Review

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Review

• Where should I spend
• most of my time?

2
Ground Rules

• This review is not all-inclusive
• You are still responsible for
• Extra notes, comments added in class to clarify a
  concept, etc

3
Birth Plan

• Be familiar with terms and common issues that
  parents should consider
• Be familiar with the summary statements in the
  circumcision guidelines document
• -anesthesia?
• -UTI?
• -penile cancer?
• -AIDS?
• ...

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Terminology of Birth

• Recognition of labor
• retraction
• bloody show
• Hydrostatic dilator
• Mechanisms of birth

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Stages of Labor What happens? How long does it
last?

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Retention of Placental Parts

• Symptoms? Clinical signs?
• Management?
• Complications?

8
Management of Labor Pain

• Type of pain felt in each stage
• Nulliparous vs. Multiparous
• What determines maternal satisfaction? What does
  not?

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Nonpharmacological Pain Relief

• Continuous labor support (doula)
• Benefits?
• Warm water baths
• Efficacy? Effect on epidurals?
• Risks? Recommendations?
• Sterile Water Injections
• Position, Touch Massage

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Natural Birth

• Effect on endorphins, adrenal glands, etc.

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Pharmacological - Benefits/Risks
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Complications of Labor

• Polarity - power
• Chiropractic relationship?

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Primary ( ) inertia vs. Secondary
inertia ( )
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Abnormal Polarity

• Disordered
• Hypertonic lower pole
• Colicky uterus
• Constriction ring aka ________
• Cervical dystocia

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Passage

• Pelvis shape
• contracted pelvis
• 2 cm
• Tumor, fibroid, cysts, fracture

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Puerperium - ?

• ___ weeks
• Lochia rubra
• Lochia serosa
• Lochia alba

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• Expected changes in tissues
• involution
• How does breastfeeding affect ovulation?
• Considerations related to different types of birth

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Puerperium Concerns

• Hemorrhage
• Top 3 causes?
• Infection (risk factors? s/s? Tx?)
• Endometritis
• UTI
• Mastitis
• Wounds

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Puerperium Concerns

• Endocrine (S/S?)
• Postpartum Thyroiditis PPT
• Thyrotoxicosis
• Hypothyroidism
• Postpartum Graves Disease
• Less common

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Puerperium Concerns

• Psychiatric
• Postpartum Blues
• Postpartum Depression
• Postpartum Psychosis
• S/S? How common is each? What causes it? Risk
  factors?

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Breastfeeding

• How long?
• Benefits? Mom / Baby
• Contraindications?
• Preterm Infant
• Beyond infancy

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Solids

• When?
• What foods first?
• Signs of readiness
• Dangers of early solids
• Cows milk after _________
• Fruit juice
• Limit to 2-4 oz/day (with meals)
• Vitamin C increases iron absorption

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Seriously Ill

• Know red flags
• When assessing a child with a fever consider

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• ___________ alone is not a sign of serious
  illness
• Dehydration
• lt ___ diapers in a 24 hr period
• signs of dehydration

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Referral Criteria?