Obstetric and Gynecological Nursing - The Carter Center

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7.1.5 Unstable lie 189 7.1.6. Compound or Complex Presentation 190 7.1.7 Occupitio- Posteririor Position 191 7.2. Post partum Hemorrhage 193 7.2.1 Atonic Postpartum Hemorrhage 195 7.2.2 Traumatic Post Partum Hemorrhage 196 7.2.3 Hypo Fibrinogenaemia 197 7.3. Prolonged Labour 200 7.4 Prolapse of Cord 203 7.5 Cephalopelvic Disproportion 205 7.6 Contracted Pelvis 206 7.7 Retained Placenta 207 7.8 Adherent Placenta 208 7.9 Rupture of the Uterus 209 7.10 Lacerations 213 7.11 Premature Rupture of the Membrane 215 (PROM) Review Questions 226 CHAPTER EIGHT : ABNORMAL PUERPERIUM 218 8.1 Urinary Complications 218 8.2 Breast Infections 219 8.2.1 Acute Puerperal Mastitis 219 8.2.2 Breast Abscess 220 8.3 Puerperal Sepsis 221 8.4. Puerperal Psychosis 223 viii
8.5 Subinvolution 225 Review Questions 226 CHAPTER NINE : INDUCTION OF LABOUR 227 9.2 Augmentation (Stimulation) Of Labour 232 9.3 Trial of Labour 233 Review Questions 236 CHAPTER TEN : OBSTETRIC OPERATIONS 237 10.1 Forceps Delivery 237 10.2 Caesarean Section 243 10.3 Destructive Operations /Embryotomy/ 246 10.4 Version 248 10.4.1 Internal Version 248 10.4.2 External Cephalic Version 249 10.5 Vacuum Extraction / Ventouse delivery/ 250 Review Questions 252 CHAPTER ELEVEN : CONGENITAL ANOMALIES 253 OF THE FEMALE GENITAL ORGANS 11.1 Uterine Abnormalities 254 11.2 Cervix Abnormalities 155 11.3 Vaginal Abnormalities 257 Review Questions 258 ix
Page 1 and 2: LECTURE NOTES For Nursing Students
Page 3 and 4: Preface This lecture note offers nu
Page 5 and 6: Acknowledgement My deepest apprecia
Page 7 and 8: 2.3.5 Fallopian tube or uterne tube
Page 9: CHAPTER SIX : ABNORMAL PREGNANCY 12
Page 13 and 14: LIST OF FIGURES Figuer 1. Normal Fe
Page 15 and 16: ABBRIVATIONS ACTH Adreno cortico tr
Page 17 and 18: CHAPTER ONE INTRODUCTION Care of ch
Page 19 and 20: Hemorrhage, sepsis (infection), tox
Page 21 and 22: CHAPTER TWO ANATOMY OF FEMALE PELVI
Page 23 and 24: sacrum is concave and is referred t
Page 25 and 26: diamond in shape. The obstretrical
Page 27 and 28: Table 2 .Features of the four types
Page 29 and 30: The Fetal Skull The fetal head is t
Page 31 and 32: Regions of the Skull A. The occiput
Page 33 and 34: . Suboccipitofrontal 10cm from belo
Page 35 and 36: Figure 6 . Female external genitali
Page 37 and 38: Position:- In the non-pregnant fema
Page 39 and 40: • Round ligament - Ligaments form
Page 41 and 42: • provides a site for fertilizati
Page 43 and 44: maturation of reproductive organs a
Page 45 and 46: Thispain, called mitlelschmerz may
Page 47 and 48: 2.5. The Breast Anatomy The female
Page 49 and 50: Amplulla: the widened-out portion o
Page 51 and 52: Review Questions 1. List different
Page 53 and 54: the ampullar portion. The functiona
Page 55 and 56: Blastocyst Trophoblast Inner cell m
Page 57 and 58: penetrate. Viruses, however, can cr
Page 59 and 60: Figure 10 . The fetal circulation (
Page 61 and 62:
Appearance of the Placenta at Term
Page 63 and 64:
Identification On inspection, the p
Page 65 and 66:
Placenta infarction Placental infar
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Oarl cavity feels salivation Gums-
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• Creatinine and BUN decrease bec
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- Increase in the lower extermities
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- Lower part cervix and isthmus cha
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6. Fainting: - In early pregnancy f
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women feels it at 18-20 weeks the m
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Multipara a woman who has given bir
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The Obstetric History 1. Past Obste
Page 83 and 84:
Breast Examination Asses the size,
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1.2 Fundal Palpation Purpose- To kn
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3. Deep pelvic Palpation: (3 rd Leo
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Auscultation: Check Fetal heart, ra
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• Rest at least 10 hrs at night a
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CHAPTER FOUR NORMAL LABOUR At the e
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- Labour is said to be established
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To assess progress of labour - Stat
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Relief of pain & promotion of comfo
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Uterine contraction - Frequency per
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advanced labour women may be assess
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Method - by abdominal palpation ide
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Eg. Partograph Name _______________
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- Caput - Sutures and Fontanelles.
