Tweede lijn intra- en postpartaal
Deel 2
1
,DEEL CAROLINE ................................................................................................................... 7
FOETALE BEWAKING ............................................................................................................ 7
BASIS-HARTFREQUENTIE ....................................................................................................... 7
RESPIRATOIRE ACIDOSE......................................................................................................... 7
METABOLE ............................................................................................................................. 7
ACIDOSE ............................................................................................................................... 7
FOETALE TACHYCARDIE ......................................................................................................... 7
FOETALE TACHYCARDIE ......................................................................................................... 8
ONSTABIELE BASISLIJN .......................................................................................................... 8
VARIABILITEIT ......................................................................................................................... 8
CYCLING ............................................................................................................................ 9
SALTATOIR ......................................................................................................................... 9
ZIGZAG ............................................................................................................................... 9
SINUSOÏDAAL ........................................................................................................................ 9
SINUSOÏDAAL ..................................................................................................................... 9
PSEUDO-SINUSOÏDAAL ...................................................................................................... 9
A-TYPISCH ....................................................................................................................... 10
SINUSOÏDAAL ................................................................................................................... 10
ACCELERATIES .................................................................................................................... 10
SHOULDERING ................................................................................................................. 10
OVERSHOOTING .............................................................................................................. 10
DECELERATIES ..................................................................................................................... 10
BARORECEPTOR .............................................................................................................. 10
CHEMORECEPTOR ........................................................................................................... 10
MOTHERS ............................................................................................................................ 11
AANPASSINGS-MECHANISME FOETUS.................................................................................. 11
RISICOFACTOREN ................................................................................................................ 11
UITSLUITEN CHRONISCHE HYPOXIE ..................................................................................... 11
CHECKLIST INTERPETATIE CTG ............................................................................................. 12
HYPOXIE .............................................................................................................................. 12
GEEN HYPOXIE..................................................................................................................... 12
ACUTE HYPOXIE ................................................................................................................... 12
3-6-9-12-15 MINUTEN REGEL ................................................................................................ 13
SUBACUTE HYPOXIE ............................................................................................................ 13
GRADUEEL TOENEMENDE HYPOXIE ...................................................................................... 13
CHRONISCHE HYPOXIE ........................................................................................................ 14
O2 TOEDIENING ................................................................................................................... 14
BLOEDGAS-WAARDEN NAVELSTRENG-BLOED ...................................................................... 14
STAN ELEKTRODE ................................................................................................................. 15
02 SATURATIE-METING ......................................................................................................... 15
SCHEDEL-STIMULATIE .......................................................................................................... 15
PH-METRIE ........................................................................................................................... 15
TROMBO-EMBOLISCHE AANDOENINGEN............................................................................ 16
ALGEMEEN .......................................................................................................................... 16
RISICO ................................................................................................................................. 16
DIEP VENEUZE TROMBOSE ................................................................................................... 16
LONGEMBOLIE .................................................................................................................... 16
SINUSTROMBOSE ................................................................................................................ 16
TROMBOFILIE....................................................................................................................... 17
ACUUT LONGOEDEEM ......................................................................................................... 17
OPPERVLAKKIGE TOMBOFLEBITIS ......................................................................................... 18
AMNIONEMBOLIE ................................................................................................................ 18
PLACENTA AFWIJKINGEN ................................................................................................... 19
PLACENTA INPLANTING ........................................................................................................ 19
2
, PLACENTA ........................................................................................................................... 19
RETENTIE ............................................................................................................................. 19
PLACENTA SOLUTIO ............................................................................................................. 20
VRUCHTWATERAFWIJKINGEN ............................................................................................ 21
OLIGO-HYDRAMNION .......................................................................................................... 21
POLYHYDRAMNION ............................................................................................................. 21
MECONIUM-HOUDEND VRUCHTWATER (MHV) ..................................................................... 21
NS PROLAPS, AMNIOTOMIE, SCALP ELEKTRODE, VBAC & UTERUSRUPTUUR ........................ 23
NAVELSTRENG-PROLAPS ..................................................................................................... 23
AMNIOTOMIE ....................................................................................................................... 24
VOCHTBLAAS ................................................................................................................... 24
SCALP ELEKTRODE ............................................................................................................... 25
