ABSTRACT
Von Willebrand disease is the most common inherited blood disorder, occurring in about 1% of the population. It results from a deficiency in the quality or quantity of von Willebrand factor, which is necessary for adequate hemostasis. An evidenced-based approach is prudent when this derangement is coupled with a potentially fatal obstetric complication. This article examines the anesthetic management of a parturient with a known diagnosis of von Willebrand disease who presented to the labor and delivery unit in active labor and with a suspected uterine placental abruption.
Subject(s)
Abruptio Placentae/diagnosis , Perinatal Care , Pregnancy Complications, Hematologic , von Willebrand Disease, Type 1 , Abruptio Placentae/nursing , Adult , Anesthesia, Obstetrical , Cesarean Section , Deamino Arginine Vasopressin/administration & dosage , Diagnosis, Differential , Female , Humans , Nurse Anesthetists , Pregnancy , Pregnancy OutcomeSubject(s)
Abruptio Placentae/nursing , Emergency Nursing , Adolescent , Apgar Score , Continuity of Patient Care , Female , Humans , Pregnancy , Risk Factors , Terminology as TopicSubject(s)
Cooperative Behavior , Documentation/standards , Interdisciplinary Communication , Neonatology , Nursing Records/standards , Obstetrics , Abruptio Placentae/diagnosis , Abruptio Placentae/nursing , Adult , Asphyxia Neonatorum/diagnosis , Asphyxia Neonatorum/nursing , Cardiotocography , Delayed Diagnosis , Female , Germany , Humans , Infant, Newborn , Pregnancy , Resuscitation/nursingSubject(s)
Continuity of Patient Care/legislation & jurisprudence , Fetal Death , Fetal Monitoring/nursing , Homicide/legislation & jurisprudence , Malpractice/legislation & jurisprudence , Abruptio Placentae/nursing , Adult , Disseminated Intravascular Coagulation , Female , Humans , Physician-Nurse Relations , Pregnancy , TennesseeABSTRACT
Intrapartum emergencies are challenging to all perinatal nurses because of the increased risk of adverse outcomes for the mother and fetus. Perinatal emergencies, such as seizures, amniotic fluid embolus, hemorrhage, and uterine rupture, create physiological challenges and trigger intrinsic survival techniques. The pregnant uterus becomes a vital source of blood volume during hypovolemic events because it is not considered a vital organ. The pregnancy itself may become burdensome, and birth may occur as an intrinsic maternal compensatory mechanism. The resultant fetal hypoxemia may also stress the fetus into initiating labor. During extensive oxygen desaturation and decompensation, the focus should be on maternal stabilization, which will subsequently enhance fetal stabilization. Clinical assessments, critical thinking, decision making, and resource allocation must be quick and appropriate to increase the likelihood of a positive outcome for the mother, fetus, and neonate.
Subject(s)
Delivery, Obstetric/nursing , Neonatal Nursing/methods , Nurse's Role , Nursing Assessment , Obstetric Labor Complications/nursing , Obstetric Nursing/methods , Abruptio Placentae/nursing , Embolism, Amniotic Fluid/nursing , Emergencies , Female , Humans , Hypoxia/etiology , Hypoxia/prevention & control , Infant, Newborn , Neonatal Nursing/standards , Nursing Assessment/methods , Nursing Methodology Research , Obstetric Labor Complications/prevention & control , Obstetric Nursing/standards , Perinatal Care/methods , Postpartum Hemorrhage/nursing , Pregnancy , Quality Assurance, Health Care , Seizures/nursing , United States , Uterine Rupture/nursingSubject(s)
Malpractice/legislation & jurisprudence , Nurse Practitioners/legislation & jurisprudence , Abruptio Placentae/nursing , Adult , Fatal Outcome , Female , HIV Infections/complications , HIV Infections/nursing , Humans , Liver Diseases/complications , Liver Diseases/nursing , Pregnancy , Pregnancy Outcome , Quality of Health Care/legislation & jurisprudence , Quality of Health Care/standardsSubject(s)
Abruptio Placentae/nursing , Emergency Nursing , Adult , Female , Humans , Nursing Assessment , PregnancyABSTRACT
Placental abruption is a clinical circumstance in which the anesthetist is confronted with a patient who is undergoing a variety of physiological insults. The principles of basic life support, appropriate fluid management, and cooperative gynecological surgeons will aid in the delivery of optimal care to both the mother and the fetus.