,Table of Contents
Shock .......................................................................................................................................................................................................................................................... 5
Shock ................................................................................................................................................................................................................................................................................................ 5
Shock – Zwangerschap ................................................................................................................................................................................................................................................................... 10
Hypovolemische Shock................................................................................................................................................................................................................................................................... 12
Cardiogene Shock ........................................................................................................................................................................................................................................................................... 14
ObstrucCeve Shock......................................................................................................................................................................................................................................................................... 15
DistribuCeve Shock – Neurogene Shock......................................................................................................................................................................................................................................... 17
DistribuCeve Shock – AnafylacCsche Shock ................................................................................................................................................................................................................................... 18
DistribuCeve Shock – SepCsche Shock ........................................................................................................................................................................................................................................... 20
Vasovagale ReacCe / Syncope (VVS)............................................................................................................................................................................................................................................... 22
OrthostaCsche Hypotensie (OH) .................................................................................................................................................................................................................................................... 26
Shock – Obstetrische Pathologie ............................................................................................................................................................................................................... 28
Vruchtwaterembolie ...................................................................................................................................................................................................................................................................... 28
Inversio Uteri .................................................................................................................................................................................................................................................................................. 33
Cervicale Shock .............................................................................................................................................................................................................................................................................. 36
Foetale Hartslagfrequen=e & Foetale Condi=e .......................................................................................................................................................................................... 38
De Foetale HartslagfrequenCe ....................................................................................................................................................................................................................................................... 38
De Foetale CondiCe – Pathologie ................................................................................................................................................................................................................................................... 40
De Foetale HartslagfrequenCe – Kenmerken van het CTG (in volgorde van beoordeling) ............................................................................................................................................................. 41
2
,Foetale Bewaking – Ante Partum .............................................................................................................................................................................................................. 46
Het Ante Partum CTG ..................................................................................................................................................................................................................................................................... 47
De Chandraharan CTG ClassificaCe & InterpretaCe........................................................................................................................................................................................................................ 49
Echoscopie ..................................................................................................................................................................................................................................................................................... 51
Echoscopie – Doppler-flow-velocimetrie........................................................................................................................................................................................................................................ 52
Het Biofysisch Profiel...................................................................................................................................................................................................................................................................... 60
Ante Partum Pathologie – Minder Leven ....................................................................................................................................................................................................................................... 60
Ante Partum Pathologie – Intra Uteriene Groei RestricCe ............................................................................................................................................................................................................. 61
Ante Partum Pathologie – Gemelli Graviditeit ............................................................................................................................................................................................................................... 64
Foetale Bewaking - Intra Partum............................................................................................................................................................................................................... 71
Het Intra Partum CTG ..................................................................................................................................................................................................................................................................... 71
Het Intra Partum CTG – De Foetale HartslagfrequenCe ................................................................................................................................................................................................................. 73
Het Foetaal ECG / STAN®-methode ................................................................................................................................................................................................................................................ 74
Microbloedonderzoek .................................................................................................................................................................................................................................................................... 82
Intra Partum Pathologie – Langdurig Gebroken Vliezen................................................................................................................................................................................................................. 82
Intra Partum Pathologie – Meconium Houdend Vruchtwater ....................................................................................................................................................................................................... 84
Intra Partum Pathologie – Maternale PijnsClling ........................................................................................................................................................................................................................... 85
Intra Partum Pathologie – SecCo i.a. .............................................................................................................................................................................................................................................. 85
Intra Partum Pathologie – BijsCmulaCe / Inleiding van de Baring.................................................................................................................................................................................................. 86
Intra Partum Pathologie – Prematuriteit / SeroCniteit ................................................................................................................................................................................................................... 89
Navelstreng pH en Bloedgassen ..................................................................................................................................................................................................................................................... 90
3
, Pathologie van de Neonaat ....................................................................................................................................................................................................................... 91
De Neonatale CondiCe – Fysiologie................................................................................................................................................................................................................................................ 91
De Grauwe Neonaat – Soorten Cyanose ........................................................................................................................................................................................................................................ 93
Respiratoire ComplicaCes – Transiënte Tachypneu van de pasgeborene (TTN) / “Wet Lung Syndrome” ...................................................................................................................................... 95
Respiratoire ComplicaCes – Meconium AspiraCe Syndroom (MAS) .............................................................................................................................................................................................. 96
Respiratoire ComplicaCes – (Infant) Distress Syndrome (RDS) ....................................................................................................................................................................................................... 98
Respiratoire ComplicaCes – Persisterende Pulmonale Hypertensie (PPHN) ................................................................................................................................................................................ 100
Aangeboren Hartafwijkingen (AHA) / Congenitaal Cor ViCum ..................................................................................................................................................................................................... 101
Early-onset Neonatale InfecCe ..................................................................................................................................................................................................................................................... 105
Hypoglykemie ............................................................................................................................................................................................................................................................................... 109
ABCDE(F)G Methode ............................................................................................................................................................................................................................... 114
Quick Scan .................................................................................................................................................................................................................................................................................... 114
Primary Survey ............................................................................................................................................................................................................................................................................. 114
Secondary Survey ......................................................................................................................................................................................................................................................................... 115
Kraambed – Pathologie........................................................................................................................................................................................................................... 115
