When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina. Placenta previa happens in about 1 in 200 pregnancies.
Placenta praevia risk factors include a previous delivery, age older than 35 and a history of previous surgeries, such as a caesarean section (C-section) or uterine fibroid removal.
The main symptom is bright red vaginal bleeding without pain during the second-half of pregnancy. The condition can also cause severe bleeding before or during delivery.
Limited physical activity is recommended. A C-section is often required in severe cases.
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina. Placenta previa happens in about 1 in 200 pregnancies.
Placenta praevia risk factors include a previous delivery, age older than 35 and a history of previous surgeries, such as a caesarean section (C-section) or uterine fibroid removal.
The main symptom is bright red vaginal bleeding without pain during the second-half of pregnancy. The condition can also cause severe bleeding before or during delivery.
Limited physical activity is recommended. A C-section is often required in severe cases.
Maternal Care: The first stage labour Monitoring and managementSaide OER Africa
Maternal Care addresses all the common and important problems that occur during pregnancy, labour, delivery and the puerperium. It covers: the antenatal and postnatal care of healthy women with normal pregnancies, monitoring and managing the progress of labour, specific medical problems during pregnancy, labour and the puerperium, family planning, regionalised perinatal care
Series of events that takes place in the genital organ in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called labour.
there are four stages of labour.
Emergencies that occur in pregnancy or during or after labor and delivery.
main emergencies are
Ectopic Pregnancy
Uterine Inversion
Obstetrical Shock
Cord Prolepses
Amniotic Fluid Embolism
Postpartum Hemorrhage
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
3. Introduction
Labor : Uterine contractions resulting in progressive
dilation and effacement of the cervix and
accompanied by descent and expulsion of the fetus.
Abnormal labor, dystocia, and failure to progress are
terms used to describe a difficult labor pattern
Approximately 20 % of labors involve dystocia
4. Stages of labor
NORMAL LABOR — divided into Four stages
First stage: time from the onset of labor until
complete cervical dilatation
Second stage: time from complete cervical dilatation
to expulsion of the fetus
Third stage: time from expulsion of the fetus to
expulsion of the placenta
Fourth stage: the 1st
post partum hour..
5. Recommendations on definitions of
the first stage of labor:
The first stage is further subdivided into the latent
active ,and transition phase
latent phase-
onset of regularly perceieved contractions and ends
when rapid cervical dilatation begins
Contractions are mild
Lasting 20-40 seconds
Cervical effacement occurs,cervix dilate 0-3 cm
6 hours in nullipara and 4.5 hours in multipara.
6. .ACTIVE PHASE
Cervical dilatation increasing from 4-7 cm
Contractions last 40-60 seconds and occur every 3-5
minutes
3 hours in nullipara and 2 hours in multipara
Show and spontaneous ruptures of membranes may
occur
7. ACTIVE PHASE DIVIDED INTO
THREE ADDITIONAL PHASES:
-Acceleration phase
-phase of maximum slope
-deceleration phase
8. TRANSITION PHASE
CONTRACTIONS REACH THEIR PEAK OF
INTENSITY
CERVICAL DILATATION INCREASE FROM 8- 10CM
CONTRACTIONS LASTS FOR 60- 90 SECONDS
OCCUR EVERY 2-3 MINUTES
IF THE MEMBRANES ARE NOT RUPTURED
PREVIOUSLY THEY WILL RUPTURE AT 10 CM
19. Diagnosis of labor
The determination of whether a woman is in labor is made
within one hour of admission .
Diagnosis of labor is made only when painfull contractions
are accompanied by any one of the following :
Bloody show
Rupture of the membranes
Full cervical effacement.
Cervical dilatation is not part of the criteria
Meet the criteria
Didn’t meet the
criteria
Rest &
observation
Until next day
Antinatal
ward
20. Diagnosis of labor
The correct diagnosis of labor is considered to be the
single most important determination in the
management of labor because an incorrect diagnosis
of active labor will lead to inappropriate
interventions and an increased likelihood of cesarean
delivery.
21. MANAGEMENT OF FIRST STAGE
OF LABOUR
OBJECTIVE-TO HAVE A WATCHFUL EXPECTANCY
AND TO MONITOR THE PROGRESS OF LABOUR
AND TO PREVENT COMPLICATIONS
INITIAL ASSESSMENT-
Onset of contraction
Frequency
Duration
Memebrane
Liquor
Present and previous obstetric history,drug history
32. MANAGEMENT
GENERAL-emotional support and assurance are
given
BOWEL-encourage women for warm bath,soap
enema
REST AND AMBULATION-when membranes are
intact women is encouraged for ambulation,when
ruptured women advised for rest.
DIET-fruit juice ,soup,salt lemon juice is
recommended.NPO 6-8 hours prior to surgery
BLADDER CARE-encourage the women to empty the
bladder,if failed catheterization with aseptic tecniques
36. Cont…..
Watch for maternal and fetal well being.
Psychological preparation of the mother
P/V examination should be done :
1 to 4 hours in the first stage and at 1 hour intervel at
the second stage
At rupture of membranes to evaluate for cord
prolapse
Prior to intrapartum administration of analgesia
When the parturient feels the urge to push
When the FHR falls,to evaluate the conditions like
uterine rupture or cord prolapse
37. Contd….
Placement of intravenous line at the time of admission is
recommended.-it is found that women who received
Intravenous hydration at 250ml/hr had fewer labors
persisting for over 12 hours and less need for oxytocin
augmentation than those who received 120ml/hr.
