Induction of Labor
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ABCDE Acronym Blood Transfusion 231 Major Trauma 234 Maternal
Cambridge University Press 978-0-521-26827-1 - Obstetric and Intrapartum Emergencies: A Practical Guide to Management Edwin Chandraharan and Sir Sabaratnam Arulkumaran Index More information Index ABCDE acronym albumin, blood plasma levels 7 arterial blood gas (ABG) 188 blood transfusion 231 allergic anaphylaxis 229 arterio-venous occlusions 166–167 major trauma 234 maternal collapse 12, 130–131 amiadarone, overdose 178 aspiration 10, 246 newborn infant 241 amniocentesis 234 aspirin 26, 180–181 resuscitation 127–131 amniotic fluid embolism 48–51 assisted reproduction 93 abdomen caesarean section 257 asthma 4, 150, 151, 152, 185 examination after trauma 234 massive haemorrhage 33 pain in pregnancy 154–160, 161 maternal collapse 10, 13, 128 atracurium, drug reactions 231 accreta, placenta 250, 252, 255 anaemia, physiological 1, 7 atrial fibrillation 205 ACE inhibitors, overdose 178 anaerobic metabolism 242 automated external defibrillator (AED) 12 acid–base analysis 104 anaesthesia. See general anaesthesia awareness under anaesthesia 215, 217 acidosis 94, 180–181, 186, 242 anal incontinence 138–139 ACTH levels 210 analgesia 11, 100, 218 barbiturates, overdose 178 activated charcoal 177, 180–181 anaphylaxis 11, 227–228, 229–231 behaviour/beliefs, psychiatric activated partial thromboplastin time antacid prophylaxis 217 emergencies 172 (APTT) 19, 21 antenatal screening, DVT 16 benign intracranial hypertension 166 activated protein C 46 antepartum haemorrhage 33, 93–94. benzodiazepines, overdose 178 Addison’s disease 208–209 See also massive -
Review Article Umbilical Cord Hematoma: a Case Report and Review of the Literature
Hindawi Obstetrics and Gynecology International Volume 2018, Article ID 2610980, 6 pages https://doi.org/10.1155/2018/2610980 Review Article Umbilical Cord Hematoma: A Case Report and Review of the Literature Gennaro Scutiero,1 Bernardi Giulia,1 Piergiorgio Iannone ,1 Luigi Nappi,2 Danila Morano,1 and Pantaleo Greco1 1Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, Azienda Ospedaliero-Universitaria S. Anna, University of Ferrara, Via Aldo Moro 8, 44121 Cona, Ferrara, Italy 2Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Viale L. Pinto, 71100 Foggia, Italy Correspondence should be addressed to Piergiorgio Iannone; [email protected] Received 17 December 2017; Accepted 21 February 2018; Published 26 March 2018 Academic Editor: John J. Moore Copyright © 2018 Gennaro Scutiero et al. *is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. To deepen the knowledge in obstetrics on a very rare pregnancy complication: umbilical cord hematoma. Methods.A review of the case reports described in the last ten years in the literature was conducted in order to evaluate epidemiology, predisposing factors, potential outcomes, prenatal diagnosis, and clinical management. Results. Spontaneous umbilical cord hematoma is a rare complication of pregnancy which represents a serious cause of fetal morbidity and mortality. *ere are many risk factors such as morphologic anomalies, infections, vessel wall abnormalities, iatrogenic causes, and traction or torsion of the cord, but the exact etiology is still unknown. -
15 Complications of Labor and Birth 279
Complications of 15 Labor and Birth CHAPTER CHAPTER http://evolve.elsevier.com/Leifer/maternity Objectives augmentation of labor (a˘wg-me˘n-TA¯ -shu˘n, p. •••) Bishop score (p. •••) On completion and mastery of Chapter 15, the student will be able to do cephalopelvic disproportion (CPD) (se˘f-a˘-lo¯ -PE˘L- v i˘c the following: di˘s-pro¯ -PO˘ R-shu˘n, p. •••) 1. Defi ne key terms listed. cesarean birth (se˘-ZA¯ R-e¯-a˘n, p. •••) 2. Discuss four factors associated with preterm labor. chorioamnionitis (ko¯ -re¯-o¯-a˘m-ne¯-o¯ -NI¯-ti˘s, p. •••) 3. Describe two major nursing assessments of a woman dysfunctional labor (p. •••) ˘ ¯ in preterm labor. dystocia (dis-TO-se¯-a˘, p. •••) episiotomy (e˘-pe¯ z-e¯-O˘ T- o¯ -me¯, p. •••) 4. Explain why tocolytic agents are used