By Wayne R. Cohen
Hard work and supply Care: a pragmatic consultant helps and reinforces the purchase of the sensible obstetric talents wanted for helping a winning birth.Beginning with an important section of profitable exertions care, speaking with the sufferer, the authors consultant you thru common supply exercises and exam options. They then tackle the easiest techniques to the entire diversity of demanding situations that may come up in the course of hard work and supply. all through, the 15 chapters supply concise functional tips with:algorithmic selection treesclinical administration tipsdetailed drawingsLabor and supply Care: a pragmatic advisor presents an intensive tour-de-force of the sensible obstetric talents wanted for top and most secure perform according to medical adventure and facts.
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Extra info for Labor and Delivery Care: A Practical Guide
Keep this rule in mind to avoid confusion. A. RT. P. A. LT. P. 1 The four quadrants of the pelvis used to describe fetal position, viewed as encountered during a vaginal examination with the patient in lithotomy position. For easy description, the pelvis is divided into four quadrants; a left and a right anterior and a left and a right posterior. The position of the presenting part is defined according to that quadrant in which its reference point lies (Fig. 1). For example, if the occiput in a vertex presentation is in the left anterior quadrant of the pelvis, the position is left occiput anterior (LOA).
Approach to the examination You should cultivate a uniform approach to the abdominal examination and follow it in each case. That is the best way to obtain accurate results and prevent omissions (Fig. 2). First determine the fundal height by placing the hypothenar eminence of the upper hand (left hand if you are at the patient’s right side) against the mother’s abdomen. With gentle pressure, you will be able to perceive where the upper margin of the fundus is located. Uterine height can be quantitated by means of a centimeter tape measure.
In the course of a normal pregnancy with a fetus in longitudinal lie, among women who are not markedly obese, you can expect the fundal height, in centimeters, to be equivalent to the number of weeks from the beginning of the last menstrual period from about 20 to 36 weeks. Examine the surface of the uterus for tenderness or abnormal masses, and note if there is uterine enlargement suggesting polyhydramnios or multiple gestation. 18 Chapter 2 Gravida in labor E F A Introduce yourself: Maintain eye contact.