Labor, Delivery, and Post-Partum Care
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What is the tx for pre-term labor?
- Mg sulfate
- Nifedipine (used most)
What is the purpose of tx for pre-term labor?
to allow time for administration of corticosteroids and transfer to another facility if needed
What is the tx for labor induction?
Oxytocin (pitocin - most used)
What is the tx for labor pain?
- IV narcotics (meperidine, morphine, fentanyl)
- Epidural (fentanyl and/or bupivacaine)
- Spinal analgesia
- Nerve block
What is the tx for group B Strep infection in pregnancy?
- Pen G
What is the non-pharmacological tx for labor pain?
- Labor support via doula/nurse, other caregiver
- Warm water bath
- Intradermal injections of sterile water
What are the non-pharmacological tx to induce labor?
What is the tx for post-partum depression?
- SSRI (DOC, esp. Sertraline)
What are the benefits of breastfeeding for the infant?
- Optimal source of nutrition
- Complete composition of nutrients, growth factors, enzymes, immune factors, and hormones
- May decrease infection rate
- Decrease allergies, otitis media, lymphoma, and gastroenteritis
- Decreased incidence of constipation
- May improve cognitive function later in life
- Enhanced maternal bonding
What are the benefits of breastfeeding for the mother?
- Faster recovery from pregnancy
- Faster wt reduction
- Decreased chance of breast and ovarian cancer
- Decreased chance of osteoporosis
- Postponement of menses
- Economic benefit
- Enhanced bonding
What factors affect drug tx during lactation?
- Drug dose and duration
- Route and frequency
- Maternal metabolism
- Maternal clearance
- Blood flow to breasts
- Milk pH
- Milk composition
- Maternal plasma level
- Molecular weight
- Lipid solubility
- Protein binding
- Age of baby
- Feeding pattern of baby
- Amount of milk ingested
- Drug ADME of baby
What are some ways to reduce infant exposure to drugs during breastfeeding?
- Drug selection
- Avoid nursing during peak drug concentration
- Plan feeding before next dose
- Take qd meds at night or during longest sleeping period
What would you like to do?
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