Nearly 10% of all births are classified as preterm (1). Whilst improvements in medical care for preterm newborns have improved survival rates, prematurity still accounts for up to 70% of perinatal death and nearly 50% of poor chronic neurologic outcome and cerebral palsy (CP). CP is therefore the most common cause of chronic disability in children (2). In Australia, a baby is born with a brain injury that underlies CP every 15 hours. This condition is characterised by damage to the developing brain causing motor and postural impairments that inevitably lowers the patient’s quality of life. The majority of these cases occur before 37 weeks of gestation due brain immaturity and susceptibility to maternal and fetal complications (3). Of these …show more content…
Chorioamnionitis is associated with pregnancies which have been further complicated by premature rupture of membranes (PROM) and spontaneous delivery (3). PROM does not have to be present to be diagnosed with chorio; more than a third of patients that deliver preterm will have intact placental membranes, yet 13% of these patients will later be diagnosed with chorioamnionitis (4). Nevertheless the addition of PROM increases the chances of acquiring chorio during pregnancy. PROM it is the most easily identifiable risk factor for the condition, along with vaginal bacterial abnormalities, meconium stained amniotic fluid, prologued labour and other factors that make the mother susceptible to …show more content…
Prostaglandin release stimulates uterine contraction, which cause the baby to move down the birth canal and weaken the membranes. Metalloproteases initiate the degradation of the chorion and amnion that inevitably cause them to rupture.
Preterm chorioamnionitis causes inflammation and injury to the brain and increases the risk of intraventricular haemorrhage and diffuse white matter injury (6). With no treatments available to protect the baby from the infection, most cases involving ruptured membranes require the baby to be delivered early to reduce the risk of further complication. However, by the time of delivery, the baby has been exposed to infection and the associated risks to the developing brain, not to mention the risk of preterm delivery itself.
Fetal inflammatory response
These women could anticipate delays in normal growth and development for the fetus. The exact cause of post term pregnancy is unknown. The mother experiencing post term pregnancy is at risk for trauma, hemorrhage, infection, and labor abnormalities (Ward et al., 2016, p. 543). Labor induction prior to 42 weeks’ gestation prevents MAS and other complications. A biophysical profile measuring the heart rate, breathing and body movements, tone, and the amniotic fluid volume is used to monitor the fetus for intrapartum fetal stress that could cause passage of meconium. Diabetic woman is at high risk for preeclampsia or eclampsia, infection, hydramnios, postpartum hemorrhage, and cesarean birth (Ward et al., 2016, p. 383). In addition, fetal macrosomia prolongs labor due to shoulder dystocia. The glucose challenge test, and the 3- hour OGTT is used for gestational diabetes screening, done after 24 weeks of pregnancy. Abnormalities of the respiratory system as explained earlier are the most concerning complication of MAS, needing immediate
In conclusion, the first stage of giving birth consists of contractions that will help get the baby's head into the birth canal and get ready for delivery, along with the cervix thinning out and dilation increasing. During the second stage, you will begin to push the baby out. As the tissue starts to stretch, you might experience “the ring of fire”. Shortly after the stretch, the baby's head will be out and then its body. The final stage is quick and almost effortless.
Many questions about the causes of Sudden Infant Death Syndrome (SIDS), also known as “crib death,” are still unresolved. The mysterious and elusive nature of SIDS creates problems, doubts, and more questions. This paper will present some of the most commonly asked questions as well as the answers that have been uncovered by scientists after years of research and study.
Having described the scenario, this essay will now focus on the anatomy and physiology during Laura’s third stage. After the delivery of her baby, Laura’s uterus continued to contract and retract due to the effect of oxytocin on the myometrium. Herman (2000) and Herman et al. (2002) describe the placental separation in three stages; latent, contraction/detachment and expulsion. During the latent phase Laura’s myometrium begun to contract and retract. During the contraction/detachment phase Laura’s myometrium continued to contract and retract. Therefore, the surface area decreased under the placenta and it detached from the spongy layer of the decidua, consequently exposing the maternal spiral arteries. During the expulsion phase, Laura’s placenta descended into her lower uterine segment and the membranes peeled away from the walls of her uterus. With further contractions of her uterus, Laura’s placenta and membranes descended into her vagina and expelled from it.
According to Lucile Packard Children’s Hospital, “In the United States, nearly thirteen percent of babies are born preterm, and many of these babies also have a low birth weight.” The baby may be put into the NICU for varies reasons. However, the most common reason that a child is put into the NICU is because he or she is premature. Premature means the baby was born before the 36 weeks. It is never good for a baby to be born early, as this could mean that the baby is not fully developed. There are other factors as to why a child may need to be put into the NICU after birth. For instance, birth defects can be the cause of why a baby is put into the NICU. A baby may be born with an infection such as herpes or chlamydia which can damage the newborns immune system at such a young age. Low blood sugar or hypoglycemia can also cause an infant to be put into the NICU. Some maternal factors of why a baby may be put into the NICU is if the mother is “younger than 16 or older than 40.” If the parent may be an alcoholic or expose the baby to drugs, this can put the child into NICU care. If the parent has an STD or sexual transmitted disease, the baby is most likely going to have to be put into the intensive care unit. “Twins, triplets, and other multiples are often admitted into the NICU, as they tend to be born earlier and s...