VBAC ................................................................................................................................... 25
UTERUSRUPTUUR ................................................................................................................ 26
KUNSTVERLOSSING ........................................................................................................... 27
SOORTEN ............................................................................................................................ 27
VAGINALE KUNSTVERLOSSING ............................................................................................. 27
INDICATIES ...................................................................................................................... 27
VEREISTEN ....................................................................................................................... 27
CONTRA-INDICATIES ........................................................................................................ 27
TAAK VRVR ....................................................................................................................... 27
COMPLICATIES ................................................................................................................. 28
VACUUM VS FORCEPS ...................................................................................................... 28
SECTIO CAESAREA ............................................................................................................... 28
SOORTEN ......................................................................................................................... 29
GENTLE SECTIO TECHNIEK ............................................................................................... 29
INDICATIES ...................................................................................................................... 29
VOORZORGEN.................................................................................................................. 29
VERLOOP INGREEP ........................................................................................................... 29
COMPLICATIES ................................................................................................................. 30
AANDACHTS-PUNTEN SECUNDAIRE. SECTIO .................................................................... 30
SPOEDSECTIO .................................................................................................................. 30
TAAK VRVR BIJ PRIMAIRE SECTIO ....................................................................................... 30
PIJN................................................................................................................................... 32
DEFINITIES ........................................................................................................................... 32
GROEPEN PIJNSTILLING ....................................................................................................... 32
INHALATIE ANALGESIE ......................................................................................................... 32
EPIDURALE ANESTHESIE (EDA) ............................................................................................. 32
TECHNIEKEN .................................................................................................................... 34
PROCES ........................................................................................................................... 34
TAAK VAN DE VRVR ........................................................................................................... 34
BIJWERKINGEN ................................................................................................................. 35
AANDACHTSPUNTEN VRVR ............................................................................................... 35
SYSTEMISCHE ANESTHESIE .................................................................................................. 36
TIJDENS ONTSLUITINGSFASE ............................................................................................ 36
POSTPARTAAL .................................................................................................................. 36
WATERINJECTIES .............................................................................................................. 37
OVERZICHT FARMACOLOGISCHE PIJNSTILLING .................................................................... 38
SCHOUDERDYSTOCIE........................................................................................................ 39
SCHOUDER-DYSTOCIE......................................................................................................... 39
RISICOFACTOREN ............................................................................................................ 39
BELEID ............................................................................................................................. 39
3
, COMPLICATIES ................................................................................................................. 40
PREVENTIE ....................................................................................................................... 40
DEEL EEF ........................................................................................................................... 41
PATHOLOGISCHE STAND VAN HET CAPUT .......................................................................... 41
ANATOMIE ........................................................................................................................... 41
AFMETINGEN FOETALE SCHEDEL ...................................................................................... 41
VLAKKEN VAN HODGE ...................................................................................................... 41
ORIËNTATIEPUNTEN BEKKEN ............................................................................................ 42
SOORTEN LIGGINGEN .......................................................................................................... 42
OVERZICHT LIGGINGEN .................................................................................................... 42
AFKORTINGEN .................................................................................................................. 42
NORMALE BARING ............................................................................................................... 43
DEFINITIES ....................................................................................................................... 43
BARMINGS-MECHANISME ACHTERHOOFDS-LIGGING ACHTERHOOFD VOOR (Aav)............ 43
ACHTERHOOFDSLIGGING .................................................................................................... 45
ACHTERSTE PLAATSING (Aala / Aara) ................................................................................. 45
BARINGS-MECHANISME ACHTERSTE PLAATSING .............................................................. 45
GEBOORTE-MECHANISME Aala/Aara ROTATIE 135 ........................................................... 46
GEBOORTE-MECHANISME Aala/Aara ROTATIE 45 ............................................................. 47
VERLOOP VAN ARBEID ...................................................................................................... 47
NADELEN EN COMPLICATIES ............................................................................................ 48
TAAK VRVR ....................................................................................................................... 48
KRUINLIGGING .................................................................................................................... 49
KRUINLIGGING (Kaa)......................................................................................................... 49
DISTANIA BIJ KRUINLIGGING ............................................................................................. 50
BARINGS-MECHANISME KRUINLIGGING ........................................................................... 50
OBSTRETISCHE INTERVENTIES .......................................................................................... 51