ANTIBIOTIC PROPHYLAXIS –in some centers to prevent
early onset neonatal infection intravenous penicillin is given
38. Active management of labor
It refers to active control, rather than passive observation,
over the course of labor by the obstetrical provider.
It includes three essential elements
I. Careful diagnosis of labor by strict criteria
II.Constant monitoring of labor with specific standards for
normal progression
III.Prompt intervention (eg, amniotomy, high dose
oxytocin) according to established guidelines if progress
is unsatisfactory .
39. Active management of labor
The active management of labor is generally limited to
women who meet the following criteria:
1) Nulliparous
2)Term pregnancy
3)Singleton infant in cephalic presentation
4)No pregnancy complications
5)Experiencing spontaneous onset of labor.
40. Active management of labor
Nulliparous labor tends to be more subject to failure
to progress .
administration of oxytocin, sometimes at high
dosages, is one of the interventions involved in active
management. This is safer in nulligravid women since
the nulligravid uterus is virtually immune to rupture
(except as a result of manipulation or previous
surgery)
41. Active management of labor
Recommendation on routine amniotomy
Limited evidence showed no substantial benefit for
early amniotomy and routine use of oxytocin
compared with conservative management of labor.
In normally progressing labor, amniotomy should not
be performed routinely.
Combined early amniotomy with use of oxytocin
should not be used routinely.
42. ACTIVE MANAGEMENT OF
LABOUR
Interventions with amniotomy,and/or high dose
oxytocin are initiated if progress does not succeed
according to the defined standards.
Rupture of the fetal membranes provides
information
About fetal status,but does not appear to significantly
accelerate labour.In the dublin protocol,rupture must
be performed before treatment with oxytocin which is
administered only in the presence of clear amniotic
fluid.
43. ACTIVE MANAGEMENT OF
LABOUR
If membranes are ruptured when there is
polyhydramnios or an inengaged fetal presenting
part,it is prudent to use a small gauze needle,rather
than a hook,to puncture the fetal membranes in one
or more places,and to perform the procedure in the
operating room.This controlled amniotomy permits
emergency cesarean delivery in the event of an
umbilical cord prolapse.
Routine amniotomy should not be performed in
women with active hepatitis B and C or HIV inoreder
to minimize exposure of the fetus to ascending
infection.
44. ACTIVE MANAGEMENT OF
LABOUR
Slower progress in the nulliparous patient is most
often the result of inefficient uterine action.
In the absence of medical contraindications,labour
that falls to progress is treated with oxytocin.
45. MONITORING
It is desirable that all examinations should be done by
single individual to minimize interobservor
variations.
A vaginal examination during labour often raises
anxiety and interrupts the women focus
Increased number of vaginal examination is
associated with neonatal sepsis
46. Monitoring:
Recommendations on monitoring during the
established first stage of labor
A pictorial record of labor (partogram) should be used once labor is established.
4 hourly temperature and blood pressure
hourly pulse
half-hourly documentation of frequency of contractions
frequency of emptying the bladder
vaginal examination offered 4 hourly, or when there is concern about progress
Intermittent auscultation of the fetal heart after a contraction should occur for at least
1 minute, at least every 15 minutes, and the rate should be recorded as an average.
48. DIAGNOSIS OF POOR
PROGNOSIS OF LABOUR
Prolonged bradycardia and meconium stained liquor
Possibility of foetal distress
Prolonged latent phase when more than eight hours
in primigrvida and more than six hours in
multigravida
Prolonged latent phase may be due to fault in power,
passage or passenger
Passage is small due to contracted pelvis
Passenger, hydrocephalous, brow [occiput not felt]
Large baby, shoulder presentation
49. ROLE OF NURSE IN CARING OF THE WOMAN IN
THE FIRST STAGE OF LABOUR
Admitting client to birthing area after determining
that client is in labor
Determining if client's membranes have ruptured
Encouraging family participation as appropriate with
the labor process
Performing Leopold maneuver and vaginal exams as
appropriate
Monitoring maternal vital signs and fetal heart rate
and patterns, reporting any deviations or
abnormalities
50. CONTD…..
Applying electronic fetal monitor as appropriate
Assessing pain level, instituting positioning,
breathing, relaxation, and other methods for pain
control; administering analgesics as ordered
Providing ice chips, wet washcloth, or hard candy
Encouraging voiding at least every 2 hours
Assisting with anesthetic administration
Assisting with amniotomy with assessment of fetal
heart rate, fetal positioning, and fetal cord after
amniotomy
51. CONTD….
Assisting with amniotomy with assessment of fetal
heart rate, fetal positioning, and fetal cord after
amniotomy
Cleansing perineum and assisting with pad changes
regularly
Monitoring progress including vaginal discharge,
cervical dilation and effacement, position, and fetal
descent
Performing vaginal examinations as necessary
Assisting coach and supporting client and partner
52. CONTD…..
Palpating to determine contraction intensity
Reassuring client about normal fetal heart rates
Adjusting monitor to achieve and maintain clear
tracing
Interpreting rhythm strips when at least a 10-minute
tracing has been obtained
53. CONTD…..
Preparing supplies and equipment for delivery
Notifying primary health care provider at appropriate
time to scrub for attending delivery
Verifying maternal and fetal heart rate response to
uterine contractions during intrapartal care
Instructing client and partner about reasons for
electronic monitoring
Applying tocotransducer snugly after determining
fetal position via Leopold maneuver