In America, 1 out of 8 children are born premature. The earlier a child is born from their suggested due date, the poor severe the condition the child can receive. With health conditions of the mother, that may be a main reason why a child may become premature. Women with uterine, cervical abnormalities, or having twins, triplets, etc. may cause a risk of preterm labor. A women’s health is a main factor of how their child may come out. Smoking, drinking, use of illegal drugs may cause women to have preterm labor as well. To...
eclampsia in a pregnant woman can put her and her unborn child at risk. A risk
Deering, S.H. (2004). Abruptio placentae. Department of obstetrics and gynecology: Madigan army medical center, 2, 3.
Postpartum hemorrhage is the leading cause of maternal mortality in the world, according to the World Health Organization. Postpartum hemorrhage (PPH) is generally defined as a blood loss of more than 500 mL after a vaginal birth, more than 1000 mL after a cesarean section, and a ten percent decrease in hematocrit levels from pre to post birth measurements (Ward & Hisley, 2011). An early hemorrhage occurs within 24 hours of birth, with the greatest risk in the first four hours. A late hemorrhage happens after 24 hours of birth but less than six weeks after birth. Uterine atony—failure for the uterine myometrium to contract—is the most common postpartum hemorrhage (Venes, Ed.).(2013). Other etiologies include lower genital tract lacerations, uterine inversion, retained products of conception and bleeding disorders (Kawamura, Kondoh, Hamanishi, Kawasaki, & Fujita, (2014).
However, about 20 to 40 percent of women who attempt VBAC required caesarean section as a result of failed trial of labour. Statically, about 0.2 to 1.5 percent of VBAC will be complicated by rupture of uterus. There’s some evidence for association between the type of uterine incision in previous caesarean section(s) and the risk of uterine rupture. Transverse uterine incision has the lowest risk of 0.2-1.5% as to vertical or T-shaped incisions that have 4-9% risk. Note direction of skin incision does not always reflect the direction of uterine incision. Both failure of labour and ruptured uterus require an emergency caesarean. Conversely, 60 to 80 percent of women who are considered candidates for a trial of labour after caesarean will have a successful vaginal birth. Fortunately, the risk of foetal death is very low with both VBAC and elective caesarean section but higher in
Sepsis is a “cunning, insidious and non-specific illness” (Raynor, 2012) but progression can be rapturous with a sudden catastrophic circulatory collapse and mortality up to 50%. (Angus et al., 2001) Over five million cases arise per year of maternal sepsis, resulting in an estimated 62,000 maternal deaths globally (WHO, 2008) During the 18th and 19th century, puerperal sepsis resulted in 50% of maternal deaths over Europe (Loudon, 2000). The World Health Organisation (WHO) defined puerperal sepsis as ‘infection of the genital tract occurring at any time between the rupture of membranes or labour, and the 42nd day postpartum, of which two or more of the following are present: pelvic pain, fever 38.5C or more, abnormal vaginal discharge, abnormal smell of discharge, and delay in the rate of reduction of size of uterus (less than 2 cm a day during the first 8 days)’ (WHO, 1992).
Reddy, U. M., Zhang, J., Sun, L., Chen, Z., Raju, T. N., & Laughon, K. (2012). Neonatal mortality by attempted route of delivery in early preterm birth. American Journal of Obstetrics & Gynecology, 207(2). doi:10.1016/j.ajog.2012.06.023
Unlike vaginal birth delivery, the process of a cesarean delivery is quite different, but just as safe as giving vaginal birth (Taylor, 1). When delivering a baby using the cesarean method, there are two ways anesthetic can be used. The women can be put into an unconscious state using the anesthetic, therefore she will be asleep during the entire operation and her coach may not be present. The other way for the anesthetic to be used would be in an epidural or spinal block to temporarily numb the woman from her waist down. In this case the mother will be awake and her coach may be present to give her extra support. Once the anesthetic is working, an incision is made in the abdomen either horizontally or vertically, depending on the reason for the cesarean delivery. A vertical incision is made when the baby is in trouble and needs to be out as quickly as possible, when there is more time the horizontal incision is used. The baby is then lifted out of the uterus and gone for the APGAP procedure. The placenta is then removed and the mother’s reproductive organs are examined before closing the incision (Taylor, 1).
During pregnancy, many complications may occur. Some of these complications include birth defects, Ectopic pregnancies, Preeclampsia, and miscarriage. The most common birth defects are those associated with the brain and spinal column, heart, and limbs. The other common defect concerns the chromosomes in the cells of the fetus. (Ex. downs syndrome.) In an ectopic pregnancy, the fertilized egg attaches itself in a place other than inside the uterus. Most ectopic pregnancies occur in a fallopian tube. The narrow fallopian tubes are not designed to hold a growing embryo, so the fertilized egg in this type of pregnancy cannot develop normally. Preeclampsia is a condition where the mother suddenly experiences a sudden increase in blood pressure after about the 7th month of pregnancy. This can be a deadly situation for the mother; usually the doctors will have her deliver the baby prematurely. Miscarriages are usually caused by chromosomal abnormalities, Infections, uncontrolled diabetes, uterine abnormalities, or a woman's production of certain antibodies during pregnancy can also cause an early miscarriage.
Schendel#, D. E., Schuchat, A., & Thorsen, P. (2002). Public health issues related to infection in pregnancy and cerebral palsy. Mental Retardation & Developmental Disabilities Research Reviews, 8(1), 39-45.