AANGEZICHTSLIGGING ........................................................................................................ 51
AANGEZICHTS-LIGGING (Aakv) ......................................................................................... 51
BARINGS-MECHANISME ................................................................................................... 51
Aaklv / Aakldw .................................................................................................................. 51
Aakrv / Aakrdw .................................................................................................................. 51
GEBOORTE-MECHANISME BIJ Aaklv .................................................................................. 52
GEBOORTE-MECHANISME BIJ Aakra .................................................................................. 53
BELEID / EFFECT OP ARBEID ............................................................................................. 53
COMPLICATIES ................................................................................................................. 53
TAAK VRVR ....................................................................................................................... 53
VOORHOOFDSLIGGING ....................................................................................................... 54
VOORHOOFDS-LIGGING (Vkv) .......................................................................................... 54
GEBOORTE-MECHANISME (Vkv) ........................................................................................ 54
BELEID ............................................................................................................................. 54
HOGE RECHTSTAND............................................................................................................. 55
HOGE RECHTSTAND ......................................................................................................... 55
BARINGS-MECHANISME ................................................................................................... 55
DIEPE DWARSSTAND ............................................................................................................ 56
DIEPE DWARSSTAND ........................................................................................................ 56
(Aaldw of Aardw) ............................................................................................................... 56
BARINGSMECHANISME .................................................................................................... 56
BEHANDELING ................................................................................................................. 56
ASYNCLITISME ..................................................................................................................... 57
ASYNCLITISME / WANDBEENLIGGING ............................................................................... 57
(Waldw / Wardw)............................................................................................................... 57
BARINGSMECHANISME .................................................................................................... 57
STUITLIGGING ................................................................................................................... 58
4
, DEFINITIE............................................................................................................................. 58
OORZAKEN .......................................................................................................................... 58
DIAGNOSE ........................................................................................................................... 58
STANDEN STUITLIGGING ...................................................................................................... 58
WIJZE VAN............................................................................................................................ 58
BEVALLING .......................................................................................................................... 58
PRENATAAL BELEID .............................................................................................................. 59
CONTRA-INDICATIES............................................................................................................ 59
COMPLICATIES .................................................................................................................... 59
VAGINALE STUITPARTUS ....................................................................................................... 59
BELEID TIJDENS ................................................................................................................ 59
ARBEID............................................................................................................................. 59
VOORBEREIDING VAGINALE STUITPARTUS ........................................................................ 60
BARINGS-MECHANISME ................................................................................................... 60
STAPPENPLAN VAGINALE STUITGEBOORTE ....................................................................... 60
HANGREEP VAN BRACHT .................................................................................................. 61
PARTIËLE STUITEXTRACTIE ................................................................................................ 62
GEBOORTE HOOFD .......................................................................................................... 63
NAZORG .............................................................................................................................. 63
UITWENDIGE KERING / VERSIE .............................................................................................. 64
CONTRA-INDICATIES ........................................................................................................ 64
TECHNIEK ........................................................................................................................ 64
COMPLICATIES ................................................................................................................. 65
INDUCTIE VAN DE BARING ................................................................................................. 66
INDUCTIE / PRE-INDUCTIE .................................................................................................... 66
INDELING ............................................................................................................................ 66
INDICATIES .......................................................................................................................... 66
CONTRA-INDICATIES............................................................................................................ 66
NADELEN VAN INDUCTIE ...................................................................................................... 66
FACTOREN DIE UITKOMST INDUCTIE BEÏNVLOEDEN .............................................................. 66
INDUCTIEMETHODEN .......................................................................................................... 67
NIET-FARMACOLOGISCHE METHODEN ................................................................................. 67
FOLEY-CATHETER ............................................................................................................. 67
COOK-BALLON ................................................................................................................. 67
TECHNIEK BALLONCATHETER ........................................................................................... 67
STRIPPING ....................................................................................................................... 68
AMNIOTOMIE.................................................................................................................... 68
FARMACOLOGISCHE METHODEN ......................................................................................... 68
PROSTAGLANDINES ......................................................................................................... 68
OXYTOCINE ...................................................................................................................... 70
