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