PRECIPITATE LABOR  Continuously monitor uterine

contractions and FHR patterns

 Refers to labor that lasts 3 hours or
less  Encourage the woman to relax as
possible
 More common in multiparous
patients and in women who have  Explain all procedures and
received oxytocin induction or treatments being initiated.
amniotomy.
 Instruct the woman with a history of
 The mother is at risk for hemorrhage precipitate labor that it may occur
secondary to premature separation with future pregnancies; advise to
of the placenta and for lacerations plan for such an occurrence in
due to the force and rapidity of the advance.
birth.
UTERINE INVERSION
Causes:
 The inverted fundus may lie within
 Lack of maternal tissue resistance to the uterine cavity of the vagina or, in
the passage of the fetus. total inversion, protrude from the
vagina.
** The fetus is at risk for subdural
hematoma, possibly from the rapid Causes :
release of pressure on the fetal head.
 May occur after the birth of the
Assessment Findings : neonate, especially if traction is
applied to the uterine fundus when
 Strong uterine contractions with the uterus is not contracted.
signs of premature placental
separation.  May also occur when the placenta is
inserted at the fundus, during birth
Treatment : the passage of the fetus pulls the
 A tocolytic may be administered to fundus down.
reduce the strength and frequency Assessment Findings :
of the contractions.
 A large sudden gush of blood from
 Plans for immediate delivery are the vagina.
necessary.(CS)
 Non-palpable fundus in the
Nursing Interventions: abdomen
 Provide emotional and physical  Signs and symptoms of shock if the
support to the woman and family. loss of blood continues unchecked
for more than few minutes
 Hypotension  Assist with the measures to relax
the uterus
 Pallor
 Provide emotional support and
 dizziness and diaphoresis explaination what's happening and
 Possible exsanguination if bleeding procedures being done
continues unchecked  Be prepared to perform CPR if the
Treatment : woman's heart fails from the sudden
blood loss.
 IV fluids and blood component
therapy to replace fluid volume and  Anticipate administering antibiotic as
blood loss ordered

 General anesthesia, or tocolytic may UTERINE RUPTURE

be administered to relax the uterus  Occurs when the uterus undergoes
 Due to uterine exposure, antibiotic is more strain than it's capable of
indicated postpartally sustaining and then ruptures.

 As a last resort, the patient may  Rupture can be complete, going

require an emergency hysterectomy. through endometrium, myometrium,
and peritoneum, or incomplete,
Nursing Interventions : leaving the peritoneum intact.

 Initiate IV therapy as ordered – if the Causes :

woman has an IV line in place,
increased the flow rate to achieve  Usually occurs from a previous
optimal flow of fluid to restore fluid cesarean birth, such as when a
volume. vertical scar from a previous incision
is present.
 Administer oxygen by mask as
ordered  Can also occur from hysterectomy
repair.
 Keep in mind that administering an
oxytoxic only compounds the  Other causes include :
inversion  prolonged labor, faulty
 Never attempt to remove the presentation, multiple gestation,
placenta if it's still attached because use of oxytocin, traumatic
this will create more bleeding. maneuvers using forceps or
traction.
 Monitor VS at least every 15
minutes. Assessment Findings :
 Indentation appearing across the  Anticipate the use of IV oxytocin to
abdomen over the uterus contract the uterus and minimize
(pathologic retraction ring) bleeding.

 Strong uterine contractions without  Prepare the woman for a possible

any cervical dilation. laparotomy as an emergency
measure – explanation is necessary.
 Indications of complete uterine
rupture  If applicable, offer emotional support
for the loss of this child or loss of
 sudden, severe pain during a future children (if hysterectomy or
strong labor contraction tubal ligation is performed).

 report of a tearing sensation  Allow them to express their

emotions without feeling threatened.
 cessation of uterine contractions

 hemorrhage

Treatment :

 Focuses on the following measures :

 Fluid replacement

 IV oxytocin to contract the uterus

and minimize bleeding

 A cesarean birth will be done to

ensure safety of neonate

 Manual removal of the placenta

under general anesthesia may be
necessary.

 A laparotomy may be necessary as

an emergency measure to control
bleeding and repair the rupture;
hysterectomy or tubal ligation may
be performed.

Nursing Interventions :

 Administer emergency fluid

replacement therapy as ordered.