Cesarean Section - Indications
- Active Genital Herpes Infection
- Cervical Cancer
- Eclampsia (Preeclampsia)
- History of Uterine Surgery
- History of C-section (Vertical)
- Malpresentation
- Fetal Distress
- Cord Compression/Prolapse
- Failed Vaginal Delivery
- Cephalopelvic Disproportion
- Abruptio Placentae or Placenta Previa
Placenta Previa
- Placenta Covers Cervical Os
- Painless
- Bright Red Vaginal Bleeding
- Stable Fetus
- Bed Rest
- Observation
- Unstable Fetus
- C-section Delivery
- Risk for Shock
- Magnesium Sulfate
- Tocolysis
Abruptio Placentae
- Premature Separation of Placenta
- Tearing Pain
- Bleeding (Often Concealed)
- Rigid Uterus
- Contractions
- Prepare for Vaginal Delivery
- Increased Risks for Neonate
- Rh (Rhesus) Incompatibilities
- Increased Risk for Shock
- Monitor Fetal Heart Rate
Mechanism of Labor
- Engagement
- Descent
- Flexion
- Internal Rotation
- Extension
- External Rotation (Restitution)
- Expulsion of Infant
Induction of Labor
- Premature Rupture of Membranes
- Danger to Fetus or Mother
- Prolonged Gestation
- Placenta Abnormalities
- Transverse Fetal Position
- Prolapsed Umbilical Cord
- Active Genital Herpes Infection
- Uterine Muscle Incision
- Hemorrhage
True vs. False Labor
- Bloody Show
- Regular, Strong Contractions
- Progressive Effacement and Dilation
- Engagement of Presenting Part
- Irregular Contractions
- Cervix Soft
- No Engagement of Presenting Part
Premature Rupture of Membranes (PROM)
- Rupture > 1 Hour Before Labor
- Infection
- PROM History
- Incompetent Cervix
- Fern Test
- Nitrazine Paper Test
- Ultrasound
- Consider Tocolytics
- Consider Antibiotics
- < 34 Weeks Gestation
- Corticosteroids
- > 34 Weeks Gestation
- Induction of Labor
Prolapsed Umbilical Cord
- Cord Prolapses
- Visualization of Cord
- Prolonged or Variable Decelerations
- Hips Elevated
- Insert 2 fingers in Vagina
- Saline Towel on Cord
- Oxygen
Incompetent Cervix
- Premature Cervical Dilation
- Recurring Miscarriage
- Short Cervix
- Cervical Cerclage
- Rest
- Labor
Decelerations (and Accelerations) Overview
- VEAL CHOP
- Variable Deceleration
- Cord Compression
- Early Deceleration
- Head Compression
- Acceleration
- Okay
- Late Deceleration
- Placental Insufficiency
Early Decelerations
- Fetal Head Compression
- Uterine Contractions
- Placement of Internal Mode of Monitoring
- Vaginal Examination
- Fundal Pressure
- Normal Pattern
Variable Decelerations
- Umbilical Cord Compression
- Abnormal Cord Position
- Transition Phase
- Oxygen with Non-Rebreather (8-10 L/min)
- Change Maternal Position
- Discontinue Oxytocin
Late Decelerations
- Uteroplacental Insufficiency
- Disruption of Oxygen Transfer to Fetus
- Abnormal Pattern
- Discontinue Oxytocin
- Oxygen with Non-Rebreather (8-10 L/min)
- Side-lying Position
- Elevate Legs
- Increase Rate of IV Solution
Vasa Previa
- Fetal Vessels Over Internal Cervical Os
- Velamentous Umbilical Cord Insertion
- Placental Abnormalities
- Multiparity
- Rupture of Membranes
- Painless Vaginal Bleeding
- Fetal Distress
- Doppler Ultrasound
- Emergency Cesarean Delivery