NUR 4445 Intrapartum Complications
1. What is macrosomia? What are the risk factors for macrosomia (6)?
Answer
- Baby weighing e 4,000 g (8 lb 8 oz) at birth.
- Risk factors associated with macrosomia
· Obesity, diabetes, pelvic abnormalities, post-date pregnancy, short stature, previ- ous shoulder
dystocia
2. What are the maternal complications associated with macrosomia (5)?
Answer
- Cephalopelvic disproportion (CPD)
- Dysfunctional labor
- Prolonged labor
- Soft tissue laceration during vaginal birth
- Postpartum hemorrhage
3. What are the fetal complications associated with macrosomia (9)?
Answer
- Shoul- der dystocia (head is born but anterior shoulder cannot pass through cervix, if
unresolved can lead to death)
- Brachial plexus injury
- Fractured clavicle
- Asphyxia
- Hypoglycemia
- Meconium aspiration
- Hyperbilirubinemia
- Obesity
- Diabetes
4. What does nursing assessment in preparation for delivery look like in macrosomia (4)?
Answer
, - Want to identify before labor onset to reduce the occurrence of associated maternal fetal
problems.
- Evaluation of maternal pelvis if a large fetus is suspected
- Estimation of fetal size
- Ultrasonography may be indicated
5. What does nursing management look like during delivery with macrosomia
(7)?
Answer
- Unexpected shoulder dystocia is critical problem
- assist woman in McRoberts maneuver or apply suprapubic pressure to aid in the birth of the
fetal shoulders
- Application of fundal pressure is contraindicated
- Evaluation of rates of cervical dilation and fetal descent
- Continuous fetal monitoring
report any sign of labor dysfunction or non-reassuring fetal status to HCP
- Lack of fetal descent should raise suspicion that infant may be too large for vaginal birth
- Support and inform laboring woman and her partner
6. What does neonatal assessment look like with macrosomia (4)?
Answer
- Inspect newborn for cephalohematoma, Erb palsy, and fractured clavicles
- Inform nursery staff of any problems
- Close monitoring for cerebral, neurologic, and motor problems
- Monitor BG
7. What does maternal care/assessment look like with macrosmia (2)?
Answer
- Ex- pect uterine atony and boggy (soft) uterus
- Monitor for and treat uterine hemorrhage
1. What is macrosomia? What are the risk factors for macrosomia (6)?
Answer
- Baby weighing e 4,000 g (8 lb 8 oz) at birth.
- Risk factors associated with macrosomia
· Obesity, diabetes, pelvic abnormalities, post-date pregnancy, short stature, previ- ous shoulder
dystocia
2. What are the maternal complications associated with macrosomia (5)?
Answer
- Cephalopelvic disproportion (CPD)
- Dysfunctional labor
- Prolonged labor
- Soft tissue laceration during vaginal birth
- Postpartum hemorrhage
3. What are the fetal complications associated with macrosomia (9)?
Answer
- Shoul- der dystocia (head is born but anterior shoulder cannot pass through cervix, if
unresolved can lead to death)
- Brachial plexus injury
- Fractured clavicle
- Asphyxia
- Hypoglycemia
- Meconium aspiration
- Hyperbilirubinemia
- Obesity
- Diabetes
4. What does nursing assessment in preparation for delivery look like in macrosomia (4)?
Answer
, - Want to identify before labor onset to reduce the occurrence of associated maternal fetal
problems.
- Evaluation of maternal pelvis if a large fetus is suspected
- Estimation of fetal size
- Ultrasonography may be indicated
5. What does nursing management look like during delivery with macrosomia
(7)?
Answer
- Unexpected shoulder dystocia is critical problem
- assist woman in McRoberts maneuver or apply suprapubic pressure to aid in the birth of the
fetal shoulders
- Application of fundal pressure is contraindicated
- Evaluation of rates of cervical dilation and fetal descent
- Continuous fetal monitoring
report any sign of labor dysfunction or non-reassuring fetal status to HCP
- Lack of fetal descent should raise suspicion that infant may be too large for vaginal birth
- Support and inform laboring woman and her partner
6. What does neonatal assessment look like with macrosomia (4)?
Answer
- Inspect newborn for cephalohematoma, Erb palsy, and fractured clavicles
- Inform nursery staff of any problems
- Close monitoring for cerebral, neurologic, and motor problems
- Monitor BG
7. What does maternal care/assessment look like with macrosmia (2)?
Answer
- Ex- pect uterine atony and boggy (soft) uterus
- Monitor for and treat uterine hemorrhage
