Description
The following tests and examinations are necessary for insuring the safety and health of mother and child.
Uterine contractions
# Uterine contractions can be measured by the mother's subjective expressions or by directly palpating the abdomen to get a sense of the contractions and laxity.
# The interval, frequency, and intensity of the contractions, and the baby's heartbeat can be measured with a metrodynamometer. Equipment on the belly may be uncomfortable for the mother, but it is the most accurate way to monitor the baby.
Abdominal examination
# By palpating the mother's abdomen, the position of the baby can be determined.
Pelvic examination
An internal examination is an important element in managing childbirth. It examines the inside of the vagina and pelvis. When performing a pelvis examination, a finger is usually inserted in the vagina, but it can also be done through the anus.
What an internal examination will check for:
# How soft, short, and open the uterine opening is.
# How far the baby's head has descended into the birth canal.
# Whether the pelvis and vagina are narrow or wide.
# Whether the baby is facing up, down, or sideways; how hard the baby's head is; how swollen the baby's head is from labor.
# When there is vaginal bleeding (i.e., "colporrhagia"), examinations must be prohibited. If colporrhagia is severe, then an internal examination can be performed only after preparations for a cesarean section are made. Of course, vaginal bleeding must be distinguished from normal prenatal discharge with blood.
Amniotic fluid
# A quarter of all mothers begin labor when their water breaks. Delivery usually begins within 24 hours after the water breaks. If the baby is still in the uterus after 24 hours, then the chance of an infection developing in the uterus is high.
# After observing amniotic fluid from the uterine opening with a colposcope, the secretion is tested by using acidity (pH) test paper.
# The presence of meconium in the amniotic fluid and unpleasant smell provide important clues regarding the baby's condition.
Anal Examination
# Some doctors avoid using the vagina for pelvic examinations and, instead, use the anus to check the condition of the uterine opening (i.e., cervix).
# Examinations differ depending on the doctor's skill, but an anal examination is generally less accurate than a vagina examination. One advantage of the anal examination is that there is less chance for infection.
# When there is a high risk of infection or many internal examinations are expected, an anal examination can be used to determine how open the cervix is, and how far the baby's head has descended.
Vital Signs
# Vital signs measure changes in pulse, body heat, breathing, and blood pressure.
# With the tension and stress of childbirth, the mother can have a faster pulse; however, if the pulse continues to grow faster, it could be a sign of dehydration or exhaustion. Body temperature is measured every hour if the water has broke or there are reasons to suspect a rise in body heat.
# The mother's breathing can change depending on the birth process. When the body is under stress, hyperventilation occurs and breathing becomes deeper and faster. Failure to use breathing techniques appropriately during labor can cause hyperventilation, accompanied by complaints of dizziness and aches in the extremities. Covering the mouth and nose with a paper bag or both hands and breathing in and out alleviates hyperventilation.
# The reasons for low/high blood pressure must be determined. High blood pressure can be caused by pain and anxiety, while low blood pressure can be caused by local anesthesia, medication, or bleeding.
Laboratory Test
# Urine test: Checks for possible complications with the mother's hydration level, nutriture, and blood pressure.
# Blood test: Check for anemia; identifying the blood type helps prepare for any emergencies that could occur during labor.
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