OR/MATERNAL

Parts:

1. DR (delivery room)
2. LR (labor room)
3. RR (recovery room)

Instruments for NORMAL SPONTANEOUS DELIVERY

1. Basin
2. Needle holder
3. Kelly clamp
4. Tissue forceps
5. Mayo scissor

Instruments for CESAREAN SECTION

1. Big basin
2. Kidney basin
3. (6) Allis
4. (2) Kelly Curve
5. (6) mosquito curve
6. (2) needle holder
7. (5) sponge
8. (1) thumb forcep
9. (1) tissue forcep
10. (2) Richardson
11. (1) Bladerette
12. (1) Army Navy

Instruments for DILATION AND CURETTAGE

1. Vaginal speculum- depth
2. Hysterometer - pangipit
3. Tenaculum - pangkayod
4. Sharp curette
5. Dull curette
6. Ovum forcep (straight)
7. Ovum forcep (curve)

CONTRACTION ASSESSMENT

1. Interval
2. Duration
3. Intensity
4. Frequency

DEVICES:

1. Cardiotocography - used to monitor FHT and contraction
2. Doppler ultrasound

Pattern for cleaning perineum before birth

Leopold’s maneuvers

1. Funtal grip (assess fetal presentation)
2. Lateral grip (assess fetal back)
3. Pawliks grip (assess fetal lie)
4. Pelvic grip ( assess fetal attitude)

REASON OF LARGER THAT DATE OF UTERUS

M - aternal hydramnios

M - olar pregnancy

M - ultiple pregnancy

M - acrosomic baby

M - iscalculated AOG

REASON OF SMALLER THAT DATE OF UTERUS

S - mall gestation of intrauterine growth restriction

M - isabortion

A - nomalies

L - length miscalculation

L - ow amniotic fluid

Newborn care

POSTPARTUM CARE

4 T’s OF POSTPARTUM LABOR

T- one = Uterine Atony

T- rauma = Laceration

T- issue = Retain Placenta

T- hrombin - Hematoma

POST PARTUM ASSESSMENT

B - rest

U - terine

B - ladder

B - owel

L - ochia

E - pisiotomy

H - emarhoids

E - motions

BLOOD LOSS

1. Normal Delivery = 500 cc
2. Cesarean Section = 1000 cc

COMPUTATION:

PREGNANCY SCORING

ESTIMATED DUE DATE:

January- March = + 9 months + 7 days

April - December = - 3 months + 7 days + 1 year

AGE OF GESTATION

In weeks: fundal height cm x 8 ÷ 7

In months: fundal height cm x 2 ÷ 7

2 types of placenta:

1. Schultze
   (shiny and glistening from the fetal membranes)
2. Duncan
   (It looks raw, red, and irregular, with the ridges or cotyledons)

MEDICAL ABBREVIATIONS:

BOW = Bag of water

TMS= Tickle Meconium Stain

OU = Both eyes/ Oculus Uterque.

PU = Pregnancy uterine (Full term),

gtts = drops

G - gravida

P - parity

PPO = Postpartum Order

DAT = Diet As Tolerated

NPO = Nothing per orem

PRN = Pro re nata

RMLE = Right MedioLateral Episiotomy

EDD = Estimated Due Date

FH- Fundal Height

IUFD = Intrauterine Fetal Death

CIL = Cephalic in Labor

Mechanisms (Cardinal Movements) of Labor

1. Engagement
2. Descent
3. Flexion
4. Internal rotation
5. Extension
6. External rotation
7. Expulsion

STAGES OF LABOR

1. FIRST STAGE
2. Latent phase

• Contractions are mild and short, lasting 20 to 40 seconds.
• Cervical effacement occurs
• cervix dilates from 0 to 3 cm.
• The phase lasts approximately 6 hours in a nullipara and 4.5 hours in a multipara

1. Active phase

• cervical dilatation occurs more rapidly, increasing from 4 to 7 cm.
• Contractions lasting 40 to 60 seconds, and every 3 to 5 minutes.
• Show and rupture of the membrane
• This phase lasts 3 hours in a nullipara and 2 hours in a multipara.

1. Transition phase

• contractions reach their peak of intensity, occurring every 2 to 3 minutes with a duration of 60 to 90 seconds
• cervical dilatation of 8 to 10 cm.

2. SECOND STAGE

• is the period from full dilatation and cervical effacement to the birth of the infant.
• this stage takes about 1 hour.

3. THIRD STAGE

• The third stage of labor, the placental stage, begins with the advent of the infant and ends with the delivery of the placenta
• The following signs that the placenta has loosened and is ready to deliver:
  • Lengthening of the umbilical cord
  • Sudden gush of vaginal blood
  • Change in the shape of the uterus
  • Firm contraction of the uterus
  • Appearance of the placenta at the vaginal opening