The midwife is an autonomous and responsible professional (Department of Health, 2010) and the main care provider of pregnant women in the UK (Sandal et al., 2013). The midwife is hence in a good position to promote the wellbeing of midwifery clients by providing optimal care and support to meet their physical, emotional, psychological and informational needs (NMC, 2015, Hunter, 2002). Although the midwife is autonomous, she is accountable to the law, the Nursing and Midwifery Council and her employer for her practice and decisions (Griffith et al 2010). It is important for the midwife to be aware of the law, ethics, and professional issues that relate to midwifery in addition to her clinical knowledge, as these will aid her in making …show more content…
The placenta separates itself from the wall of the uterus and is delivered after the birth of the baby. In placenta abruption however, the placenta detaches from the wall of the uterus before or during the birth of the baby (Oyelese and Cande, 2006). Placenta abruption causes 33% of antepartum haemorrhage in pregnant women (Raynor et al, 2012). It is a major obstetric emergency occurring in around one in a hundred pregnancies and it requires urgent medical attention (Hanretty, 2010). Placenta abruption is also a major cause of maternal and foetal mortality or morbidity (CMACE, 2011).
The causes of placenta abruption are not fully known but some of its risk factors include pre-eclampsia, chronic hypertension, trauma to the abdomen, high parity, increased age, multiple pregnancy, previous history of placental abruption, previous caesarean section, smoking, substance abuse, oligohydramnios, premature or prolonged rupture of membranes and blood clotting disorders (Chapman & Charles, 2013). Placenta abruption can be mild, moderate or severe based on the level of placenta detachment and the maternal or foetal compromise (Crafter, 2009). It can also be concealed, revealed or mixed haemorrhage, based on the visibility of bleeding from the vagina (Crafter, 2009, Kenny, 2011). Signs and symptoms of placenta abruption include abdominal pain, rigid and tender uterus, visible or concealed bleeding, and foetal compromise (Yerby, 2010, Kenny, 2011). The impact of placenta
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**Placenta problems** can cause you to experience pain too. Placental abruption sometimes occurs in the last weeks of pregnancy. It can cause your placenta to start peeling away from the uterus, causing low amniotic fluid. Symptoms include tenderness in the uterus, back pain, abdominal pain, rapid contractions and vaginal bleeding.
Accreta has three distinct types; placenta accreta, placenta increta and placenta percreta. Placenta accreta represents 79% of accreta cases, while placenta increta represents 14% of cases and placenta percreta represents 7% of cases. In placenta accrete the villi are affixed to the myometrium of the uterus; in placenta increta the placental villi grow through the myometrium, and in placenta percreta the placenta villa grow through the myometrium and invade other structures such as the bladder and colon (Balayla & Bondarenko, 2012). The risks and complications are related to the degree in placental invasion (Figure
• Maternal injuries include cervical lacerations, vaginal hematomas, hemorrhage, perineal tears, and anal sphincter injury.
Researchers do not know exactly what causes an amniotic fluid embolism. However, they do believe that a ruptured uterus, ruptured membranes and a pressure gradient from vein to uterus can increase the risk of this condition. There has also been
Trauma is an important cause of maternal and fetal morbidity and mortality, and blunt abdominal trauma is a particular concern. Approximately 8% of pregnant women sustain some form of traumatic injury. Automobile accidents and falls account for most of the injuries. Studies of pregnant women involved in automobile accidents have demonstrated increased rates of premature rupture of membranes, placental abruption, preterm birth, and stillbirth. A recent study examines pregnancies complicated by traumatic injuries and outcomes in relation to place of triage.