in preterm labor. external version (p. •••) 5. Interpret the term premature rupture of membranes. fern test (p. •••) 6. Identify two complications of premature rupture of forceps (p. •••) membranes. hydramnios (hi¯-DRA˘ M-ne¯-o˘s, p. •••) 7. Differentiate between hypotonic and hypertonic uterine hypertonic uterine dysfunction (hi¯-pe˘r-TO˘ N-i˘k U¯ -te˘r-i˘n, dysfunction. p. •••) 8. Name and describe the three different types of breech hypotonic uterine dysfunction (hi¯-po¯-TO˘ N-i˘k, p. •••) presentation. induction of labor (p. •••) ¯ 9. List two potential complications of a breech birth. multifetal pregnancy (mu˘l-te¯-FE-ta˘l, p. •••) nitrazine paper test (NI¯-tra˘-ze¯n, p. •••) 10. Explain the term cephalopelvic disproportion (CPD), and oligohydramnios (p. •••) discuss the nursing management of CPD. -
Umbilical Cord Prolapse Guideline
Umbilical Cord Prolapse Guideline Document Control Title Umbilical Cord Prolapse Guideline Author Author’s job title Specialty Trainee in Obstetrics and Gynaecology Directorate Department Women’s and Children’s Obstetrics and Gynaecology Date Version Status Comment / Changes / Approval Issued 1.0 Mar Final Approved by the Maternity Services Guideline Group in 2011 April 2011. 1.1 Aug Revision Minor amendments by Corporate Governance to 2012 document control report, headers and footers, new table of contents, formatting for document map navigation. 2.0 Feb Final Approved by the Maternity Services Guideline Group in 2016 February 2016. 2.1 Apr Revision Harmonised with Royal Devon & Exeter guideline 2019 3.0 May Final Approved by Maternity Specialist Governance Forum 2019 meeting on 01.05.2019 Main Contact ST1 O&G Tel: Direct Dial– 01271 311806 North Devon District Hospital Raleigh Park Barnstaple Devon EX31 4JB Lead Director Medical Director Superseded Documents Nil Issue Date Review Date Review Cycle May 2019 May 2022 Three years Consulted with the following stakeholders: (list all) Senior obstetricians Senior midwives Senior management team Filename Umbilical Cord Prolapse Guideline v3. 01May 19.doc Policy categories for Trust’s internal Tags for Trust’s internal website (Bob) website (Bob) Cord, accidents, prolapse Maternity Services Maternity Page 1 of 11 Umbilical Cord Prolapse Guideline CONTENTS Document Control .................................................................................................... 1 1. Introduction -
Induction of Labour in Late and Postterm Pregnancies and Its
Original Article 793 Induction of Labour in Late and Postterm Pregnancies and its Impact on Maternal and Neonatal Outcome Die Geburtseinleitung bei übertragener Schwangerschaft und die Auswirkungen auf mütterliches und kindliches Outcome Authors F. Thangarajah*, P. Scheufen*, V. Kirn, P. Mallmann Affiliation University Hospital of Cologne, Department of Obstetrics and Gynecology, Cologne, Germany Key words Abstract Zusammenfassung l" induction of labour ! ! l" delivery Introduction: This study aimed to determine the Einleitung: Diese Studie untersuchte die Auswir- l" cesarean section effects of induction of labour in late-term preg- kungen der Geburtseinleitung in der Spätschwan- l" materno‑fetal medicine nancies on the mode of delivery, maternal and gerschaft bzw. bei Übertragung auf die Art der Schlüsselwörter neonatal outcome. Entbindung sowie auf das mütterliche und kind- l" Geburtseinleitung Methods: We retrospectively analyzed deliveries liche Outcome. l" Entbindung between 2000 and 2014 at the University Hospi- Methoden: Alle in der Universitätsklinik Köln l" Kaiserschnittentbindung tal of Cologne. Women with a pregnancy aged be- zwischen 2000 und 2014 erfolgten Entbindungen l" Perinatalmedizin tween 41 + 0 to 42 + 6 weeks were included. wurden retrospektiv untersucht. Alle Frauen, die Those who underwent induction of labour were in der 41 + 0 bis 42 + 6 Schwangerschaftswoche compared with women who were expectantly entbanden, wurden in die Studie eingeschlossen. managed. Maternal and neonatal outcomes were Schwangere Frauen, bei denen eine Geburtsein- evaluated. leitung durchgeführt wurde, wurden mit Frauen Results: 856 patients were included into the verglichen, die exspektativ behandelt wurden. study. The rate of cesarean deliveries was signifi- Die mütterlichen und kindlichen Outcomes wur- cantly higher for the induction of labour group den ausgewertet. -
