Prolapsed Umbilical Cord

According to the World Health Organization (WHO, 2016), preterm birth are the birth that happened before 37 ended weeks of pregnancy and is one of the number reason of newborn deaths and the second prominent cause of deaths in children below five. The preterm babies have chances of an amplified risk of illness, disability and death. In the first weeks, the complications of premature birth may include: breathing problems, heart problems, brain problems, temperature control problems, gastrointestinal problems, blood problems, metabolism problems, immune system problems. Long-term complications includes cerebral palsy, impaired cognitive skills, vision problem, hearing problems, dental problems, behavioral and psychological problems, chronic health issues.

Injuries occurring during birth are denoted to as birth trauma or obstetrical injuries and they are associated with different etiological causes. The important causes of birth trauma are macrosomia, breech presentation, shoulder dystocia, and forceps-assisted deliveries [3]. Traumatizing maneuvers during the deliveries will result in these fractures in the assisted deliveries [4]. The trauma may occur due to use of forces, excessive traction or pulling, unintended pressure on soft organs such as eyes. Trauma to the limb usually occurs when the limb is pulled in cases of obstructed labor or shoulder dystocia (Head out, shoulder stuck). An Indian study on birth trauma revealed that the fractured clavicle was commonest bone fractured

Vacuum assisted deliveries are a method to help facilitate a vaginal birth even if the mother is becoming to exhausted to push or if the baby has reached a difficult position during labor and is prevented from progressing. While the vacuum may be helpful for the labor it runs the risk of causing a subgaleal hemorrhage (SHG) in newborns this condition is a result of the connection between the sinuses of the scalp and the veins of the brain have been ruptured which causes bleeding and swelling of the head and can lead to severe hypovolemia and death (Davis, 2001). SGH occurrences after vacuum delivery are in the range of 26 to 45 per 1000 vaginal deliveries (Modanlou, 2010). In order to treat and correct SGH nurses are

Compared to the general adult population the maternal airway management can be more challenging as changes during pregnancy can increase the difficulty of intubation (Brien and Conlon, 2013). Its makes hard to insert laryngoscope when the patient have a large breast, the chance of bleeding and swelling increases due to oedema and vascularity of the upper respiratory tract, and the patient desaturate quicker as there is increase in oxygen requirements and there is reduced in functional residual capacity (Mushambi et al, 2015). As a result of all the changes during pregnancy, if the problems encountered during the intubation of Mrs D were to happen to an obstetric patient, it is important to provide optimal surgical condition for to progress rapidly while aiming for a good neonatal outcome (Local theatre policy, 2015b). In obstetric patients, much of the issue is about the urgency with which the foetus must be delivered and the surgical operation must be done as quickly as possible - therefore making decisions in the event of certain clinical situations occurring will require a much quicker decision making process because there is an immediate threat to the life of the woman or foetus (Mushambi et al, 2015). This is why emergency obstetric anaesthesia is such a potentially hazardous

It is easy to see that the medical abilities and tools we had 50 years ago are nothing in comparison to what we have today. Among these advances has been the extent to which we can prevent illness and disability. Fetal surgery first emerged in the 1980’s by Dr Michael Harrison aka “the father of fetal surgery,” when he decided to look into ways doctors could fix certain defects before birth to avoid their inevitable, devastating consequences. It has since expanded its practice to a number of hospitals across the country, although it is still an uncommon procedure. It involves opening up the mother 's uterus (just as a doctor would during a caesarean section) so that the fetus is exposed as much as needed to be operated on. The fetus is then put back and the uterus is closed until it is time for the mother to go into labor. The fetus is never detached from the mother and is essentially being operated on while inside the womb (Smajdor). While it may seem like a positive life changing procedure, there are many perspectives out there that support

In 2006, data was collected on 303 babies who were diagnosed with anencephaly and were not terminated. Of those 303 babies, about 40% were born prematurely (before 37 weeks) and 4% beyond 42 weeks. Two-thirds of the mothers were either induced or had a planned cesarean section for those born at term. Polyhydramnios was present in 30% of the cases which accounted for 60% of those born prematurely. When delivered by cesarean section, 4% died during birth, 53% died within twenty-four hours, 30% lived up to five days, and 13% lived longer than six days. For vaginal births, 37% of babies died during birth when a doctor or midwife ruptured the amniotic bag, opposed to 18% if the amniotic bag ruptured naturally.

