Observed Intervention
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
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The newborn assessment should include respiration rate, capillary refill, pulses, pallor and circulation checks. Signs of a hemorrhage may present themselves prior to scalp edema and could lead to treating a hemorrhage quicker and more successfully than if treatment is prolonged until the scalp starts to swell (Modanlou, 2010).
Conclusion
Monitoring the head circumference after a vacuum assisted delivery is a crucial part in detection of subgaleal hemorrhages. While performing newborn assessments and doing the ordered head measuring assessing the infant’s circulation, through capillary refill and pulses, palpating the head for any “bogginess”, and assessing and monitoring any edema along the suture lines of the infant’s skull are also crucial for early detection of SGH (Modanlou, 2010). It is also if there is a suspicion or confusion on if the feeling of the infant’s head is a hemorrhage or some other anomaly, acting fast is key in prevent further damage and working towards treated the SGH. Measuring the head circumference is an effective, nonintrusive and noninvasive way to detect the start, or possibly a prolonged, sugaleal hemorrhage following a vacuum assisted vaginal delivery if the assessment is taking place hourly for at least 8 hours following delivery (Modanlou, 2010).
While head measuring of a newborn may not be the most effective method of detecting a hemorrhage, it is an important piece to an assessment, and it is important the physicians, CNAs
C. Application of a fetal scalp electrode as soon as her membranes rupture in labor.
An abnormal heartbeat can be an indicator for other issues, such as a damaged heart valve. The next step is checking percussion, this portion of the examination the provider will tap on the patient's chest and abdomen. The provider is looking and listening for a specific sound under normal conditions. If there is a change in fluids or air there will be a different sound. The last portion of the physical examination is palpation. The provider will apply pressure using his fingers feeling along the body regions and organs. Palpation provides information about the size of an organ and changes in its consistency, shape, and tenderness, and can help determine the presence of a foreign mass. Based on the results of Mr. Smith's physical examination the provider determined that additional labs would need to be drawn. The provider ordered a complete blood count, which includes: a platelet, red blood cell, and white blood cell count, as well as a blood potassium check. Mr. Smith's labs were not within the normal limits, so the provider admitted him into the hospital. Hospital staff treated his deficiencies and sent him
Temp 97.5, blood pressure 123/83, O2 sat 95% on room air, pulse 81. Alert male, no acute distress. Pleasant and cooperative. Pupils equal, round, react to light. Examination of the scalp reveals laceration on the posterior scalp. Wound edges well approximated
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.
A commonly known procedure when it comes to hospital births are epidurals. An epidural is an injection of a drug between the “epidural space” which causes
This woman was invited to the maternity assessment unit due to spontaneous rupture of membranes. This is her first birth in this country as her other 3 children were born in India- All normal vaginal deliveries. Although, her antenatal period had been low risk, she had not had a recent enough full blood count (FBC) taken, which would put her at risk of having a low Hb level and due to her parity – she could also be at risk of a postpartum hemorrhage (Royal college of obstetricians & gynaecologists, 2009). Therefore, the decision was made to put her on delivery suite rather than in the low risk birth centre.
This kind of hematoma will not be able to cross suture lines of the skull due to being bound by the periosteum; therefore, cephalohematoma’s are distinguishable by a bulge under the baby’s scalp, due to swelling, that does not cross the midline. Because of the excess blood collection, there may be color changes and nurses should monitor the baby for anemia, and jaundice which can happen once the blood starts to break down.
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
In the case of the CNM who delivered a 35 week breeched infant, several factors need
Few decades ago routine episiotomy was performed at the rate of up to 100% around the globe. Episiotomy was believed to ease vaginal delivery, reduce the rate of deep perineal tears, speed up the healing of the surgical laceration as opposed to the spontaneous vaginal tear and reduce postpartum complications, such as perineal pain and urinary incontinence (Hargrove & Penner, 2011).
Postpartum hemorrhage (PPH) is a significantly life-threatening complication that can occur after both vaginal and caesarean births (Ricci & Kyle, 2009). Simpson and Creehan (2008) define PPH as the amount of blood loss after vaginal birth, usually more than 500mL, or after a caesarean birth, normally more than 1000mL. However, the definition is arbitrary, attributed to the fact that loss of blood during birth is intuitive and widely inaccurate (Ricci & Kyle, 2009). In line with this, studies have suggested that health care providers consistently underestimate actual blood loss, thus, an objective definition of PPH would be any amount of bleeding that exposes a mother in hemodynamic jeopardy (Ricci &
The first and probably most important thing to notice about the child is their skin color. The blood circulates through a child’s body very quickly because it is so small. A child’s skin will react to the blood volume that is currently circulating throughout their body, changing color as the blood flow becomes less adequate. It will likely be normal, blue (cyanotic), pale (pallor), or have a waxy look. The child’s skin should look normal, which is pink or rosy. If the child looks blue or pale at all, their blood is not circulating adequately. The waxy look on a child could mean there has been a lack of circulation long enough to cause death. The best places to look for color abnormalities are around the lips, under the eyes, the cheeks, fingertips
To test whether or not the baby will have the condition, a test called ‘Combined test’ is available to women who are 10-14 weeks deep into pregnancy. The test involves a combination of a typical ultrasound scan with the aid of a blood test. By undergoing this test, a blood sample from you will be taken and during the scan a measurement of the fluid found at the back of the baby’s neck will also be taken. Your age and along with the results of these tests will give the doctors an idea of how severe the condition if it present.
Over the years birthing methods have changed a great deal. When technology wasn’t so advanced there was only one method of giving birth, vaginally non-medicated. However, in today’s society there are now more than one method of giving birth. In fact, there are three methods: Non-medicated vaginal delivery, medicated vaginal delivery and cesarean delivery, also known as c-section. In the cesarean delivery there is not much to prepare for before the operation, except maybe the procedure of the operation. A few things that will be discussed are: the process of cesarean delivery, reasons for this birthing method and a few reasons for why this birthing method is used. Also a question that many women have is whether or not they can vaginally
A review of the literature by the authors found extensive data to support the Odon device as being the more cost effective and reasonable choice for complicated labor. When comparing current options available today like the use of forceps and the vacuum extractor all approved assisted instrument for complicated labor the authors found that the vacuum extractor is less likely to achieve vaginal delivery than forceps but is associated with lower caesarean deliveries and less perineal and fetal injuries. With further testing and