摘要:

ABSTRACTObstetric ultrasound has become well integrated into management of pregnancy, labor, and delivery. An increasing number of nurse‐midwives have expanded their roles to include the use of this technology. This article reviews the basic principles of ultrasound physics, the content of ultrasound examinations, and the performance of basic scans. The uses of limited scans for third‐trimester antepartum assessment and intrapartum management are reviewed. Issues surrounding the use of obstetric ultrasound, including limited scans, routine ultrasound screening, and necessary education, are discussed. Information on incorporating the use of ultrasound procedures into nurse‐midwifery practice is inc

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90097-Z

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTIntrapartum amnioinfusion is being used in a variety of clinical settings and for multiple therapeutic modalities to prevent fetal distress and improve outcomes. The procedure has demonstrated efficacy in cases of variable decelerations and thick, meconium‐stained amniotic fluid. Amnioinfusion has been shown to improve maternal and neonatal outcomes by decreasing cesarean sections for fetal distress, improving cord pH, and decreasing the amount of meconium present below the cords at delivery. This article describes the pathophysiology of amniotic fluid volume disorders that indicate the use of amnioinfusion, reviews the literature regarding the indications and therapeutic effects, and describes techniques for the use of amnioinfusion. In addition, there is a discussion of the contraindications associated with the use of amnioinfusion and its use in and out of hospital settings. The technique for amnioinfusion is simple, easy, and inexpensive to initiate. It can be performed in a variety of settings, provided there is adequate equipment, personnel, and emergency services available. Certified nurse‐midwives should become familiar and comfortable with the procedure in order to provide complete care for the families they se

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90098-2

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTExternal cephalic version has been used periodically for centuries to manage breech presentations. As cesarean section rates have escalated in the last two decades, ways to curb this rise have been evaluated. By reducing the number of infants that arrive in labor in a representation, it is possible to impact the overall cesarean section rate. External cephalic version is a safe, effective method when used in appropriate cases of breech presentation. A forward or backward roll can be accomplished in women at term with singleton gestations, adequate amniotic fluid, and reactive nonstress tests. Parity, fetal and placental position, and descent of the presenting part may all influence the success rate of the version.

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90099-3

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTSubdermal contraceptive implants have only recently been approved for use in the United States. At present, only one subdermal contraceptive implant, Norplant, is approved in the United States. This article describes the development of Norplant, its efficacy and safety, a description of the system, education for clients, side effects, indications and contraindications, insertion and removal, incorporation into midwifery practice, and education for health professionals regarding its use.

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90100-U

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTThe vacuum extractor has become a widely used instrument in many settings. It has proven to be a reliable method of ensuring safe passage of the fetus and/or enhancing maternal effort during the second stage of labor. The principles of vacuum‐assisted birth are learned relatively easily and have been incorporated into many nurse‐midwifery practices. This article reviews the principles of vacuum extraction as they apply to the practice of nurse‐midwifery. Vacuum extractors available to nurse‐midwives are compared. Nurse‐midwives are familiarized with vacuum extraction so that they can make an Informed choice concerning the vacuum extractor as an appropriate tool within their practice. This article is not intended to teach nurse‐midwives to use the vacuum extractor. It does, however, provide guidelines for credentialing those nurse‐midwives choosing to incorporate the principles of vacuum extraction into t

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90101-L

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

ABSTRACTFetal scalp blood sampling (FSBS), in conjunction with fetal heart rate monitoring, is a method of fetal surveillance that may avoid cesarean delivery of the healthy fetus or indicate the need for immediate delivery of a compromised fetus. Some researchers have recently begun to question the efficacy of FSBS. In this article, three nurse‐midwives discuss FSBS as a tool in assessing fetal well‐being during labor and consider whether FSBS is a nurse‐midwifery proc

ISSN:0091-2182    

DOI:10.1016/0091-2182(93)90102-M

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY