Decelerations (and Accelerations) Overview
- VEAL CHOP
- Variable Deceleration
- Cord Compression
- Early Deceleration
- Head Compression
- Acceleration
- Okay
- Late Deceleration
- Placental Insufficiency
Early Decelerations
- Fetal Head Compression
- Uterine Contractions
- Placement of Internal Mode of Monitoring
- Vaginal Examination
- Fundal Pressure
- Normal Pattern
Late Decelerations
- Uteroplacental Insufficiency
- Disruption of Oxygen Transfer to Fetus
- Abnormal Pattern
- Discontinue Oxytocin
- Oxygen with Non-Rebreather (8-10 L/min)
- Side-lying Position
- Elevate Legs
- Increase Rate of IV Solution
Variable Decelerations
- Umbilical Cord Compression
- Abnormal Cord Position
- Transition Phase
- Oxygen with Non-Rebreather (8-10 L/min)
- Change Maternal Position
- Discontinue Oxytocin
Mechanism of Labor
- Engagement
- Descent
- Flexion
- Internal Rotation
- Extension
- External Rotation (Restitution)
- Expulsion of Infant
Induction of Labor
- Premature Rupture of Membranes
- Danger to Fetus or Mother
- Prolonged Gestation
- Placenta Abnormalities
- Transverse Fetal Position
- Prolapsed Umbilical Cord
- Active Genital Herpes Infection
- Transfundal Uterine Incision
- Hemorrhage
True vs. False Labor
- Bloody Show
- Regular, Strong Contractions
- Progressive Effacement and Dilation
- Engagement of Presenting Part
- Irregular Contractions
- Cervix Soft
- No Engagement of Presenting Part
Cesarean Section - Indications
- Active Genital Herpes Infection
- Cervical Cancer
- Eclampsia (Preeclampsia)
- History of Uterine Surgery
- History of C-section (Vertical)
- Malpresentation
- Fetal Distress
- Cord Compression/Prolapse
- Failed Vaginal Delivery
- Cephalopelvic Disproportion
- Abruptio Placentae or Placenta Previa
Premature Rupture of Membranes (PROM)
- Rupture > 1 Hour Before Labor
- Infection
- PROM History
- Incompetent Cervix
- Fern Test
- Nitrazine Paper Test
- Ultrasound
- Consider Tocolytics
- Consider Antibiotics
- < 34 Weeks Gestation
- Corticosteroids
- > 34 Weeks Gestation
- Induction of Labor