Parto Normal - ppt2
Cargado por
milyviera98Temas abordados
- riesgo de aspiración,
- tacto vaginal,
- cuidado neonatal,
- métodos no farmacológicos,
- anomalías del parto,
- trabajo de parto,
- interacción madre-hijo,
- clampeo del cordón,
- intervenciones obstétricas,
- morbimortalidad
Parto Normal - ppt2
Cargado por
milyviera98Temas abordados
- riesgo de aspiración,
- tacto vaginal,
- cuidado neonatal,
- métodos no farmacológicos,
- anomalías del parto,
- trabajo de parto,
- interacción madre-hijo,
- clampeo del cordón,
- intervenciones obstétricas,
- morbimortalidad
Common questions
Con tecnología de IAThe restriction on food and liquid intake during labor stems from the fear of aspiration if general anesthesia is required. Yet, maternal morbidity from gastric aspiration is extremely low. Restricting intake doesn't necessarily reduce gastric content and can lead to dehydration and ketosis in prolonged labor. Therefore, it's recommended to allow light feeding and fluid intake during labor to avoid these complications . This evaluation suggests that fears surrounding aspiration don't outweigh the benefits of allowing mothers to maintain hydration and energy levels during labor.
Non-pharmacological pain management involves providing prenatal care that prepares the woman for labor, encouraging her to find comfortable positions, allowing movement, and using showers or massages for relief. These methods, along with support from a companion, significantly reduce stress and fear, which can increase pain levels . While epidural analgesia is effective in more difficult labors, its routine use is discouraged to prevent unnecessary medicalization of childbirth . This approach helps manage pain effectively by leveraging psychological comfort and physical ease.
Enemas were traditionally used due to beliefs that they stimulate uterine contractions and help in the descent of the baby's presentation. However, enemas are uncomfortable, pose risks like intestinal injury, and increase non-productive healthcare costs without clear benefits. Cases of colitis and anaphylactic shock have been reported post-enema administration . Perineal shaving has been used with the intention of reducing infections and aiding in suturing after episiotomies, but scientific evidence indicates that it does not reduce infection rates and might even increase the risk for HIV and Hepatitis B infections. It similarly raises healthcare costs without tangible benefits, making these practices largely outdated .
Applying fundal pressure, or the Kristeller maneuver, during the second stage of labor can lead to complications such as uterine rupture, abnormal fetal heart patterns, and increased risk of trauma to the mother and fetus. Therefore, the practice is generally discouraged unless absolutely necessary . This highlights the importance of allowing natural progress in labor, promoting patient safety and reducing unnecessary interventions.
Intermittent auscultation, which is simpler and less costly, is typically preferred for normal labors. It can be done using a Pinard stethoscope or a handheld Doppler. Performed every 30 minutes during the dilation phase and after contractions in the expulsive phase, it does not limit the mother's movement . In contrast, continuous electronic fetal monitoring provides more objective data but is resource-intensive and often includes more interventions without significant benefits in low-risk pregnancies. It restricts movement, adding further discomfort for the mother while also increasing labor costs .
Key cardiovascular monitoring practices during labor include observing the amniotic fluid and monitoring fetal heart rate. The appearance of meconium in the amniotic fluid can indicate fetal distress. Intermittent auscultation with a Pinard or Doppler is routinely used for fetal heart rate monitoring in normal labor, while electronic monitoring is reserved for high-risk cases . These practices are crucial for detecting early signs of fetal distress, thus enabling timely interventions to ensure maternal and fetal health.
Systemic analgesics during labor are generally discouraged due to their potentially harmful side effects on both mother and fetus. They can lead to sedation, impact the mother's ability to participate actively in labor, and cause neonatal respiratory depression. Non-pharmacological methods and epidural analgesia post-dilation are alternatives that avoid these risks while managing pain effectively . This evaluation suggests that balancing pain relief with safety is paramount in labor management.
Support from a companion during childbirth has been shown to be crucial in alleviating pain and stress. The presence of a supportive figure reduces stress and fear, both of which contribute to increased pain levels . This companionship provides emotional support, reassurance, and aids in practical pain relief measures such as adopting comfortable positions or receiving massages . Consequently, the psychological and physical benefits significantly improve the childbirth experience for many women.
In normal labor scenarios, auscultation is favored because it is cost-effective and doesn't hinder the mother's mobility. It involves periodic listening with a Doppler or Pinard device, which suffices under low-risk circumstances. Continuous electronic monitoring, while offering more precise data, tends to result in unnecessary interventions and increases costs without benefit in normal cases . The approach balances fetal health monitoring effectiveness with minimizing undue medical interventions and costs.
Allowing women to choose their position during labor can alleviate discomfort, reduce labor duration, and improve fetal positioning. It encourages mobility, thus facilitating optimal fetal descent and reducing the likelihood of interventions. Limiting women to supine positions can lead to poorer outcomes by increasing stress and pain . This practice empowers women to actively participate in labor, improving overall satisfaction and outcomes by catering to individual comfort and medical needs.
