Page 273 - Critical Maternity & Newborn Health Nursing
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the nurse should call for urgent assistance.
- The nurse should explain her findings and emergency measures
that may be needed to the mother and her birth partner.
If an oxytocin infusion is in progress this should be stopped.
- If the cord lies outside the vagina, then it should be gently replaced
to maintain oxygenation, prevent spasm, to maintain temperature and
prevent drying.
Administering oxygen to the mother by face mask at 4 L/min may
improve fetal oxygenation
Relieving pressure on the cord
-The risks to the fetus are hypoxia and death as a result of cord compression.
-The risks are greatest with prematurity and low birth weight
- The midwife may need to keep her fingers in the vagina and hold
the presenting part off the umbilical cord, especially during a
contraction.
-The mother can be helped to change position to further reduce
pressure on the cord.
- Raising her pelvis and buttocks or adopting the knee–chest position
will cause the fetus to gravitate towards the diaphragm
Knee- chest position
- The foot of the bed may also be raised (Trendelenburg position) to
relieve compression on the cord.
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