Episotomy = 2nd most common surgical procedure - #1 = cutting umbilical cord

Risks:Increase of :3rd & 4th degree lacerationsPost perineal painRisk of infectionPain & edema which may inhibit urination & defecationRisk of blood lossRisk of persistent dyspareunia or painful intercoursePsychological depressionHealth care cost

EpisiotomyWhich type ?

Perineal lacerations: 1st degree = involving skin or vaginal mucosa BUT NOT into

muscle2nd degree = extending from skin & vaginal mucosa into m

muscles of perineum3rd degree = extending from skin, vaginal muscosa into the a

anal sphincter4th degree = extending through the rectal mucosa into the

lumen of the rectum

Cervical / Vaginal TearsHematomas

PARTURITION

R=Right L=LeftRSA = Frank breechROP = Occiput posteriorRMA = Mentum anteriorROA = Occiput anterior

LSA = Complete breechLOP = Occiput posteriorLMA = Mentum anteriorLOA = occiput anterior

Intermittent vs continuous? What if mom says I don’t won’t a monitor?

EXTERNAL INTERNAL WHAT’S DIFFERENT ??

WHAT WOULD BE SOME CAUSES ??TACHYCARDIA - THAT WOULD BE INFLUENCED BY MOM

Uterus may becomeichemic duringContractions

Which one is moreOf an ominous sign?

What do you as RNDo?

Change mom positionCheck BPIncrease IVStop PitO2 Call doctor

1.

2.

3.4.

5.

of fetal

& late recovery uterine

Suctioning ofneonate beforetakes first breath - Why ??

WHEN INTERFER - MORE THINGS CAN GO WRONG

SCORE OF 6 OR MORE = 95% SUCCESSFUL INDUCTION

When is prostaglandins contraindicated ?If client has history ofasthma attacks

Cord prolapse - what should you check ? Further interventionAmnionitis or chorioamnionitis

What complications mayOccur ?

CONTRACTION ON PITOCIN

Pitocin

RISKS TO MOM ?

LACERATIONSHEMATOMAIN VAGINAL -CERVICAL AREA

RISKS TO BABY ?

ECCHYMOSISLACERATIONSCEPHALHEMATOMACAPUT SUCCEDANEUMCHIGNON

Reasons for C-Section

C-Section incision on outside does not determineWhat the incision on the uterus is

ADD UTERUS & CONCERNS AS ANY DELIVERY – POSTPARTUM CARE