TAAK VRVR ........................................................................................................................... 70
OVERZICHT INDUCTIE METHODEN ....................................................................................... 70
POSTPARTUM HAEMORRAGHIE .......................................................................................... 78
HAEMORRAGIE .................................................................................................................... 78
OORZAKEN .......................................................................................................................... 78
TONUS................................................................................................................................. 78
BEHANDELING ................................................................................................................. 79
TRAUMA............................................................................................................................... 79
PERINEUMRUPTUUR......................................................................................................... 80
CERVIXRUPTUUR .............................................................................................................. 80
VAGINARUPTUUR ............................................................................................................. 81
VULVARUPTUREN ............................................................................................................. 81
TISSUE ................................................................................................................................. 81
TROMBINE ........................................................................................................................... 82
DIC .................................................................................................................................. 82
5
, SYNDROOM VAN SHEEHAN .............................................................................................. 82
UTERUSRUPTUUR ............................................................................................................. 83
INVERSIO UTERI................................................................................................................ 83
MEERLINGEN ..................................................................................................................... 85
MEERLING- .......................................................................................................................... 85
ZWANGERSCHAP ................................................................................................................. 85
TYPEN.................................................................................................................................. 85
DIAGNOSE MEERLINGZWS ................................................................................................... 85
COMPLICATIES .................................................................................................................... 85
TTS – twin-to-twin-syndroom ............................................................................................. 86
TIJDENS PARTUS ............................................................................................................... 86
VAGINALE BEVALLING .......................................................................................................... 86
INTERTWIN-INTERVAL ....................................................................................................... 87
VERTEX-VERTEX TWEELING ............................................................................................... 87
VERTEX-NON-VERTEX TWEELING ...................................................................................... 87
SPECIFIEKE SITUATIES ...................................................................................................... 87
SECTIO ................................................................................................................................ 88
KERNPUNTEN ...................................................................................................................... 88
6
Deel 2
1
,DEEL CAROLINE ................................................................................................................... 7
FOETALE BEWAKING ............................................................................................................ 7
BASIS-HARTFREQUENTIE ....................................................................................................... 7
RESPIRATOIRE ACIDOSE......................................................................................................... 7
METABOLE ............................................................................................................................. 7
ACIDOSE ............................................................................................................................... 7
FOETALE TACHYCARDIE ......................................................................................................... 7
FOETALE TACHYCARDIE ......................................................................................................... 8
ONSTABIELE BASISLIJN .......................................................................................................... 8
VARIABILITEIT ......................................................................................................................... 8
CYCLING ............................................................................................................................ 9
SALTATOIR ......................................................................................................................... 9
ZIGZAG ............................................................................................................................... 9
SINUSOÏDAAL ........................................................................................................................ 9
SINUSOÏDAAL ..................................................................................................................... 9
PSEUDO-SINUSOÏDAAL ...................................................................................................... 9
A-TYPISCH ....................................................................................................................... 10
SINUSOÏDAAL ................................................................................................................... 10
ACCELERATIES .................................................................................................................... 10
SHOULDERING ................................................................................................................. 10
OVERSHOOTING .............................................................................................................. 10
DECELERATIES ..................................................................................................................... 10
BARORECEPTOR .............................................................................................................. 10
CHEMORECEPTOR ........................................................................................................... 10
MOTHERS ............................................................................................................................ 11
AANPASSINGS-MECHANISME FOETUS.................................................................................. 11
RISICOFACTOREN ................................................................................................................ 11
UITSLUITEN CHRONISCHE HYPOXIE ..................................................................................... 11
CHECKLIST INTERPETATIE CTG ............................................................................................. 12
HYPOXIE .............................................................................................................................. 12
GEEN HYPOXIE..................................................................................................................... 12
ACUTE HYPOXIE ................................................................................................................... 12
