Page 67 - 2023 Elctronic Book (3) Normal Labor_Neat

Evaluation (Expected Outcome)
• The placenta is expelled without difficulty.

• The physiological status of the woman remains normal.

Care of the newborn include:

Care of the newborn include:

1- Clearance of the air passages (nose, mouth, and pharynx) by a mucus cather or suction
pump.

2- Apgar score is determined 1 and 5 minutes after delivery of the infant

3- Aplastic clamp is applied 5cm from fetal abdomen to avoid umbilical hernia. The cord is

th
inspected for bleeding and painted with alcohol. The cord usually falls on the 6 day. If the
cord is thick and the umbilical cord clamp cannot be applied, the cord is ligated by two

thick silk ligatures.

4- The infant is examined for injuries and congenital anomalies as imperforate anus.

5- Vernix caseosa is removed from the neck, maxilla and groins and a bath is not
necessary.

6- The infant is weighted, gestational age is determined, dressed and bracelets is applied
for identification.

7- Penicillin eye drops or ointment is used to protect against gonococcal ophthalmia

neonatorum. Tetracycline or erythromycin ointment can be used.

8- Vitamin k1 is given to all infant immediately after delivery as 1gm IM or is given orally
as 1gm at birth and the dose is repeated at the end of the first and third week (3 oral dose).

In high-risk infants who are liable, to develop hemorrhage as preterm as asphyxiated
infants, the first dose is given IM and then two oral dose are given as above.

Fourth stage of labor:

Definition:

It is the stage of early recovery. Begins immediately after expulsion of the placenta

and membranes and lasts for one hour. During which careful observation for the patient

particularly the signs of postpartum hemorrhage. Uterine massage is usually done every 5

minute during this period.

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