Management of Prolonged Decelerations ▲
OBG_1106_Dildy.finalREV 10/24/06 10:05 AM Page 30 OBGMANAGEMENT Gary A. Dildy III, MD OBSTETRIC EMERGENCIES Clinical Professor, Department of Obstetrics and Gynecology, Management of Louisiana State University Health Sciences Center New Orleans prolonged decelerations Director of Site Analysis HCA Perinatal Quality Assurance Some are benign, some are pathologic but reversible, Nashville, Tenn and others are the most feared complications in obstetrics Staff Perinatologist Maternal-Fetal Medicine St. Mark’s Hospital prolonged deceleration may signal ed prolonged decelerations is based on bed- Salt Lake City, Utah danger—or reflect a perfectly nor- side clinical judgment, which inevitably will A mal fetal response to maternal sometimes be imperfect given the unpre- pelvic examination.® BecauseDowden of the Healthwide dictability Media of these decelerations.” range of possibilities, this fetal heart rate pattern justifies close attention. For exam- “Fetal bradycardia” and “prolonged ple,Copyright repetitive Forprolonged personal decelerations use may onlydeceleration” are distinct entities indicate cord compression from oligohy- In general parlance, we often use the terms dramnios. Even more troubling, a pro- “fetal bradycardia” and “prolonged decel- longed deceleration may occur for the first eration” loosely. In practice, we must dif- IN THIS ARTICLE time during the evolution of a profound ferentiate these entities because underlying catastrophe, such as amniotic fluid pathophysiologic mechanisms and clinical 3 FHR patterns: embolism or uterine rupture during vagi- management may differ substantially. What would nal birth after cesarean delivery (VBAC). The problem: Since the introduction In some circumstances, a prolonged decel- of electronic fetal monitoring (EFM) in you do? eration may be the terminus of a progres- the 1960s, numerous descriptions of FHR ❙ Complete heart sion of nonreassuring fetal heart rate patterns have been published, each slight- block (FHR) changes, and becomes the immedi- ly different from the others. -
Cord Prolapse
CLINICAL PRACTICE GUIDELINE CORD PROLAPSE CLINICAL PRACTICE GUIDELINE CORD PROLAPSE Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and the Clinical Strategy and Programmes Division, Health Service Executive Version: 1.0 Publication date: March 2015 Guideline No: 35 Revision date: March 2017 1 CLINICAL PRACTICE GUIDELINE CORD PROLAPSE Table of Contents 1. Revision History ................................................................................ 3 2. Key Recommendations ....................................................................... 3 3. Purpose and Scope ............................................................................ 3 4. Background and Introduction .............................................................. 4 5. Methodology ..................................................................................... 4 6. Clinical Guidelines on Cord Prolapse…… ................................................ 5 7. Hospital Equipment and Facilities ....................................................... 11 8. References ...................................................................................... 11 9. Implementation Strategy .................................................................. 14 10. Qualifying Statement ....................................................................... 14 11. Appendices ..................................................................................... 15 2 CLINICAL PRACTICE GUIDELINE CORD PROLAPSE 1. Revision History Version No. -
OBGYN-Study-Guide-1.Pdf
