Obstetric and Gynecological Nursing - The Carter Center

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4. Pawlick's Grip: (4 th Leopard Maneuver) The lower pole of the uterus is grasped with the right hand the midwife facing the women's head, feel the occiput and sinciput, note which is lower. Figure 15. Pwlick’s grip (Derexllewllyn-Jone,Vol.1,1990) 72
Auscultation: Check Fetal heart, rate and rhythm, count for one minute if regular. Method: Use Pinards stethoscope - hand should not touch it while listening, - ear must be in close from contact with stethoscope, Pelivic assessement - By x-ray of the pelvis - Clinical (assessing sign of contracted pelvis) - Head fitting Head fitting The head is the best pelvimeter METHOD 1: Head fitting, sitting patient, Method Let her lie on a couch, place hand on the Symphysis pubes and get the woman to sit up by her own effort. The effort should force the head in to the pelvis. METHOD 2 : Left hand grip method Grasp the fetal head with left hand and push it down wards and backwards if a sense of give is felt the head has entered and there is no over and no cephalo pelvic disproportion. Genito-Urinary System - Frequency of micturation - Check for abnormal discharge 73
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LECTURE NOTES For Nursing Students
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Preface This lecture note offers nu
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Acknowledgement My deepest apprecia
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2.3.5 Fallopian tube or uterne tube
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CHAPTER SIX : ABNORMAL PREGNANCY 12
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8.5 Subinvolution 225 Review Questi
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LIST OF FIGURES Figuer 1. Normal Fe
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ABBRIVATIONS ACTH Adreno cortico tr
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CHAPTER ONE INTRODUCTION Care of ch
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Hemorrhage, sepsis (infection), tox
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CHAPTER TWO ANATOMY OF FEMALE PELVI
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sacrum is concave and is referred t
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diamond in shape. The obstretrical
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Table 2 .Features of the four types
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The Fetal Skull The fetal head is t
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Regions of the Skull A. The occiput
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. Suboccipitofrontal 10cm from belo
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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
Page 67 and 68: Oarl cavity feels salivation Gums-
Page 69 and 70: • Creatinine and BUN decrease bec
Page 71 and 72: - Increase in the lower extermities
Page 73 and 74: - Lower part cervix and isthmus cha
Page 75 and 76: 6. Fainting: - In early pregnancy f
Page 77 and 78: women feels it at 18-20 weeks the m
Page 79 and 80: Multipara a woman who has given bir
Page 81 and 82: The Obstetric History 1. Past Obste
Page 83 and 84: Breast Examination Asses the size,
Page 85 and 86: 1.2 Fundal Palpation Purpose- To kn
Page 87: 3. Deep pelvic Palpation: (3 rd Leo
Page 91 and 92: • Rest at least 10 hrs at night a
Page 93 and 94: CHAPTER FOUR NORMAL LABOUR At the e
Page 95 and 96: - Labour is said to be established
Page 97 and 98: To assess progress of labour - Stat
Page 99 and 100: Relief of pain & promotion of comfo
Page 101 and 102: Uterine contraction - Frequency per
Page 103 and 104: advanced labour women may be assess
Page 105 and 106: Method - by abdominal palpation ide
Page 107 and 108: Eg. Partograph Name _______________
Page 109 and 110: - Caput - Sutures and Fontanelles.
Page 111 and 112: Echanism of Labour in a Normal Vert
Page 113 and 114: ERGOMETRINE: 0.5mgs. in a syringe w
Page 115 and 116: 1. Separation of the placenta Mecha
Page 117 and 118: 3. Controlled cord traction with ou
Page 119 and 120: Advantage: It allows the placenta t
Page 121 and 122: Inspect the umbilical cord a) Check
Page 123 and 124: Ergometrine Route Time to act Durat
Page 125 and 126: The guiding principles is to watch
Page 127 and 128: B. Delayed cord clamping The cord c
Page 129 and 130: - Method of delivery- spontaneous o
Page 131 and 132: 4.4. Episiotomy Definition: The mak
Page 133 and 134: 4. Lateral: The incision is begun o
Page 135 and 136: Layers to be repaired 1. Vaginal wo
Page 137 and 138: 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 -
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The mother should rest in bed. An u
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The first encounter may not result
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The degree of haemolysis and the nu
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Transmission of infection to the fe
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Post natal care Separation of the b
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giving several short pushes during
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- Maternal hyperglycemia should be
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Review Questions 1. List the differ
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All ill fitting part is associated
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On auscultation The fetal heart bea
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cord prolapse). - Sedation often ne
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up gently delivery slowly taking 2
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Diagnosis On palpation - the head i
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Complications Maternal Fetal - Obst
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make sure no cord prolapsed and to
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If diagnosed during the first stage
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Management Encourage the mother to
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7.2.1 Atonic Postpartum Hemorrhage
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Cause - Delivery through partially
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Management of Severe PPH in a Healt
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Cause in 1 st stage 1) In-efficient
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4 Reduced pelvic out let. A forceps
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- If the fetus is not alive and the
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Methods of determining C.P.D. 1. De
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3 Placenta percrata- through muscle
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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
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Review Questions 1. What are the co
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More severe infection may consist o
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Prevention The best method of treat
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Managing Puerperal sepsis 1. Isolat
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8.5 Subinvolution Sub involution is
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CHAPTER NINE INDUCTION OF LABOUR At
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Table 6 .Bishops Score System Induc
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- Fluid balance chart - Urine test
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Nipple stimulation, which releases
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Conditions in which trial of scar i
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CHAPTER TEN OBSTETRIC OPERATIONS At
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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
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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
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In those persons with recurrent les
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Presentation Sign and symptom A wom
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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
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Local disorders of the genital trac
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. Missed abortion This is the term
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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
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cervical canal and are multiple. Th
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Vulval Cysts Bartholin’s cyst- It
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GLOSSARY Abortion Termination of pr
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Intra uterine growth retardation Fe
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