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OB SIMS 10/25/2019 Complications During Labor (Cesarean Section (Post Op,…
OB SIMS 10/25/2019
Complications During Labor
Cesarean Section
Meds
Anesthesia
General Anesthesia
Spinal
CBC
Platelets > 100,000
Lactated Ringers
Foley Catheter (Remove after 8 hrs)
Post Op
Walk before 8hr to prevent blood clot
Check vitals for hemorrhage/shock
Check fundus for firmness, height, & midline position
Shoulder Dystocia
Causes
Macrosomia/LGA
GA PD
GDM w/out induction/ tall dad & small mom
Turtling
Interventions:
Moro Reflex
Suprapubic
McRoberts: open legs wide & pull back
!:2 nurses for baby
3:1 nurses for Mom
Hit Emergency
Pre-term Labor
#1 Cause is PROM
Meds: Magnesium Sulfate
Antidote: Calcium Gluconate
Terbutaline: 0.25mg Subcut: Hold if HR >120
Monitor magnesium levels q4h
Betamethasone (baby): Under 33 weeks :12mg IM x2doses 24hr apart
Check LS Ratio (2:1 = "Good Sign"
Nifedipine (CCB) - 100mg PO: Check BP: Hold if Systolic <90
Dx: Fibronectin Test - Speculum
Induction/Augmentation
Cytotec: Postpardum Hemorrhage: 50 mg PO or PV