3-6-9-12-15 MINUTEN REGEL ................................................................................................ 13
SUBACUTE HYPOXIE ............................................................................................................ 13
GRADUEEL TOENEMENDE HYPOXIE ...................................................................................... 13
CHRONISCHE HYPOXIE ........................................................................................................ 14
O2 TOEDIENING ................................................................................................................... 14
BLOEDGAS-WAARDEN NAVELSTRENG-BLOED ...................................................................... 14
STAN ELEKTRODE ................................................................................................................. 15
02 SATURATIE-METING ......................................................................................................... 15
SCHEDEL-STIMULATIE .......................................................................................................... 15
PH-METRIE ........................................................................................................................... 15
TROMBO-EMBOLISCHE AANDOENINGEN............................................................................ 16
ALGEMEEN .......................................................................................................................... 16
RISICO ................................................................................................................................. 16
DIEP VENEUZE TROMBOSE ................................................................................................... 16
LONGEMBOLIE .................................................................................................................... 16
SINUSTROMBOSE ................................................................................................................ 16
TROMBOFILIE....................................................................................................................... 17
ACUUT LONGOEDEEM ......................................................................................................... 17
OPPERVLAKKIGE TOMBOFLEBITIS ......................................................................................... 18
AMNIONEMBOLIE ................................................................................................................ 18
PLACENTA AFWIJKINGEN ................................................................................................... 19
PLACENTA INPLANTING ........................................................................................................ 19
2
, PLACENTA ........................................................................................................................... 19
RETENTIE ............................................................................................................................. 19
PLACENTA SOLUTIO ............................................................................................................. 20
VRUCHTWATERAFWIJKINGEN ............................................................................................ 21
OLIGO-HYDRAMNION .......................................................................................................... 21
POLYHYDRAMNION ............................................................................................................. 21
MECONIUM-HOUDEND VRUCHTWATER (MHV) ..................................................................... 21
NS PROLAPS, AMNIOTOMIE, SCALP ELEKTRODE, VBAC & UTERUSRUPTUUR ........................ 23
NAVELSTRENG-PROLAPS ..................................................................................................... 23
AMNIOTOMIE ....................................................................................................................... 24
VOCHTBLAAS ................................................................................................................... 24
SCALP ELEKTRODE ............................................................................................................... 25
VBAC ................................................................................................................................... 25
UTERUSRUPTUUR ................................................................................................................ 26
KUNSTVERLOSSING ........................................................................................................... 27
SOORTEN ............................................................................................................................ 27
VAGINALE KUNSTVERLOSSING ............................................................................................. 27
INDICATIES ...................................................................................................................... 27
VEREISTEN ....................................................................................................................... 27
CONTRA-INDICATIES ........................................................................................................ 27
TAAK VRVR ....................................................................................................................... 27
COMPLICATIES ................................................................................................................. 28
VACUUM VS FORCEPS ...................................................................................................... 28
SECTIO CAESAREA ............................................................................................................... 28
SOORTEN ......................................................................................................................... 29
GENTLE SECTIO TECHNIEK ............................................................................................... 29
INDICATIES ...................................................................................................................... 29
VOORZORGEN.................................................................................................................. 29
VERLOOP INGREEP ........................................................................................................... 29
COMPLICATIES ................................................................................................................. 30
AANDACHTS-PUNTEN SECUNDAIRE. SECTIO .................................................................... 30
SPOEDSECTIO .................................................................................................................. 30
TAAK VRVR BIJ PRIMAIRE SECTIO ....................................................................................... 30
PIJN................................................................................................................................... 32
DEFINITIES ........................................................................................................................... 32
GROEPEN PIJNSTILLING ....................................................................................................... 32
INHALATIE ANALGESIE ......................................................................................................... 32
EPIDURALE ANESTHESIE (EDA) ............................................................................................. 32
TECHNIEKEN .................................................................................................................... 34
PROCES ........................................................................................................................... 34
TAAK VAN DE VRVR ........................................................................................................... 34
BIJWERKINGEN ................................................................................................................. 35
AANDACHTSPUNTEN VRVR ............................................................................................... 35
SYSTEMISCHE ANESTHESIE .................................................................................................. 36
TIJDENS ONTSLUITINGSFASE ............................................................................................ 36
