EMT-Chapter 37-Obstetrics and Care of the Newborn

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EMT-Chapter 37-Obstetrics and Care of the Newborn
2013-07-22 13:43:32
emt obgyn newborn

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  1. Bloody Show
    The mucus that are expelled from the vagina as labor begins.
  2. Placenta
    The fetal organ through which the fetus exchanges nourishment and waste products during pregnancy.
  3. Afterbirth
    The placenta and other tissues that are expelled immediately after the birth of a child.
  4. Umbilical Cord
    • An extension of the placenta through which the fetus receives nourishment.
    • Covered by a protective substance called the wharton jelly.
  5. Amniotic Sac
    membrane that forms the sac that hold the fetus suspended in the amniotic fluid.
  6. Crowning
    When the fetus head appears at the vaginal opening.
  7. Trimester
    • First trimester: week 1 to 12
    • Second trimester: week 13 to 27
    • Third trimester: week 28 to 40
  8. Antepartum
    The period of pregnancy prior to the onset of labor.
  9. Spontaneous Abortion
    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.
  10. Placenta Previa
    • 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.
  11. Abruptio Placentae
    • Abnormal separation of the placenta from the uterine wall prior to birth. Two types.
    • Complete: complete abruption
    • Partial: partially torn
  12. Ectopic Pregnancy
    Anywhere the fertilization occurs that is not in the fallopian tube and fertilized egg is not embedded in the uterus.
  13. Pregnancy Induced Hypertension(PIH)
    High blood pressure associated with pregnancy.
  14. 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.
  15. Secondary Assessment for Antepartum Emergency
    • SAMPLE
    • OPQRST
    • 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?
  16. Labor
    • 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 60secĀ 
    • Braxton-Hicks Contractions-false labor, painless, short
    • Stage 2: Expulsion
    • Stage 3: Placental
  17. Perineum
    The area of skin between a female's vagina and anus.
  18. Nuchal Cord
    An umbilical cord that is wrapped around the infant's neck.
  19. Intrapartum
    The period of time from the onset of labor to delivery of the infant.
  20. Prolapsed Cord
    When the umbilical cord, rather than the head of the fetus, is the first part to protrude from the vagina.
  21. Breech Birth
    • 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.
  22. Limb Presentation
    • 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
  23. Meconium Staining
    • 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.
  24. Premature Infant
    • An infant weighing less than 5lbs, or an infant born before the 38th week.
    • Extremely careful care, blow by O2
  25. Postterm Pregnancy
    Gestation beyond 42 weeks.
  26. Postmaturity Syndrome
    When gestation beyond 42 weeks leads to reduced O2 and nutrient delivery to the fetus.
  27. Precipitous Delivery
    • Birth of the fetus after less than 3hrs of labor.
    • Usually occurs in women with multipara.
  28. Shoulder Dystocia
    When the fetal head delivers but the shoulders are too large to deliver.
  29. Preterm Labor
    Labor that occurs after the 20th but prior to the 37th week.
  30. Premature Rupture Of the Membranes(PROM)
    Spontaneous rupture of the amniotic sac prior to true labor and before the end of the 37th week.
  31. Postpartum
    The period following delivery of the infant.
  32. Postpartum Hemorrhage
    The loss of greater than 500ml of blood following delivery.
  33. 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