EMT-Chapter 37-Obstetrics and Care of the Newborn
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The mucus that are expelled from the vagina as labor begins.
The fetal organ through which the fetus exchanges nourishment and waste products during pregnancy.
The placenta and other tissues that are expelled immediately after the birth of a child.
- An extension of the placenta through which the fetus receives nourishment.
- Covered by a protective substance called the wharton jelly.
membrane that forms the sac that hold the fetus suspended in the amniotic fluid.
When the fetus head appears at the vaginal opening.
- First trimester: week 1 to 12
- Second trimester: week 13 to 27
- Third trimester: week 28 to 40
The period of pregnancy prior to the onset of labor.
Without apparent cause, the termination of a pregnancy before the fetus reaches the stage of viability, generally before the 20th week of pregnancy. Also called miscarriage.
- Abnormal implantation of the placenta over or near the opening of the cervix. Three types.
- Total: placenta completely covers the os.
- Partial: covers partial of the cervix
- Marginal: implanted near the neck.
- Abnormal separation of the placenta from the uterine wall prior to birth. Two types.
- Complete: complete abruption
- Partial: partially torn
Anywhere the fertilization occurs that is not in the fallopian tube and fertilized egg is not embedded in the uterus.
Pregnancy Induced Hypertension(PIH)
High blood pressure associated with pregnancy.
Supine Hypotensive Syndrome
Inadequate return of the venous blood to the heart, reduced cardiac output, and lowered blood pressure resulting from pressure on the inferior vena cava by the uterus and the fetus when a patient in late pregnancy is supine.
Secondary Assessment for Antepartum Emergency
- Have you been pregnant before?
- If so how many? (Gravida-pregnancies, para-births)
- How many resulted in live births?
- Were they vaginal or by C-sec?
- Any complications with any of the births?
- Any pain or discomfort?
- Can you point out where the pain is?
- Duration of pain or cramps?
- How often do the cramps occur?
- Last period?
- The physiological process by which the fetus is expelled from the uterus in to the vagina and then outside the body.
- Stage 1: Dilation-contractions last 30-60sec, 20-30min apart, to 3-4min apart, lasting at least 60sec
- Braxton-Hicks Contractions-false labor, painless, short
- Stage 2: Expulsion
- Stage 3: Placental
The area of skin between a female's vagina and anus.
An umbilical cord that is wrapped around the infant's neck.
The period of time from the onset of labor to delivery of the infant.
When the umbilical cord, rather than the head of the fetus, is the first part to protrude from the vagina.
- A common abnormality of delivery in which the fetal buttocks or lower extremities are low in the uterus and are the first to be delivered.
- 1. Position the mother with her buttocks and the edge of a firm surface or bed
- 2. Have her hold her logs in a flexed positions
- 3. As the infant delivers, do not pull on the legs, but support them.
- 4. Allow the entire body to be delivered as you simply support it. Continue with care for the neonate as in the normal delivery.
- When an arm or leg is the first fetal part to protrude from the vaginal opening.
- 1. Have the patient's pelvis elevated
- 2. Call ALS and immediate transport
- A greenish or brownish yellow staining of the amniotic fluid, caused by a fetal bowel movement resulting from distress.
- Fetus has gone through an hypoxic event.
- Immediate and aggressive suction.
- An infant weighing less than 5lbs, or an infant born before the 38th week.
- Extremely careful care, blow by O2
Gestation beyond 42 weeks.
When gestation beyond 42 weeks leads to reduced O2 and nutrient delivery to the fetus.
- Birth of the fetus after less than 3hrs of labor.
- Usually occurs in women with multipara.
When the fetal head delivers but the shoulders are too large to deliver.
Labor that occurs after the 20th but prior to the 37th week.
Premature Rupture Of the Membranes(PROM)
Spontaneous rupture of the amniotic sac prior to true labor and before the end of the 37th week.
The period following delivery of the infant.
The loss of greater than 500ml of blood following delivery.
Assessment of Newborn
- 1. Appearance: cynaotic(0pt), blue feet and arms but pink trunk(1pt), good and pink(2pts)
- 2. Pulse: no pulse(0pt), under 100(1pt), over 100(2pts)
- 3. Grimace: no reflexive activity to stimulation(0pt), some facial grimace(1pt), cough sneeze or cry (2pt)
- 4. Activity: limp and displays no extremity movements(0pts), only displays flexation without any active movemen(1pt), actively moving(2pts)
- 5. Respiration: no respiratory effort(0pt), slow irregular with a weak cry(1pt), good respirations strong cry(2pt)
- 7-10pt: regular routine care
- 4-6pt: provide stimulation and O2
- 0-3: Extensive care, PPV, blow by O2, CPR if needed
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