POSTPARTAAL .................................................................................................................. 36
WATERINJECTIES .............................................................................................................. 37
OVERZICHT FARMACOLOGISCHE PIJNSTILLING .................................................................... 38
SCHOUDERDYSTOCIE........................................................................................................ 39
SCHOUDER-DYSTOCIE......................................................................................................... 39
RISICOFACTOREN ............................................................................................................ 39
BELEID ............................................................................................................................. 39
3
, COMPLICATIES ................................................................................................................. 40
PREVENTIE ....................................................................................................................... 40
DEEL EEF ........................................................................................................................... 41
PATHOLOGISCHE STAND VAN HET CAPUT .......................................................................... 41
ANATOMIE ........................................................................................................................... 41
AFMETINGEN FOETALE SCHEDEL ...................................................................................... 41
VLAKKEN VAN HODGE ...................................................................................................... 41
ORIËNTATIEPUNTEN BEKKEN ............................................................................................ 42
SOORTEN LIGGINGEN .......................................................................................................... 42
OVERZICHT LIGGINGEN .................................................................................................... 42
AFKORTINGEN .................................................................................................................. 42
NORMALE BARING ............................................................................................................... 43
DEFINITIES ....................................................................................................................... 43
BARMINGS-MECHANISME ACHTERHOOFDS-LIGGING ACHTERHOOFD VOOR (Aav)............ 43
ACHTERHOOFDSLIGGING .................................................................................................... 45
ACHTERSTE PLAATSING (Aala / Aara) ................................................................................. 45
BARINGS-MECHANISME ACHTERSTE PLAATSING .............................................................. 45
GEBOORTE-MECHANISME Aala/Aara ROTATIE 135 ........................................................... 46
GEBOORTE-MECHANISME Aala/Aara ROTATIE 45 ............................................................. 47
VERLOOP VAN ARBEID ...................................................................................................... 47
NADELEN EN COMPLICATIES ............................................................................................ 48
TAAK VRVR ....................................................................................................................... 48
KRUINLIGGING .................................................................................................................... 49
KRUINLIGGING (Kaa)......................................................................................................... 49
DISTANIA BIJ KRUINLIGGING ............................................................................................. 50
BARINGS-MECHANISME KRUINLIGGING ........................................................................... 50
OBSTRETISCHE INTERVENTIES .......................................................................................... 51
AANGEZICHTSLIGGING ........................................................................................................ 51
AANGEZICHTS-LIGGING (Aakv) ......................................................................................... 51
BARINGS-MECHANISME ................................................................................................... 51
Aaklv / Aakldw .................................................................................................................. 51
Aakrv / Aakrdw .................................................................................................................. 51
GEBOORTE-MECHANISME BIJ Aaklv .................................................................................. 52
GEBOORTE-MECHANISME BIJ Aakra .................................................................................. 53
BELEID / EFFECT OP ARBEID ............................................................................................. 53
COMPLICATIES ................................................................................................................. 53
TAAK VRVR ....................................................................................................................... 53
VOORHOOFDSLIGGING ....................................................................................................... 54
VOORHOOFDS-LIGGING (Vkv) .......................................................................................... 54
GEBOORTE-MECHANISME (Vkv) ........................................................................................ 54
BELEID ............................................................................................................................. 54
HOGE RECHTSTAND............................................................................................................. 55
HOGE RECHTSTAND ......................................................................................................... 55
BARINGS-MECHANISME ................................................................................................... 55
DIEPE DWARSSTAND ............................................................................................................ 56
DIEPE DWARSSTAND ........................................................................................................ 56
(Aaldw of Aardw) ............................................................................................................... 56
BARINGSMECHANISME .................................................................................................... 56
BEHANDELING ................................................................................................................. 56
ASYNCLITISME ..................................................................................................................... 57
ASYNCLITISME / WANDBEENLIGGING ............................................................................... 57
(Waldw / Wardw)............................................................................................................... 57
BARINGSMECHANISME .................................................................................................... 57
STUITLIGGING ................................................................................................................... 58
4
, DEFINITIE............................................................................................................................. 58
OORZAKEN .......................................................................................................................... 58
DIAGNOSE ........................................................................................................................... 58
STANDEN STUITLIGGING ...................................................................................................... 58
WIJZE VAN............................................................................................................................ 58
BEVALLING .......................................................................................................................... 58
PRENATAAL BELEID .............................................................................................................. 59