OBSTETRICS PREGNANCY Physiology of Pregnancy: • CO input increases 30-50% (max 20-24 weeks) (mostly due to increase in stroke volume) • SVR anD arterial bp Decreases (likely due to increase in progesterone) o decrease in systolic blood pressure of 5 to 10 mm Hg and in diastolic blood pressure of 10 to 15 mm Hg that nadirs at week 24. • Increase tiDal volume 30-40% and total lung capacity decrease by 5% due to diaphragm • IncreaseD reD blooD cell mass • GI: nausea – due to elevations in estrogen, progesterone, hCG (resolve by 14-16 weeks) • Stomach – prolonged gastric emptying times and decreased GE sphincter tone à reflux • Kidneys increase in size anD ureters dilate during pregnancy à increaseD pyelonephritis • GFR increases by 50% in early pregnancy anD is maintaineD, RAAS increases = increase alDosterone, but no increaseD soDium bc GFR is also increaseD • RBC volume increases by 20-30%, plasma volume increases by 50% à decreased crit (dilutional anemia) • Labor can cause WBC to rise over 20 million • Pregnancy = hypercoagulable state (increase in fibrinogen anD factors VII-X); clotting and bleeding times do not change • Pregnancy = hyperestrogenic state • hCG double 48 hours during early pregnancy and reach peak at 10-12 weeks, decline to reach stead stage after week 15 • placenta produces hCG which maintains corpus luteum in early pregnancy • corpus luteum produces progesterone which maintains enDometrium • increaseD prolactin during pregnancy • elevation in T3 and T4, slight Decrease in TSH early on, but overall euthyroiD state • linea nigra, perineum, anD face skin (melasma) changes • increase carpal tunnel (median nerve compression) • increased caloric need 300cal/day during pregnancy and 500 during breastfeeding • shoulD gain 20-30 lb • increaseD caloric requirements: protein, iron, folate, calcium, other vitamins anD minerals Testing: In a patient with irregular menstrual cycles or unknown date of last menstruation, the last Date of intercourse shoulD be useD as the marker for repeating a urine pregnancy test. -
Term Pregnancy with Umbilical Cord Prolapse
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Available online at www.sciencedirect.com Taiwanese Journal of Obstetrics & Gynecology 51 (2012) 375e380 www.tjog-online.com Original Article Term pregnancy with umbilical cord prolapse Jian-Pei Huang a,b,*, Chie-Pein Chen a,c, Chih-Ping Chen a,d, Kuo-Gon Wang a,c, Kung-Liahng Wang a,b,d a Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan b Mackay Medicine, Nursing and Management College, Taipei, Taiwan c Division of High Risk Pregnancy, Mackay Memorial Hospital, Taipei, Taiwan d Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan Accepted 10 March 2011 Abstract Objective: To investigate the incidence, management, and perinatal and long-term outcomes of term pregnancies with umbilical cord prolapse (UCP) at Mackay Memorial Hospital, Taipei, from 1998 to 2007. Materials and Methods: For this retrospective study, we reviewed the charts, searched a computerized birth database, and contacted the families by telephone to acquire additional follow-up information. Results: A total of 40 cases of UCP were identified among 40,827 term deliveries, an incidence of 0.1%. Twenty-six cases (65%) were delivered by emergency cesarean section (CS). Of the neonates, 18 had an Apgar score of <7 at 1 minute, 10 of these scores being sustained at 5 minutes after birth, and three infants finally died. Eleven UCPs occurred at the vaginal delivery of a second twin, and nine with malpresentation. All of the infants who had good perinatal outcomes also had good long-term outcomes. -
Induction of Labour at Term in Older Mothers
Induction of Labour at Term in Older Mothers Scientific Impact Paper No. 34 February 2013 Induction of Labour at Term in Older Mothers 1. Background and introduction The average age of childbirth is rising markedly across Western countries.1 In the United Kingdom (UK) the proportion of maternities in women aged 35 years or over has increased from 8% (approximately 180 000 maternities) in 1985–87 to 20% (almost 460 000 maternities) in 2006–8 and in women aged 40 years and older has trebled in this time from 1.2% (almost 27 000 maternities) to 3.6% (approximately 82 000 maternities).2 There is a continuum of risk for both mother