep Intraoperative Postoperative