CONTRA-INDICATIES............................................................................................................ 59
COMPLICATIES .................................................................................................................... 59
VAGINALE STUITPARTUS ....................................................................................................... 59
BELEID TIJDENS ................................................................................................................ 59
ARBEID............................................................................................................................. 59
VOORBEREIDING VAGINALE STUITPARTUS ........................................................................ 60
BARINGS-MECHANISME ................................................................................................... 60
STAPPENPLAN VAGINALE STUITGEBOORTE ....................................................................... 60
HANGREEP VAN BRACHT .................................................................................................. 61
PARTIËLE STUITEXTRACTIE ................................................................................................ 62
GEBOORTE HOOFD .......................................................................................................... 63
NAZORG .............................................................................................................................. 63
UITWENDIGE KERING / VERSIE .............................................................................................. 64
CONTRA-INDICATIES ........................................................................................................ 64
TECHNIEK ........................................................................................................................ 64
COMPLICATIES ................................................................................................................. 65
INDUCTIE VAN DE BARING ................................................................................................. 66
INDUCTIE / PRE-INDUCTIE .................................................................................................... 66
INDELING ............................................................................................................................ 66
INDICATIES .......................................................................................................................... 66
CONTRA-INDICATIES............................................................................................................ 66
NADELEN VAN INDUCTIE ...................................................................................................... 66
FACTOREN DIE UITKOMST INDUCTIE BEÏNVLOEDEN .............................................................. 66
INDUCTIEMETHODEN .......................................................................................................... 67
NIET-FARMACOLOGISCHE METHODEN ................................................................................. 67
FOLEY-CATHETER ............................................................................................................. 67
COOK-BALLON ................................................................................................................. 67
TECHNIEK BALLONCATHETER ........................................................................................... 67
STRIPPING ....................................................................................................................... 68
AMNIOTOMIE.................................................................................................................... 68
FARMACOLOGISCHE METHODEN ......................................................................................... 68
PROSTAGLANDINES ......................................................................................................... 68
OXYTOCINE ...................................................................................................................... 70
TAAK VRVR ........................................................................................................................... 70
OVERZICHT INDUCTIE METHODEN ....................................................................................... 70
POSTPARTUM HAEMORRAGHIE .......................................................................................... 78
HAEMORRAGIE .................................................................................................................... 78
OORZAKEN .......................................................................................................................... 78
TONUS................................................................................................................................. 78
BEHANDELING ................................................................................................................. 79
TRAUMA............................................................................................................................... 79
PERINEUMRUPTUUR......................................................................................................... 80
CERVIXRUPTUUR .............................................................................................................. 80
VAGINARUPTUUR ............................................................................................................. 81
VULVARUPTUREN ............................................................................................................. 81
TISSUE ................................................................................................................................. 81
TROMBINE ........................................................................................................................... 82
DIC .................................................................................................................................. 82
5
, SYNDROOM VAN SHEEHAN .............................................................................................. 82
UTERUSRUPTUUR ............................................................................................................. 83
INVERSIO UTERI................................................................................................................ 83
MEERLINGEN ..................................................................................................................... 85
MEERLING- .......................................................................................................................... 85
ZWANGERSCHAP ................................................................................................................. 85
TYPEN.................................................................................................................................. 85
DIAGNOSE MEERLINGZWS ................................................................................................... 85
COMPLICATIES .................................................................................................................... 85
TTS – twin-to-twin-syndroom ............................................................................................. 86
TIJDENS PARTUS ............................................................................................................... 86
VAGINALE BEVALLING .......................................................................................................... 86
INTERTWIN-INTERVAL ....................................................................................................... 87
VERTEX-VERTEX TWEELING ............................................................................................... 87
VERTEX-NON-VERTEX TWEELING ...................................................................................... 87
SPECIFIEKE SITUATIES ...................................................................................................... 87
SECTIO ................................................................................................................................ 88
KERNPUNTEN ...................................................................................................................... 88
6
