IMPORTANT TO KNOW:
Normal Ranges for Fetus:
Temp: 97.7-99.5 (preferred route is rectal)
HR: 110-160
RR: 30-60
BP: 60-80 systolic / 40-50 diastolic
Blood glucose: 40-60 (<40 = feed infant)
Bilirubin: 5-6 mg/dL
Head: 32-36
Chest: 30-33
Weight: 5.5-8.9
Need to Know Drugs:
Tocolytic drugs:
- Slow or stop contractions to prolong labor
- INMT
Pitocin/Oxytocin:
- Stimulates and strengthens contractions
- Helps stop vaginal bleeding (prevents PPH)
- Induction of labor (start mainline and then give as piggyback)
Prolactin:
- Promotes lactation
Cervical Ripening agents:
- Cervidil
- Cytotec
Pudendal Block:
- Lidocaine
- Helps with pain
- Given for episiotomy (small cut made near vagina to help babies head come out)
Betamethasone:
- Fetal lung development
- 2 doses (24 hours apart)
Magnesium Sulfate (Antidote = Calcium Gluconate):
- Prevents seizures in preeclampsia
,- Slows or stops preterm
labor Methergine:
, - Treats severe bleeding after childbirth (prevents PPH)
- CONTRAINDICATED IN PATIENT WITH HIGH BP
Drugs for Preterm Labor:
- Indomethacin - tocolytic drug that prolongs pregnancy by decreasing contractions
- Nifedipine (Procardia) - relaxes uterine contractions
- Magnesium sulfate
- Terbutaline - prevents and slows contractions
Newborn Drugs:
- Erythromycin - prevents eye infection from gonorrhea
- Hep B
- Vitamin K
FETAL ASSESSMENT & MONITORING:
EXTERNAL FETAL MONITORING:
Toco Ultrasound: detects FHR (FOLLOW HEAD)
- place lower part of umbilicus if baby is in vertex position
- place on top part of abdomen if baby is in breech position
Toco Transducer: detects uterine contractions
- placed at the top most part of the stomach
- Tracks FFIT
- Frequency of contraction
- Fetal status (how is the baby doing)
- Intensity of contraction
CERVICAL ASSESSMENT:
- DEF
INTERNAL FETAL MONITORING:
- Invasive monitoring method
- Patients who don't need internal monitoring: Breach, bleeding, placenta previa, GBS+, HIV +
- Preferred for patients who are OBESE
- Determines intensity of contractions (has IUPC attached to the uterine wall)
- Fetal scalp electrode (FSE) assess fetal heart beat and defects signs of fetal distress
WHAT TO MEASURE WHEN PATIENT IS IN LABOR & EXPERIENCING CONTRACTIONS:
- Duration: length of contraction - look at the beginning of the contraction and the end of the
same contraction (measured in seconds)
- Intensity: strength of contraction - use IUPC (intrauterine pressure catheter)
- Frequency: how often are the contractions - beginning of first contraction to the beginning of
the next contraction (measured in minutes)
Normal Ranges for Fetus:
Temp: 97.7-99.5 (preferred route is rectal)
HR: 110-160
RR: 30-60
BP: 60-80 systolic / 40-50 diastolic
Blood glucose: 40-60 (<40 = feed infant)
Bilirubin: 5-6 mg/dL
Head: 32-36
Chest: 30-33
Weight: 5.5-8.9
Need to Know Drugs:
Tocolytic drugs:
- Slow or stop contractions to prolong labor
- INMT
Pitocin/Oxytocin:
- Stimulates and strengthens contractions
- Helps stop vaginal bleeding (prevents PPH)
- Induction of labor (start mainline and then give as piggyback)
Prolactin:
- Promotes lactation
Cervical Ripening agents:
- Cervidil
- Cytotec
Pudendal Block:
- Lidocaine
- Helps with pain
- Given for episiotomy (small cut made near vagina to help babies head come out)
Betamethasone:
- Fetal lung development
- 2 doses (24 hours apart)
Magnesium Sulfate (Antidote = Calcium Gluconate):
- Prevents seizures in preeclampsia
,- Slows or stops preterm
labor Methergine:
, - Treats severe bleeding after childbirth (prevents PPH)
- CONTRAINDICATED IN PATIENT WITH HIGH BP
Drugs for Preterm Labor:
- Indomethacin - tocolytic drug that prolongs pregnancy by decreasing contractions
- Nifedipine (Procardia) - relaxes uterine contractions
- Magnesium sulfate
- Terbutaline - prevents and slows contractions
Newborn Drugs:
- Erythromycin - prevents eye infection from gonorrhea
- Hep B
- Vitamin K
FETAL ASSESSMENT & MONITORING:
EXTERNAL FETAL MONITORING:
Toco Ultrasound: detects FHR (FOLLOW HEAD)
- place lower part of umbilicus if baby is in vertex position
- place on top part of abdomen if baby is in breech position
Toco Transducer: detects uterine contractions
- placed at the top most part of the stomach
- Tracks FFIT
- Frequency of contraction
- Fetal status (how is the baby doing)
- Intensity of contraction
CERVICAL ASSESSMENT:
- DEF
INTERNAL FETAL MONITORING:
- Invasive monitoring method
- Patients who don't need internal monitoring: Breach, bleeding, placenta previa, GBS+, HIV +
- Preferred for patients who are OBESE
- Determines intensity of contractions (has IUPC attached to the uterine wall)
- Fetal scalp electrode (FSE) assess fetal heart beat and defects signs of fetal distress
WHAT TO MEASURE WHEN PATIENT IS IN LABOR & EXPERIENCING CONTRACTIONS:
- Duration: length of contraction - look at the beginning of the contraction and the end of the
same contraction (measured in seconds)
- Intensity: strength of contraction - use IUPC (intrauterine pressure catheter)
- Frequency: how often are the contractions - beginning of first contraction to the beginning of
the next contraction (measured in minutes)
