maternal powe4

• Complication with the power


  Post partal infection, Hemorrhage, Infant Mortality
• Inertia


  Time honored term that denote sluggishness of force of labor
• Most current term for Inertia


  Dysfunctional Labor
• Prolongation in the duration of labor, typically first stage of labor


  Dysfunctional Labor or prolonged labor
• Common cause of Dysfunctional labor

  If a fetus is large
• What are the ineffective uterine force

  Hypertonic, hypotonic, uncoordinated contractions
• Basic force moving fetus to birth canal

  Uterine contractions
• The desired frequency of uterine contractions in normal labor


  ONE contraction every 2-3 mins.

  Or less than FIVE in 10 mins.
• Unusually low or infrequent ( not more 2-3 in 10 mins., Occurs active phase and not painful

  Hypotonic Uterine Force
• Contractions occurs frequently, occurs in latent phase, painful

  Hypertonic uterine force
• Dysfunction at the first stage of labor


  Prolonged Latent phase, Protracted Active phase, Prolonged deceleration phase, secondary arrest of Dilation, Prolonged Descent,Arrest of Descent
• What is prolonged Latent phase and what are the management?


  The cervix is not ripe

  Management:

  Changing linen, decreasing noise, darkening room, amniotomy, oxytocin administration and CS
• Associated with CPD or fetal Malposition the management are oxytocin and CS

  PROTRACTED ACTIVE PHASE
• Occurs when it extends beyond 3 hours in nullipara or 1 hour in a multipara 


  Prolonged Deceleration Phase - occur due to abnormal fetal head/ CS
• Secondary arrest of Dilation


  Occurs if there's no progress in cervical dilation for longer 2 hrs.
• Prolonged Descent


  Second stage lasts over 3 hours.

  If poor fetal presentation and CPD:

  RUPTURE OF FETAL MEMBRANE

  OXYTOCIN
• Expected descent of fetus does not begin or movement beyond 0 station


  Arrest descent- VD if no contraindications thru oxytocin
• Common causes of Dysfunctional Labor


  Inappropriate use of analgesic

  Poor fetal position

  Extension rather than flexion

  Unripe cervix, exhausted mother, primi
• A hard band that forms across the uterus junction of upper and lower segment and interferes with fetal descent.

  Contracted Rings
• Most frequent type of contraction ring


  Pathologic Retraction Ring (Bandl's Ring)
• Management for contraction ring


  Administration of morphine IV, Tocolytic, CS, Manual evacuation of placenta
• Labor that completed fewer than 3  hours

  Precipitate Labor
• Most common Tocolytic agents used for treatment of preterm labor zre


  Magnesium sulfate, indomethacin, nifedipine
• Difference between induction and augmentation of labor


  Induction- Started Artificially

  Augmentation- refers to assisting labor that has started spontaneously but not effective
• Cervical Ripening

  More commonly used method of speeding cervical ripening thru application of prostaglandin gel such as misoprostol
• When a uterus undergoes more strain than it capable of sustaining/ strong contraction without cervical dilation

  Uterine Rupturee
• Turning inside out with either birth of fetus or delivery of the placenta

  Uterine inversion
• When does uterine inversion occur


  Occur when traction is applied to umbilical cord to remove placenta, occurs when pressure is applied to uterine fundus when uterus not contracted
• Management for uterine inversion


  Never attempt to replace inversion, remove placenta, start IV Line, oxygen, perform CPR if arrest, antibiotic therapy, CS future pregnancy
• Amniotic Fluid Embolism


  Forced into an open maternal uterine blood sinus after membrane rupture
• Signs and symptoms amniotic fluid embolism


  Sharp pain in the chest, inability to breathe, pale then turn to bluish gray