4
Shock .......................................................................................................................................................................................................................................................... 5
Shock ................................................................................................................................................................................................................................................................................................ 5
Shock – Zwangerschap ................................................................................................................................................................................................................................................................... 10
Hypovolemische Shock................................................................................................................................................................................................................................................................... 12
Cardiogene Shock ........................................................................................................................................................................................................................................................................... 14
ObstrucCeve Shock......................................................................................................................................................................................................................................................................... 15
DistribuCeve Shock – Neurogene Shock......................................................................................................................................................................................................................................... 17
DistribuCeve Shock – AnafylacCsche Shock ................................................................................................................................................................................................................................... 18
DistribuCeve Shock – SepCsche Shock ........................................................................................................................................................................................................................................... 20
Vasovagale ReacCe / Syncope (VVS)............................................................................................................................................................................................................................................... 22
OrthostaCsche Hypotensie (OH) .................................................................................................................................................................................................................................................... 26
Shock – Obstetrische Pathologie ............................................................................................................................................................................................................... 28
Vruchtwaterembolie ...................................................................................................................................................................................................................................................................... 28
Inversio Uteri .................................................................................................................................................................................................................................................................................. 33
Cervicale Shock .............................................................................................................................................................................................................................................................................. 36
Foetale Hartslagfrequen=e & Foetale Condi=e .......................................................................................................................................................................................... 38
De Foetale HartslagfrequenCe ....................................................................................................................................................................................................................................................... 38
De Foetale CondiCe – Pathologie ................................................................................................................................................................................................................................................... 40
De Foetale HartslagfrequenCe – Kenmerken van het CTG (in volgorde van beoordeling) ............................................................................................................................................................. 41
2
,Foetale Bewaking – Ante Partum .............................................................................................................................................................................................................. 46
Het Ante Partum CTG ..................................................................................................................................................................................................................................................................... 47
De Chandraharan CTG ClassificaCe & InterpretaCe........................................................................................................................................................................................................................ 49
Echoscopie ..................................................................................................................................................................................................................................................................................... 51
Echoscopie – Doppler-flow-velocimetrie........................................................................................................................................................................................................................................ 52
Het Biofysisch Profiel...................................................................................................................................................................................................................................................................... 60
Ante Partum Pathologie – Minder Leven ....................................................................................................................................................................................................................................... 60
Ante Partum Pathologie – Intra Uteriene Groei RestricCe ............................................................................................................................................................................................................. 61
Ante Partum Pathologie – Gemelli Graviditeit ............................................................................................................................................................................................................................... 64
Foetale Bewaking - Intra Partum............................................................................................................................................................................................................... 71
Het Intra Partum CTG ..................................................................................................................................................................................................................................................................... 71
Het Intra Partum CTG – De Foetale HartslagfrequenCe ................................................................................................................................................................................................................. 73
Het Foetaal ECG / STAN®-methode ................................................................................................................................................................................................................................................ 74
Microbloedonderzoek .................................................................................................................................................................................................................................................................... 82
Intra Partum Pathologie – Langdurig Gebroken Vliezen................................................................................................................................................................................................................. 82
Intra Partum Pathologie – Meconium Houdend Vruchtwater ....................................................................................................................................................................................................... 84
Intra Partum Pathologie – Maternale PijnsClling ........................................................................................................................................................................................................................... 85
Intra Partum Pathologie – SecCo i.a. .............................................................................................................................................................................................................................................. 85
Intra Partum Pathologie – BijsCmulaCe / Inleiding van de Baring.................................................................................................................................................................................................. 86
Intra Partum Pathologie – Prematuriteit / SeroCniteit ................................................................................................................................................................................................................... 89
Navelstreng pH en Bloedgassen ..................................................................................................................................................................................................................................................... 90
3
, Pathologie van de Neonaat ....................................................................................................................................................................................................................... 91
De Neonatale CondiCe – Fysiologie................................................................................................................................................................................................................................................ 91
De Grauwe Neonaat – Soorten Cyanose ........................................................................................................................................................................................................................................ 93
Respiratoire ComplicaCes – Transiënte Tachypneu van de pasgeborene (TTN) / “Wet Lung Syndrome” ...................................................................................................................................... 95
Respiratoire ComplicaCes – Meconium AspiraCe Syndroom (MAS) .............................................................................................................................................................................................. 96
Respiratoire ComplicaCes – (Infant) Distress Syndrome (RDS) ....................................................................................................................................................................................................... 98
Respiratoire ComplicaCes – Persisterende Pulmonale Hypertensie (PPHN) ................................................................................................................................................................................ 100
Aangeboren Hartafwijkingen (AHA) / Congenitaal Cor ViCum ..................................................................................................................................................................................................... 101
Early-onset Neonatale InfecCe ..................................................................................................................................................................................................................................................... 105
Hypoglykemie ............................................................................................................................................................................................................................................................................... 109
ABCDE(F)G Methode ............................................................................................................................................................................................................................... 114
Quick Scan .................................................................................................................................................................................................................................................................................... 114
Primary Survey ............................................................................................................................................................................................................................................................................. 114
Secondary Survey ......................................................................................................................................................................................................................................................................... 115
Kraambed – Pathologie........................................................................................................................................................................................................................... 115
4