Question

Your patient is a petite 23-year-old G1P0 woman. Prenatal assessment has determined that this woman will need a cesarean birth due to cephalopelvic disproportion.

A. What can this patient and you as the nurse do prenatally to ensure a safe delivery?

B. What potential risks and/or complications should the nurse be aware of and prepare for?

C. What postoperative care will this mother and/or infant need?

Answer 1

#Cephalopelvic dispropotion :-

mismatch of size between mother's pelvis and head of the baby .

#prenatal management of cephalopelvic dispropotion :-

-treatment of CPD is to continue  with normal labour .If it is failed move on to C-section.

-Trail labour :-

-doctor decide to continue with nomal labour

-if your labour moving along well,continue to monitor mothers contraction ,dilation and babys progression down the birth canal

-assess the babys heart rate and movement

-confirm babys position in birth canal through vaginal examination

-X-ray ,MRI or Ultrasound scan can perform if needed with doctors advise to confirm the position of baby and visualize mothers pelvis

- during trail labour you can change your position with the help of a nurse to open your pelvis and progress the delivery .the positions are ;

sitting

squating

side position and

going on your hands and knees

-use vaccum or forceps to deliver baby if the labour progress

-if you detect any problem like ineffective contraction ,dilation or effacement and fetal destress ,stop the trail labour immidietly and prepare the mother for C-section

# Cesarean section :-

-c-section can perform if there is no progression in vaginal delivery or detect any complication for baby or mother

-one of the other indication is cephalopelvic dispropotion

# Complications:-

CPD is uncommon .if the progress of delivery failed during the period of trail labour ,complications will develop in mother and baby .Which mainly includes;

-premature repture of membrane

-fetal destress

-umbilical cord prolapse

-extre molding and injury to  baby head

-damage to perenium of mother

-uterine repture

-shoulder dystocisa

-prolonged labour

-cesarean section

#post operative care for mother and baby after cesarean section :-

-monitor vital signs

-provide pain management -

encourage ambulation
-encourage turning and deep breathing exercise

-monitor for signs of infection and bleeding

-burning or pain on urination indicaye bladder infection

-pain ,redness or oedema of an extremity indicate thrombophlebitis

-a productive cough and chills  indicate pneuma

-provide adequate nutrition

-avoid lifting heavy objects

-hold abdomen to protect the incision while sneezing or coughing

-take care getting around

take time to sit and bond with your baby

shower normally

have sex until your doctor say you can

drink enough water

eat well balanced and healthy diet

take fiber rich food that helps to prevent constipation

keep the surgical site clean and dry

if you have any trouble like bleeding ,signs of infection or mood changed call your doctor immidietly

baby care;

helps the baby to take first breath ,for that clear mucus from the nose and mouth

clamb and cutt the umbilical cord

keep the baby warm

check APGAR score{A- activity ,P-pulse,G-grimace,A-appearance and R-respiration )

Check for any birth in juries

encourage breast feeding immidietly after delivery

check reflexes

check temperature

take the measurment

give vitamin K as per doctors order

give medical bracelet and take foot print