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Contractions more frequent, but intensity decreases. Contractions are painful, but ineffective in dilating and effacing the cervix, and a prolonged latent phase may result.
Prolonged contractions can result in fetal _______.
Bed rest and sedation to promote relaxation and reduce pain.
Management of hypertonic labor.
Pitocin infusion or amniotomy
If the hypertonic pattern continues and develops into a prolonged latent phase, what may be considered?
A hypotonic labor pattern usually develops in what phase of labor?
Characterized by < 2-3 contractions in a 10-minute period.
May occur when the uterus is overstretched from a twin gestation, or in the presence of a large fetus, hydraminios, fetal malposition, prematurity, or grand multiparity.
Important to asses for what with hypotonic labor?
Pitocin or amniotomy
During hypotonic labor contractions can be stimulated with?
Length of precipitous labor
Contributing factors include multiparity, large pelvis, previous kind of labor, and a small fetus.
1 day over 42 wks
Determination of post term pregnancy
Decreased perfusion from the placenta, Oligohydraminios, (which increases risk of cord compression), Meconium aspiration
Fetal risks associated with post term pregnancy
Non-stress Test & Biophysical Profile (BPP)
After completion of 40 wk gestation and birth has not occurred, what tests are used as assessment tools to determine fetal well-being?
Put mother in lateral sims position
What can be done to help turn the baby when in a persistent occiput posterior position?
Newborn weight of more than 4000 g at birth
Macrosomia is defined as?
CPD and shoulder dystocia
Macrosomia causes an increase risk of?
Uterine pain. Uterus feels rock solid.
Precipitating factors of Abruptio Placentae
Decrease fibrinogen level, decrease platelet count, and increase prothrombin/thromboplastin times
DIC does what to fibrinogen level, platelet count, and prothrombin/thromboplastin times?
Short of breath, usually seen in stage 2 (pushing stage) - emergency
1st sign of amniotic fluid embolism
~38 weeks; risks include labor, fetal distress (cord entanglement)
When to do external version and risks involved.
Prolapsed cord; infection
Risks of amniotomy
Prostaglandins for cervical ripening
Cervidil, Perpidil, Cytotec
Technique that can be used to relieve cord compression.
Maternal heart disease, pulmonary edema, infection and exhaustion.
Conditions that may indicate need for forceps
Could cause cephalohematoma - assess for jaundice
#1 risk of vacuum extraction & what to assess for
C/S puts later pregnancies at risk for what?
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