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Echanism of Labour in a Normal Vert
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ERGOMETRINE: 0.5mgs. in a syringe w
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1. Separation of the placenta Mecha
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3. Controlled cord traction with ou
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Advantage: It allows the placenta t
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Inspect the umbilical cord a) Check
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Ergometrine Route Time to act Durat
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The guiding principles is to watch
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B. Delayed cord clamping The cord c
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- Method of delivery- spontaneous o
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4.4. Episiotomy Definition: The mak
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4. Lateral: The incision is begun o
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Layers to be repaired 1. Vaginal wo
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CHAPTER FIVE THE NORMAL PUERPERIUM
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Lochia- discharge from the uterus d
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5.2 Management of the Puerperium An
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answer her questions and through ou
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CHAPTER SIX ABNORMAL PREGNANCY At t
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One fetus may be died and be retain
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Management of Pregnancy - Early dia
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are labeled as ‘ Twin one ‘ and
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a) Both twins presenting by the ver
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- The urine will smell of acetone,
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The liver is affected in sever case
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Moderate - Preeclampsia is usually
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Management during labour The nurse/
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35% with in the first few hours aft
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- The volume of urine and the album
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Type 1 placenta praevia - The major
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Diagnosis - Using ultrasonic scanni
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Complications • Post partam haemo
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If the blood loss is revealed; More
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- Rarely, Rhesus- isoimmunization -
Page 177 and 178:
The mother should rest in bed. An u
Page 179 and 180:
The first encounter may not result
Page 181 and 182:
The degree of haemolysis and the nu
Page 183 and 184:
Transmission of infection to the fe
Page 185 and 186:
Post natal care Separation of the b
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giving several short pushes during
Page 189 and 190:
- Maternal hyperglycemia should be
Page 191 and 192:
Review Questions 1. List the differ
Page 193 and 194:
All ill fitting part is associated
Page 195 and 196:
On auscultation The fetal heart bea
Page 197 and 198:
cord prolapse). - Sedation often ne
Page 199 and 200:
up gently delivery slowly taking 2
Page 201 and 202:
Diagnosis On palpation - the head i
Page 203 and 204:
Complications Maternal Fetal - Obst
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make sure no cord prolapsed and to
Page 207 and 208:
If diagnosed during the first stage
Page 209 and 210:
Management Encourage the mother to
Page 211 and 212:
7.2.1 Atonic Postpartum Hemorrhage
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Cause - Delivery through partially
Page 215 and 216:
Management of Severe PPH in a Healt
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Cause in 1 st stage 1) In-efficient
Page 219 and 220:
4 Reduced pelvic out let. A forceps
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- If the fetus is not alive and the
Page 223 and 224:
Methods of determining C.P.D. 1. De
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3 Placenta percrata- through muscle
Page 227 and 228:
2. Tonic contraction and Bandl’s
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Condition of the baby - Usually sti
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3. Control head, keep it flexed, so
Page 233 and 234:
Review Questions 1. What are the co
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More severe infection may consist o
Page 237 and 238:
Prevention The best method of treat
Page 239 and 240:
Managing Puerperal sepsis 1. Isolat
Page 241 and 242:
8.5 Subinvolution Sub involution is
Page 243 and 244:
CHAPTER NINE INDUCTION OF LABOUR At
Page 245 and 246:
Table 6 .Bishops Score System Induc
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- Fluid balance chart - Urine test
Page 249 and 250:
Nipple stimulation, which releases
Page 251 and 252:
Conditions in which trial of scar i
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CHAPTER TEN OBSTETRIC OPERATIONS At
Page 255 and 256:
Indication for forceps delivery - F
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In the infant: Bruising: Severe bru
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10.2 Caesarean Section Caesarean se
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Possible indications include: - The
Page 263 and 264:
types of decapitating hooks and kni
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procedure is extremely rare in cont
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- The head must be engaged. - The w
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CHAPTER ELEVEN CONGENITAL ANOMALIES
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A single remiuterus results when on
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E. Persistence of male (Wolffcan) d
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CHAPTER TWELVE INFECTION OF THE FEM
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Sign Major Minor Cervical motion Ab
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- Gentamycin iv or in loading dose
Page 281 and 282:
In those persons with recurrent les
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Presentation Sign and symptom A wom
Page 285 and 286:
Risk Factor Studies have indicates
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ecto vaginal fistula. Other types m
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12.6 Prolaps of the Uterus A descen
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- If no symptoms are present and th
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Forced inversion caused by excessiv
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therapy may be initiated to prevent
Page 297 and 298:
Local disorders of the genital trac
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. Missed abortion This is the term
Page 301 and 302:
The membranes may have ruptured and
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operation. Many mothers do not make
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I. Septic abortion Infection may oc
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Dysmenorrhea Definition-Dysmenorrhe
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esult from tension, anxiety (stress
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Implantation may occur in the fimbr
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the rupture is on the mesenteric si
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Diagnosis - The presence of interna
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Causes of infertility Female - Vagi
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Benign A. Fibrocystic breast diseas
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- Pain in the breast - Blood staine
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Treatment - Oestrogen - Progesteron
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E. Gently squeeze the nipple of eac
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- Poor uterine contraction - Subinv
Page 329 and 330:
cervical canal and are multiple. Th
Page 331 and 332:
Vulval Cysts Bartholin’s cyst- It
Page 333 and 334:
GLOSSARY Abortion Termination of pr
Page 335 and 336:
Intra uterine growth retardation Fe
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Obstetric and Gynecological Nursing - The Carter Center

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