"When caring for your babies cord stump, make sure your hands are always clean. You don't have to do anything special for the cord stump other than make sure it stays dry and clean. Expose the cord stump to air to help dry out the base. Keep the front of your baby's diaper folded down to avoid covering the stump. Let the cord fall off on its own, don't pull at it "

Why would delayed cord clamping even be a topic of discussion or in practice if it was not beneficial to some degree for the neonate or mother? Early cord clamping takes place almost immediately after delivery and delayed cord clamping is preformed anywhere for 30-180 seconds after birth. The validity of the above question has been on the rise for some time. Why some doctors have made it protocol during a delivery or simply do it only if requested is still not yet understood. Some would say there are little benefits to waiting to clamp the umbilical cord after delivery, and some say there are many benefits, and then there are those that say there is no difference whether you clamp early or delayed. Throughout my research I have learned that yet some physicians will not wait to clamp the umbilical cord, there are minimal risk, if any, and although at first I thought delayed clamping was without a doubt more beneficial than immediate clamping, they really are not profound in the grand scheme of the neonates’ health. However, I have learned that in the preterm neonate waiting to clamp the umbilical cord can be more beneficial for various reasons than in a full term neonate. Because of the medical background I have, I believe the benefits for both mother and child are important postpartum, however, those that choose to not participate in delayed clamping are not putting their newborn at any risk

Conditions that might lead to ending a pregnancy to save a woman's life include severe infections,

A cesarean hysterectomy is performed to prevent blood loss that can become life-threatening if any of the placenta remains attached after delivery. Women can suffer severe complications caused by heavy vaginal bleeding after delivery due to disseminated intravascular coagulopathy, which stops blood from clotting properly. Lung Failure and kidney failure are also known complications from the surgery.

In depth discussion of planned and emergency C/S deliveries were also discussed. Planned C/S births were defined as “breech presentation, multiple pregnancy, preterm birth, small for gestational age, placenta praevia, morbidly adherent placenta, cephalopelvic disproportion in labor, mother-to-child transmission of maternal infection, Hepatitis B and C viruses, Herpes, and maternal request for C/S birth was outlined” (National Guideline Clearinghouse, 2011). An in-depth outline of anesthesia and surgical techniques followed. It seems that this source addressed nearly every type of C/S birth technique, including “method of placental removal, exteriorization of the uterus, closure of the uterus, peritoneum, abdominal wall, and subcutaneous tissue, use of superficial wound drains, closure of skin, and even timing of antibiotic administration and thromboprophylaxis for C/S births. Care of the woman after C/S surgery, routine monitoring, pain management, eating and drinking after surgery, and removing the urinary catheter after C/S surgeries was also discussed(National Guideline Clearinghouse, 2011)”. There is even a benefits/harms section that looks at potential risks and successes of C/S deliveries. The National Guidelines Clearinghouse

Many woman give up in labor and beg the doctor to perform a cesarean section or many times the doctor does not want to wait for the laboring patient to progress on their terms and will call for a cesarean section. A cesarean section is a major abdominal surgery. Many woman are not educated in the short and long term effects of having one to be able to stay as far away from them. Maternal complications can be both physical and emotional due to the fact that the woman will not be able to care for her infant exclusively on her own during the recovery period. The first and most common complication with a cesarean section is surgical site infections. This could be caused by many things. It could be a cause of not cleaning the skin properly, a break in sterile technique, or personal hygiene of the wound during the recovery period. It can also be caused by the way the incision is closed. “ The use of staples for skin closure was associated with a marginally statistically significant increase in surgical site infections” (Corcoran 2013, pg. 1262). Infections can also be seen as urinary tract infections, endometritis, and pneumonia. Another complication that can occur from a cesarean section is a thrombus which can lead to pulmonary embolism. When a person has a cesarean section, they are bed bond more than a vaginal delivery. This causes the blood to not circulate in their legs

In the case of the CNM who delivered a 35 week breeched infant, several factors need

      Throughout the years, our brain shape has changed in result of the nutrition received. The amount of nutrition received is the biggest factor with regard to the change in brain size. Therefore, the sufficient nutrition increased the size of the brain. In result, the increased brain size created advanced cognitive functions.

The nurse must be mindful of each intervention initiated and the possible benefits of the intervention against its potential harmful effects for both mother and fetus. Not providing basic comfort measures for the mother can cause serious physical and emotional problems and could lead to possible fatigue and feelings of failure from the mother. The priority of this nursing intervention is to provide the mother and fetus with the least discomfort as possible and