purpose of an amniotomy
-enables elctronic fetal monitoring
what is the first thing we do after performing amniotomy
assess FHR
risks of performing amniotomy
- prolapse and compression of the cord
- risk of infec incr the longer membranes have been ruptured
- abruptio placenta
what is abruptio placenta
when the placenta pulls apart from the wall of the uterus
indications for performing an amniotomy
- fetal compromise (IUGR, Rh incompatibility)
- SROM near term
- post term preg
- chorioamniotitis
- HTN a/w preg
- maternal medical conditions (pre-eclampsia)
- fetal death
def chorioamniotitis
infec of the chorion
when the AFI is low, what does that indicate?
the placenta is not functioning at its max capacity anymore
contraindications for amniotomy
- placenta previa
- vasa previa
- abnormal presentation
- cord prolapse
- prev uterine surgery
- non reassuring FHR patterns
why is previous uterine surgery contraindicated for amniotomy
risk of there being a weakness in the uterine wall
other methods of induction/augmentation of labor
- cervical ripening
- oxytocin admin
what is cervadil and how does it work
- looks like a tampon
- mom admitted to antepartum and monitored overnight
- ripens cervix
what natural material contains prostaglandins
sperm
how does a transcervical cath work?
-foley cath and open up balloon
what should be done before inserting transcervical cath
admin pain meds
how is oxytocin administered for induction of labor
-diluted as an isotonic solution and given as a secondary infusion
when can oxytocin not be given and why
if the cervix is not ripened
- baby runs the risk of going into distress
def external version
promotes vaginal birth by changing fetal presentation from a breech or transverse lie to a cephalic lie
def internal version
changing the position of a second twin after the birth of a first twin
what meds is mom given before external version
tocolytics
what is immediately done following external version
assess FHR
what risks are a/w external version
- cord prolapse
- premature labor due to softened cervix
- nuchal cord
maternal trauma a/w operative delivery
- vaginal wall laceration
- hematoma
infant trauma a/w operative delivery
ecchymosis lacerations abrasions facial nerve injury/ auditory nerve injury intracranial hemorrhage CP - if severe
what two methods care considered operative vaginal birth
- forceps
- vacuum extractor
