Paramedics assessment with Problems in Pregnancy and Complicated Research Paper

Paramedics assessment with Problems in Pregnancy and Complicated Childbirth - Research Paper Example By estimating her EDC or EDD through ultrasonography or manual calculations by measuring the fundic height or getting the LMP, a rough correlation with her uterine contractions can be deduced to know if the patient is undergoing false or true labor. Rupture of membranes or excretion of a mucus plug may indicate an active labor process. General health must also be assessed if the mother has had allergies, is smoker or alcoholic, or takes any drugs or medications (Complicated childbirth). In ancient times, the mode of delivery for subsequent pregnancies after a history of cesarean section (CS) will always be CS. Currently, there are now options to undergo a trial of labor after a cesarean birth but patients must be aided in their decision making with sufficient understanding about the risks and benefits of a vaginal delivery. With TOLAC, there is a risk of uterine rupture. The following characteristics, increases the success of vaginal delivery: previous vaginal delivery, history of VB AC, spontaneous labor, competent cervix, nonrecurring indications i.e. breech, previa, herpes, preterm delivery, an interpregnancy interval of more than 18 months. Similarly, the risks associated and factors that may contribute to failure of the process are morbid obesity, Hispanic and African American race, increasing birth weight, previous history of cephalopelvic disproportion, diabetes mellitus, failure to progress labor, no history of vaginal deliveries, or a previous cesarean section. In the clinical case given, her risks of undergoing a trial of labor may be high; therefore a cesarean delivery may be recommended (Caughey, n.d.). Condition Clinical presentation Problems/Risks/Complications Management Ectopic pregnancy Signs of pregnancy i.e. amenorrhea, positive pregnancy test Abdominal pain accompanied by shoulder pain as the embryo grows distending the involved structure and compressing adjacent organs If abdominal implantation, signs of shock i.e. hypotension If cervical or fallopian tube implantation, vaginal blood loss Problem: implantation of the embryo in structures other than the uterus Risk: previous ectopic pregnancy, history of tubal surgery, history of tubal infection, progestin-only contraception, intrauterine contraceptive devices Complication: rupture of structure with the growing fetus, hemorrhage causing hypovolemic shock Early diagnosis via ?-hCG level determination Transport to a medical facility for possible surgical procedure Correct signs of shock Pain alleviation Pre-term labour Uterine contractions Small amount of cervical effacement or dilatation Problem: premature onset of labor before 38 weeks of gestation Risk: multi-gravid, intrauterine infections, premature rupture of the membranes, uterine or cervical anatomical anomalies, smoker, Complication: preterm birth, low birth weight neonate, fetal distress, infection Prehospital setting: supportive care, decrease level of stress, bed rest Hospital setting: IV salbutamol Pre-eclamp sia Hypertension; BP >140/90 mmHg Edema Proteinuria Headaches Visual disturbances Pulmonary edema Hepatic dysfunction Oliguria Thrombocytopenia or haemolysis Problem: biochemical and physiological alteration resulting to widespread vasoconstriction, organ ischemia and edema Risk: obesity, diabetes mellitus, race Complication: progression to eclampsia; brain ischemia, seizure, heart failure, decreased