Catálogo de publicaciones - libros

1. Pain in labor is a multifaceted experience with physiological, psychological, and social components. 2. Pain management in labor requires a multifaceted approach, including pharmacological and nonpharmacological options. 3. Appropriate pain management will greatly enhance the experience of labor.

1. Operative delivery is defined as any procedure undertaken to facilitate delivery of an infant. 2. Operative delivery methods include vacuum-assist delivery, forceps delivery, and cesarean section. 3. Operative delivery should be undertaken for specific indications and those indications should be specifically noted in labor record.

1. Complications of labor include prolonged transition from latent-to activephase labor, failure of cervical dilation, and failure to descend. 2. Diagnosis of an abnormality of labor requires a firm understanding of the normal progress of labor. 3. Each complication of labor requires individual assessment and management.

1. Clinically, shoulder dystocia may be diagnosed when delivery of the head is followed by an inability to deliver the shoulders. 2. Shoulder dystocia is a serious complication of delivery and must be managed rapidly to minimize maternal and fetal morbidity.

1. Normal delivery is marked by a characteristic fetal presentation and a stereotyped series of fetal repositions. 2. Failure to present in the usual occiput anterior position may lead to prolongation and complications of labor and may be incompatible with vaginal delivery. 3. Careful assessment of fetal presentation is critical to the diagnosis and management of abnormal presentations.

1. The common use of continuous fetal heart rate monitoring requires that providers be aware of the interpretation of variations in fetal heart tracings. 2. Normal fetal heart rate is 120 to 160 beats per minute (bpm) with evidence of short-and long-term variability. 3. Fetal heart rate acceleration must be distinguished from fetal tachycardia and is generally considered a favorable finding. 4. Abnormalities of fetal heart tracings may be related to either rate or deceleration.

1. Labor may be complicated by maternal infection with associated maternal and neonatal risk. 2. Management of maternal fever requires a knowledge of the common sources of infection and appropriate antibiotic coverage for those organisms. 3. Management of maternal infection requires an awareness of the risks and benefits of antibiotic use in pregnancy.

1. Postpartum hemorrhage may result from lacerations, retained placenta, uterine inversion, or coagulapathy. 2. Management of postpartum hemorrhage begins prior to delivery with assessment of precedent risk factors including macrosoma, polyhydramnios, precipitous labor, grand multiparity, anesthesia, augmentation, and cesarian delivery. 3. Postpartum hemorrhage is a critical postpartum complication that requires rapid identification and management. 4. Management of postpartum hemorrhage should proceed in a stepwise manner until hemorrhage is controlled.

1. Laceration and episiotomy are common complications of the delivery process. 2. Lacerations and extension of episiotomies may be minimized with careful management of delivery. 3. Laceration and episiotomy repair is an essential skill for all providers who deliver babies.

1. The newborn examination forms the basis for all subsequent management. It is therefore comprehensive in nature. 2. The newborn evaluation includes a review of prenatal and peripartum history, as well as newborn nursery course and physical examination.