Labor and Delivery

1. Labor and Delivery And pregnancy complications

2. Labor - Initiation • Contractions • Ruptured amniotic sac (“water breaks”)

3. Stages of Labor – Stage 1

4. Stages of Labor – Stage 1

5. Labor – Stage 2 Length: From one contraction up to 2 hours A: Resting Phase B: Descent Phase: Contractions (3-5 minutes apart, 60 seconds long) accompanied by strong urge to bear down C: Crowning Phase: Baby’s head descends to opening of vagina – does not recede with contractions

6. Labor – Stage 3 • 10-20 minutes after baby is born • Placenta, amniotic sac, umbilical cord are delivered. Lasts few minutes

7. Pregnancy Complications

8. Tubular Pregnancy/Ectopic Pregnancy Implantation of fertilized egg in any location other than the womb. Fallopian tube most common (98%) Remedy or solution for tubal pregnancy Surgery Loss of fallopian tube Chances of getting pregnant cut in half

9. Caesarian Section (C-section) Doctor removes the fetus surgically Reasons: Breach, not positioned correctly Fail to descend Mother’s pelvic structure Baby too big Active herpes Multiple births Mother or baby under stress Monitor heart beat Toxemia High blood pressure Kidney damage

10. Toxemia Unknown cause Common in teen pregnancies Swelling of face, ankles, HBP, convulsions if severe Meds, checkups, early delivery

11. Gestational Diabetes Mother’s blood brings extra glucose to the fetus Fetus makes more insulin to handle extra glucose Extra glucose gets stored as fat and fetus becomes larger than normal Glucose monitoring kit given to pregnant women with gestational diabetes

12. Rh incompatibility Mother’s immune system reacts against the fetus’s blood Causes anemia, fetal death Shots before and after pregnancy, monitor Mother Rh- and father Rh+

13. Still Birth Fully developed fetus is born dead Causes: Placenta separates too early, smoking, alcohol, drugs Umbilical cord can stop blood from getting to brain

14. Miscarriage • Any pregnancy that ends spontaneously before the fetus can survive outside the womb (gestational age: 20 to 22 weeks or less) • Occurs in 15-20% of all recognized pregnancies, usually before the 13th week of pregnancy. • Causes: Varied, and can’t always be determined. Chromosomal abnormalities, vascular disease, diabetes. • Alcohol or drug use and smoking are risk factors. • Exercise, working, and sexual intercourse do not increase risk in uncomplicated pregnancies

15. Premature/Preterm Birth • Less than 37 weeks gestational age • Greater risk for short and long term complications, including: • disabilities and impediments in growth and mental development. • Causes: Elusive and unknown • Progress made in care of premature infants, but not in reducing the prevalence of preterm births.

16. Common Birth Defects Birth defects affect one of every 33 babies in the world Can affect almost any part of the body Heart defects • Most common • 1 in every 150 babies is born with a heart defect • Accounts for 1/3 to ¼ of all defects Lip and roof of the mouth • Orofacial clefts • Cleft more common than palate • Affects about 1 in 700 to 1,000 6 months old 1 month after surgery 5 years old

17. Down Syndrome Genetic condition Affects more babies that are born to older mothers 1 in 800

18. Neural Tube Defects Spina bifida: Incomplete development of spinal cord or its coverings 1 in 1,000 Very serious and life threatening Can be closed with surgery in utero Results in disabilities Preventive measure: folic acid prior to conception

19. Fetal Alcohol Syndrome … And Drug-Affected Disorders Next Lesson!