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Nursing Care for Passengers and Uterine Inversion - Coggle Diagram
Nursing Care for Passengers and Uterine Inversion
Abnormal Fetal Presentations (Malpresentations & Malpositions)
Definition:
Any presentation other than vertex (e.g., breech, face, brow, shoulder).
Malposition:
Vertex presentation but occiput not anterior (e.g., occipito-posterior (OP)).
Causes:
Prematurity, poly/oligohydramnios, uterine anomalies, placenta previa.
Clinical Significance
Higher risk of prolonged labor, cord prolapse, and operative delivery.
2.Breech Presentation
Types:
Frank breech (65-70%): Hips flexed, knees extended.
Complete breech (15%): Hips & knees flexed ("cannonball").
Footling breech (10-15%): Feet first (highest risk of cord prolapse).
Management:
Vaginal delivery: Consider if labor progresses normally, preterm, or second twin.
Cesarean sectionCS): Preferred for term breech to reduce fetal risks.
Complications:
Fetal: Cord prolapse, fractures, Erb’s palsy.
Maternal: Trauma, sepsis.
3.Occipito-Posterior (OP) Position
Incidence: 10-34% in early labor; 5-8% persist to delivery.
Mechanism:
Favorable (90%): Long anterior rotation → vaginal delivery.
Unfavorable (10%): Deep transverse arrest → CS/instrumental delivery.
Nursing Actions:
Encourage position changes (hands-and-knees, side-lying).
Monitor labor progress; prepare for CS if rotation fails.
Cord Prolapse
Definition
: Cord descends before/with the fetus after membrane rupture.
Risks
: Malpresentation, polyhydramnios, multiparity.
Emergency Actions:
Knee-chest/Trendelenburg position to relieve cord pressure.
Minimal handling of cord; prepare for urgent CS.
Administer O₂ to mother.
Premature Rupture of Membranes (PROM/PPROM)
PROM: Rupture >37 weeks before labor.
PPROM: Rupture <37 weeks (↑ neonatal morbidity).
Management:
Term PROM: Induce labor if no spontaneous onset.
Preterm PPROM: Bed rest, corticosteroids, antibiotics, monitor for infection.
6.Uterine Inversion
Causes:.
Excessive cord traction, fundal pressure
Nursing Role:
immediate manual repositioning by physician.
IV fluids, uterotonics (e.g., oxytocin), monitor for hemorrhage.
Cesarean Section (CS)
Indications:
Breech, fetal distress, failed labor progress.
Complications:
Maternal: Infection, hemorrhage, thromboembolism.
Fetal: Injury, transient tachypnea.