A Plan Of Care For A Mother And Her Baby

This particular case study involves a 29 year old obstetric patient who presented to the labor and delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks

• Maternal injuries include cervical lacerations, vaginal hematomas, hemorrhage, perineal tears, and anal sphincter injury.

This essay will explore why consent and confidentiallity is important in midwifery practice. It will look into why it is needed and what can happen if these aspects are breeched in anyway. The National Health service was founded in 1948, this brought free healthcare to everyone. In 1902 the Midwives act becomes a law and midwifery became an established profession, fast forward to 2004 the midwives rules and standards are published and then amended in 2012 and in 2008 the code of conduct was brought into practice. These publications are legal documents in which all nurse and midwives must abide by. In these documents there are clear rules that surround both consent and confidentiality (NHS Choices 2014)

This paper will look at two different models of maternity care provided to women midwifery led care and medical led care perspectives. It will compare and contrast the midwifery caseload care and obstetric care. How this impacts on the woman’s childbearing experience and midwifery practice will also be discussed in this essay.

Researchers do not know exactly what causes an amniotic fluid embolism. However, they do believe that a ruptured uterus, ruptured membranes and a pressure gradient from vein to uterus can increase the risk of this condition. There has also been

Accreta has three distinct types; placenta accreta, placenta increta and placenta percreta. Placenta accreta represents 79% of accreta cases, while placenta increta represents 14% of cases and placenta percreta represents 7% of cases. In placenta accrete the villi are affixed to the myometrium of the uterus; in placenta increta the placental villi grow through the myometrium, and in placenta percreta the placenta villa grow through the myometrium and invade other structures such as the bladder and colon (Balayla & Bondarenko, 2012). The risks and complications are related to the degree in placental invasion (Figure

Preeclampsia is heterogeneous in its presentation as well its association with long-term effectss for child and mother. Pre-eclampsia exists as two major types, namely; maternal and placental pre-eclampsia (Ness and Roberts 1996). It is widely agreed upon that poor placentation is strongly associated with Foetal Growth Restriction (FGR), even when pre-eclampsia is absent, but it is less clearly documented in association with normal fetal growth and

Non-induced embryonic or fetal death or passage of products of conception before 20 weeks gestations (Spontaneous Abortion: Merck Manuals)

Ninety percent of all postpartum hemorrhages are caused by uterine atony-that is, failure of the uterine muscles to contract normally after the baby and placenta are delivered. The blood vessels supplying the placenta during pregnancy are severed when the placenta separates from the wall of the uterus. The bleeding that results from these severed vessels normally stops when the uterus contracts, compressing the vessels. However, if the uterus doesn't contract enough, the bleeding can continue. Significant blood loss can result from a floppy, uncontracted uterus.

The placenta is implanted in the lower uterine segment near or over the internal cervical os. The degree to which the internal cervical os is covered by the placenta has been used to classify four types of placenta previa; total, partial, marginal and low–lying. In total previa the internal os is entirely covered by the placenta. Partial placenta previa implies incomplete coverage of the internal os. Marginal placenta previa indicates that only an edge of the placenta extends to the margin of the internal os. And the last is the low – lying placenta has been used when the placenta is implanted in the lower uterine segment but not reach the os. The more descriptive classification that includes placenta previa is in the third trimester.

Trauma is an important cause of maternal and fetal morbidity and mortality, and blunt abdominal trauma is a particular concern. Approximately 8% of pregnant women sustain some form of traumatic injury. Automobile accidents and falls account for most of the injuries. Studies of pregnant women involved in automobile accidents have demonstrated increased rates of premature rupture of membranes, placental abruption, preterm birth, and stillbirth. A recent study examines pregnancies complicated by traumatic injuries and outcomes in relation to place of triage.

Placenta moves as the womb stretches and grows during pregnancy. Early in pregnancy it is very normal for the placenta to be low in the womb, but as pregnancy progresses, the placenta moves to the top of the womb (MedlinePlus, 2012). When the cervix opens for delivery the placenta should be close to the top of the womb and should occur by the third trimester. When the placenta covers the cervix this is called previa and there are three different forms of placenta previa. The first type is marginal. The placenta does not over the opening but is next to the cervix. The next type is partial and that is when the placenta covers part of the cervical opening. Lastly there is complete, the cervical opening is completely covered by the placenta. Depending on the severity of the previa it can make a vaginal delivery very complicated and will most likely result in the mother having a C-section.

The exact etiology of preeclampsia is unknown but it is hypothesized that it develops from “failure of the normal development of the maternal-fetal interface in the placenta”

Placental abruption is a serious and potentially life threatening condition for both the mother and fetus that requires urgent diagnosis and care from a multidisciplinary team. Although relatively rare, occurring in approximately 0.4 to 1% of all pregnancies, placental abruption accounts for between 10 and 20% of all perinatal mortality and approximately 10% of all preterm births (Tikkanen M 2011) and is the leading cause of vaginal bleeding after the first trimester (Oyelese Y & Ananth CV 2006). The cause of placental abruption is not well understood however it is thought to often be multifactorial and a woman’s known risk factors and co-morbidities may increase the risk status of this condition presenting although it is more often than

EP cases in northern Nigeria are of late presentations, tubal rupture with associated hemodynamic instability and consequences compounded by poor health system that differs from the global trend of early diagnosis and more conservative management (Mairiga, et al., 2009).