NURSING MANAGEMENT OF LABOR AND BIRTH AT RISK PRECIPITOUS LABOR

NURSING MANAGEMENT OF LABOR AND BIRTH AT RISK

 PRECIPITOUS LABOR

•          Labor that last 3 hour or less from the onset of contractions to the time of delivery Risk Factors:

•          Hypertonic uterine dysfunction

o    Doesn’t allow relaxation, doesn’t contribute to progression of labor, can result tin hypoxia

•          Oxytocin stimulation

o    Increases intensity and strength of labor

•          Don’t leave pt unattended

o    Higher risk of tears, and neonatal hypoxia

o    Pant with open mouth to help control the urge to push. How to deliver a baby:

•          Suction mouth and nose when head appears

•          Deliver anterior shoulder under the maternal symphysis pubis

•          Deliver the posterior shoulder and the rest of the body should slip out

Mom is at higher risk for: hemorrhaging, tissue trauma, uterine rupture, and amniotic fluid embolism

Baby is at higher risk for: fetal hypoxia, and intracranial hemorrhage Evaluation of Possible Preterm Births Fetal fibronectin:

•          A glycoprotein made by the chorion acts as the glue attaching the fetal sac to the uterine lining.

o    Usually present in early pregnancy and then in the last trimester

o    If there has been a disruption it will rise 7-14 days before impending membrane rupture (positive result)

▪      If negative also is a string predictor that labor won't start in the next 2 weeks Cervical length measurement:

•          Cervial length and width

•          Funnel width and length

•          Percentage of funneling

Risk Factors for Dystocia #1

•          Epidural analgesia/excessive analgesia

•          Multiple gestation

•          Hydramnios

•          Maternal exhaustion

•          Ineffective maternal pushing technique

•          Occiput posterior position

•          Longer first stage of labor “labor dystocia”

o    Cook Catheter- cervical ripening balloon Cook is the name of the catheter.

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