A uterine contraction can result in a decreased uteroplacental blood flow. A placenta with borderline function before labor may be unable to maintain gas exchange adequate to prevent fetal asphyxia during labor. The healthy fetus may compensate for the effects of hypoxia during labor (Parer & Livingston, 1990; Court & Parer, 1984). The compensatory response includes (1) decreased oxygen consumption, (2) vasoconstriction of nonessential vascular beds, and (3) redistribution of blood flow to the vital organs (e.g., brain, heart, , placenta adrenal glands) (Peeters et al., 1979; Cohn et al., 1974). Humoral responses (e.g., release of vasopressin and endogenous opioids, release of epinephrine from the adrenal medulla) may enhance fetal cardiac function during hypoxia (Parer, 1997). Prolonged or severe hypoxia overwhelms these compensatory mechanisms, resulting in fetal injury or
The exact etiology of preeclampsia is unknown but it is hypothesized that it develops from “failure of the normal development of the maternal-fetal interface in the placenta”
Placental abruption is a serious and potentially life threatening condition for both the mother and fetus that requires urgent diagnosis and care from a multidisciplinary team. Although relatively rare, occurring in approximately 0.4 to 1% of all pregnancies, placental abruption accounts for between 10 and 20% of all perinatal mortality and approximately 10% of all preterm births (Tikkanen M 2011) and is the leading cause of vaginal bleeding after the first trimester (Oyelese Y & Ananth CV 2006). The cause of placental abruption is not well understood however it is thought to often be multifactorial and a woman’s known risk factors and co-morbidities may increase the risk status of this condition presenting although it is more often than
Preeclampsia is heterogeneous in its presentation as well its association with long-term effectss for child and mother. Pre-eclampsia exists as two major types, namely; maternal and placental pre-eclampsia (Ness and Roberts 1996). It is widely agreed upon that poor placentation is strongly associated with Foetal Growth Restriction (FGR), even when pre-eclampsia is absent, but it is less clearly documented in association with normal fetal growth and
The World Health Organization reports that “81 percent of women in developing countries have one prenatal visit, but only 36 percent have the recommended four visits”. Prenatal care is important for both mother and fetus. In most countries midwifes are the ones that take care of the expecting mothers and deliver their babies. In the United States however midwifes have become less and less used, due to the rise of OB-GYN’s. Deciding which care provider would be the best for each pregnancy is hard question to answer. Although some experts say that OB-GYN’s have more years of schooling therefor they are more certified to deliver babies, I argue that midwifes receive adequate training and are just as certified to deliver, which could give expecting mothers a more attentive care provider that is a lot cheaper than other care providers.
This paper will look at two different models of maternity care provided to women midwifery led care and medical led care perspectives. It will compare and contrast the midwifery caseload care and obstetric care. How this impacts on the woman’s childbearing experience and midwifery practice will also be discussed in this essay.
Placenta moves as the womb stretches and grows during pregnancy. Early in pregnancy it is very normal for the placenta to be low in the womb, but as pregnancy progresses, the placenta moves to the top of the womb (MedlinePlus, 2012). When the cervix opens for delivery the placenta should be close to the top of the womb and should occur by the third trimester. When the placenta covers the cervix this is called previa and there are three different forms of placenta previa. The first type is marginal. The placenta does not over the opening but is next to the cervix. The next type is partial and that is when the placenta covers part of the cervical opening. Lastly there is complete, the cervical opening is completely covered by the placenta. Depending on the severity of the previa it can make a vaginal delivery very complicated and will most likely result in the mother having a C-section.
The placenta is implanted in the lower uterine segment near or over the internal cervical os. The degree to which the internal cervical os is covered by the placenta has been used to classify four types of placenta previa; total, partial, marginal and low–lying. In total previa the internal os is entirely covered by the placenta. Partial placenta previa implies incomplete coverage of the internal os. Marginal placenta previa indicates that only an edge of the placenta extends to the margin of the internal os. And the last is the low – lying placenta has been used when the placenta is implanted in the lower uterine segment but not reach the os. The more descriptive classification that includes placenta previa is in the third trimester.
Ninety percent of all postpartum hemorrhages are caused by uterine atony-that is, failure of the uterine muscles to contract normally after the baby and placenta are delivered. The blood vessels supplying the placenta during pregnancy are severed when the placenta separates from the wall of the uterus. The bleeding that results from these severed vessels normally stops when the uterus contracts, compressing the vessels. However, if the uterus doesn't contract enough, the bleeding can continue. Significant blood loss can result from a floppy, uncontracted uterus.