and baby with rising maternal age with numerous studies reporting multiple adverse fetal and maternal outcomes associated with advanced maternal age. Obstetric complications including placental abruption,3 placenta praevia, malpresentation, low birthweight,4–7 preterm8 and post–term delivery9 and postpartum haemorrhage,10 are higher in older mothers. As fertility declines with age, there is a greater use of assisted reproductive technologies (ARTs) and the possibility of multiple pregnancy increases. This may independently adversely affect the risks reported.11 Preexisting maternal medical conditions including hypertension, obesity and diabetes increase with advancing maternal age as do pregnancy–related maternal complications such as pre–eclampsia and gestational diabetes.12 These medical co–morbidities can all influence fetal health and are likely to compound the effect of age on the risk of pregnancy in an older -
Umbilical Cord Prolapse
Cord prolapse 2013–15 UMBILICAL CORD PROLAPSE All staff involved in maternity care should receive at least annual training in the management of obstetric emergencies including umbilical cord prolapse DEFINITION Descent of umbilical cord through cervix alongside (occult) or past presenting part (overt) in the presence of ruptured membranes Background Incidence of cord prolapse is between 0.1–0.6% 50% of cases are preceded by obstetric manipulation Cord prolapse carries a perinatal mortality rate of 91/1000 in hospital settings, mortality is largely secondary to prematurity and congenital malformations Cord prolapse is also associated with birth asphyxia asphyxia, predominantly caused by cord compression and umbilical arterial vasospasm, can result in long-term morbidity because of hypoxic ischaemic encephalopathy (see Staffordshire, Shropshire & Black country Newborn network Hypoxic ischaemic encephalopathy guideline) and cerebral palsy RECOGNITION AND ASSESSMENT Symptoms and signs Cord presentation and prolapse may occur with no outward physical signs and with a normal fetal heart rate pattern Abnormal fetal heart rate pattern (e.g. bradycardia, variable decelerations, prolonged deceleration of >1 min – particularly if soon after membrane rupture) Cord seen or felt at vaginal examination Investigations Auscultate fetal heart soon after rupture of membranes Routine vaginal examination is not indicated if liquor clear with spontaneous rupture of membranes in the presence of normal fetal heart rate and absence of risk factors Cord -
2018 Annual Meeting Friday Handouts: Ultrasound 101
North Carolina Obstetrical and Gynecological Society and NC Section of ACOG 2018 ANNUAL MEETING FRIDAY HANDOUTS: ULTRASOUND 101 April 20-22, 2018 | Omni Grove Park Inn Resort | Asheville, NC This continuing medical education activity is jointly provided by the American College of Obstetricians and Gynecologists. Introduction to Obstetric Ultrasound Sarah Ellestad, MD Maternal‐Fetal Medicine Duke University Disclosures • None 2 Objectives • Discuss ultrasound background • Review specific knobology • Review the Alara principle, Mechanical and Thermal index and why they are important • Discuss differences in probes • Review how to optimize images 3 1 Background • Ultrasound is the frequency of sound >20 KHz, which cannot be heard by humans (ie. ultrasonic) • Typical frequencies used in Ob/Gyn are between 3 and 10 MHz • Audible sound is between 20 Hz and 20 KHz 4 Background • Ultrasound waves are generated from tiny piezoelectric crystals which are packed into the ultrasound transducer. • The crystals transform electric into mechanical energy (ultrasound) and vice versa • Returning ultrasound (mechanical energy) beams from the body are converted back into electric currents • Gel is used to facilitate the transfer of sound from the transducer to the skin • Couples the transducer to the skin and permits the sound to go back and forth 5 6 2 Image generation • An image is created by sending multiple pulses from the transducer at slightly different directions and analyzing the returning echoes received into a gray scale format • Tissues that are