The document discusses three obstetric complications: precipitate labor, uterine inversion, and uterine rupture. Precipitate labor occurs in 3 hours or less and carries risks for both mother and baby. Uterine inversion involves turning of the uterus inside out, usually after delivery. It requires immediate treatment to replace fluid loss and relax the uterus. Uterine rupture is a complete or partial tear of the uterine wall during labor, often from a previous C-section scar. It requires emergency surgery to control bleeding and repair the rupture.
The document discusses three obstetric complications: precipitate labor, uterine inversion, and uterine rupture. Precipitate labor occurs in 3 hours or less and carries risks for both mother and baby. Uterine inversion involves turning of the uterus inside out, usually after delivery. It requires immediate treatment to replace fluid loss and relax the uterus. Uterine rupture is a complete or partial tear of the uterine wall during labor, often from a previous C-section scar. It requires emergency surgery to control bleeding and repair the rupture.
The document discusses three obstetric complications: precipitate labor, uterine inversion, and uterine rupture. Precipitate labor occurs in 3 hours or less and carries risks for both mother and baby. Uterine inversion involves turning of the uterus inside out, usually after delivery. It requires immediate treatment to replace fluid loss and relax the uterus. Uterine rupture is a complete or partial tear of the uterine wall during labor, often from a previous C-section scar. It requires emergency surgery to control bleeding and repair the rupture.
Refers to labor that lasts 3 hours or less Encourage the woman to relax as possible More common in multiparous patients and in women who have Explain all procedures and received oxytocin induction or treatments being initiated. amniotomy. Instruct the woman with a history of The mother is at risk for hemorrhage precipitate labor that it may occur secondary to premature separation with future pregnancies; advise to of the placenta and for lacerations plan for such an occurrence in due to the force and rapidity of the advance. birth. UTERINE INVERSION Causes: The inverted fundus may lie within Lack of maternal tissue resistance to the uterine cavity of the vagina or, in the passage of the fetus. total inversion, protrude from the vagina. ** The fetus is at risk for subdural hematoma, possibly from the rapid Causes : release of pressure on the fetal head. May occur after the birth of the Assessment Findings : neonate, especially if traction is applied to the uterine fundus when Strong uterine contractions with the uterus is not contracted. signs of premature placental separation. May also occur when the placenta is inserted at the fundus, during birth Treatment : the passage of the fetus pulls the A tocolytic may be administered to fundus down. reduce the strength and frequency Assessment Findings : of the contractions. A large sudden gush of blood from Plans for immediate delivery are the vagina. necessary.(CS) Non-palpable fundus in the Nursing Interventions: abdomen Provide emotional and physical Signs and symptoms of shock if the support to the woman and family. loss of blood continues unchecked for more than few minutes Hypotension Assist with the measures to relax the uterus Pallor Provide emotional support and dizziness and diaphoresis explaination what's happening and Possible exsanguination if bleeding procedures being done continues unchecked Be prepared to perform CPR if the Treatment : woman's heart fails from the sudden blood loss. IV fluids and blood component therapy to replace fluid volume and Anticipate administering antibiotic as blood loss ordered
General anesthesia, or tocolytic may UTERINE RUPTURE
be administered to relax the uterus Occurs when the uterus undergoes Due to uterine exposure, antibiotic is more strain than it's capable of indicated postpartally sustaining and then ruptures.
As a last resort, the patient may Rupture can be complete, going
require an emergency hysterectomy. through endometrium, myometrium, and peritoneum, or incomplete, Nursing Interventions : leaving the peritoneum intact.
Initiate IV therapy as ordered – if the Causes :
woman has an IV line in place, increased the flow rate to achieve Usually occurs from a previous optimal flow of fluid to restore fluid cesarean birth, such as when a volume. vertical scar from a previous incision is present. Administer oxygen by mask as ordered Can also occur from hysterectomy repair. Keep in mind that administering an oxytoxic only compounds the Other causes include : inversion prolonged labor, faulty Never attempt to remove the presentation, multiple gestation, placenta if it's still attached because use of oxytocin, traumatic this will create more bleeding. maneuvers using forceps or traction. Monitor VS at least every 15 minutes. Assessment Findings : Indentation appearing across the Anticipate the use of IV oxytocin to abdomen over the uterus contract the uterus and minimize (pathologic retraction ring) bleeding.
Strong uterine contractions without Prepare the woman for a possible
any cervical dilation. laparotomy as an emergency measure – explanation is necessary. Indications of complete uterine rupture If applicable, offer emotional support for the loss of this child or loss of sudden, severe pain during a future children (if hysterectomy or strong labor contraction tubal ligation is performed).
report of a tearing sensation Allow them to express their
emotions without feeling threatened. cessation of uterine contractions
hemorrhage
Treatment :
Focuses on the following measures :
Fluid replacement
IV oxytocin to contract the uterus
and minimize bleeding
A cesarean birth will be done to
ensure safety of neonate
Manual removal of the placenta
under general anesthesia may be necessary.
A laparotomy may be necessary as
an emergency measure to control bleeding and repair the rupture; hysterectomy or tubal ligation may be performed.