Obstetric Nursing Essay

1- How long is a normal TERM pregnancy?

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2- What are some questions the nurse might ask in performing a health history assessment on a pregnant patient? Why would these questions be pertinent to providing adequate care?Obstetric Nursing Essay

Review of literature is an essential component of research study as it provides a broad understanding of the research problem. A review of related literature involves the systematic identification, location, scrutiny and summary of written materials that contain information on research problem (Polit and Hungler, 1998). Keeping this in mind, the investigator studied and analyzed into the accessible sources and gained in-depth understanding from the related studies about the first aid management of obstetrical emergencies.Obstetric Nursing Essay

The role of midwife is unique in the care and treatment of a mother and child. Throughout the birth process; the role is comprehensive and involves education treatment and collaboration with a more skilled medical team. The estimate of mortality due to poor delivery practices was over 110 maternal deaths/100,000 live births. About 40 -60 % of death of women aged 15- 34 years were attributed to pregnancy and childbirth. The medical complications precipitating death, haemorrhage, hypertension and infection were also major causes of mortality related to abortion. The midwife must be prepared for all emergencies, including medical factors such as obstetric complications, referral problems such as transportation, inadequacies, and belief factors such as fear of hospitals. Risk can be reduced by frequent consultations with health workers during pregnancy, using trained attendant at every birth, being aware of danger signs, spacing pregnancies over two years apart, avoiding pregnancies at young or old ages, maintaining proper nutrition and work load, and involving midwifes at all levels of care. – Kebe. Y(2000)Obstetric Nursing Essay

STUDIES RELATED TO OBSTETRICAL EMERGENCIES
Obi SN, Ozumba BC..et.al (2001), conducted a retrospective study to identify the factors of unbooked obstetric emergency cases which increases the maternal mortality at University of Nigeria Teaching Hospital, Nigeria. The study concludes that lack of basic education and poverty are the major identifiable risk factors. Improving health care facilities, female education and regular training courses of medical personnels will help to reduce the maternal mortality.

Ray.A. M, Salihu. H.(2004) conducted a study to review the results of 15 Traditional birth attendants(TBA) and midwife based interventions that aim to improve skilled assistance in delivery and recognition and referral of complications. Outcome measures used to evaluate the impact of the programmes varied. Five of the five programmes reviewed that evaluated the impact on maternal mortality demonstrated decline in maternal mortality ratios. Two of three studies measuring morbidity related indicators found improvement of some but not all morbidity outcomes. Six of seven showed a trend of improved referral rates. Three of three found high levels of knowledge retention among trained TBAs. Programmes with the greatest impact utilised TBAs and village midwives with multisectorial interventions. These findings suggest that TBAs and village midwives contribute to positive programme outcomes.Obstetric Nursing Essay

Sharon Maslovit, Gad Barkai(2004) conducted a study to assess the effectiveness of simulation based training programme among midwives and obstetricians in Israeli Center for Medical Simulation, United Kingdom. One hundred and sixty five samples were selected by random method. Among the samples 77 were obstetricians and 88 were midwives. Questionnaire responses showed that post-test score (79.4 ± 4.3) were more than pre-test score (70 ± 5.3). The study concluded that employing high fidelity simulations of obstetrical emergencies has great teaching and learning potential and simulation can provide a learning experience that facilitates knowledge application to midwifery practice.

Kildea S, Kruske S, Bowell L (2006), conducted a descriptive study to improve the maternity emergency skills and knowledge of health service providers, without midwifery qualification at Institute of Advanced Studies, Charles Darvin University, Northern Territory Australia. The samples were given multidisciplinary short course aimed at improving knowledge and skills in detection, management and referral of obstetrical emergencies. The study concluded that the course was an effective strategy to improve the maternity services offered to women in remote Australia.

Draycott.T, Sibanda.T…et.al (2006), conducted a cohort observational study to evaluate whether obstetrical emergency care improves the neonatal outcomes. The samples are the term, cephalic presenting singleton infant. The study reveals that the infants born with 5-minute Apgar scores of

Crofts. Eills…et.al (2007), conducted a study to assess the effectiveness of obstetric emergency training programme on knowledge regarding obstetric emergencies among medical graduates in Bristol Medical Simulation Centre, England. The result of the study showed significant difference between pre-test and post-test. Post-test score was (23.1) more while comparing to pre-test score (18.1) and p< 0.001.Obstetric Nursing Essay

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Prem Kumar (2009), conducted a study to evaluate the risk factors and management of maternal and perinatal outcome of uterine rupture was conducted in Department of Obstetrics and Gynaecology, JIPMER, Pondicherry. Two fifty three case of uterine rupture was managed in 10 years. The result showed that 128 cases (50.8%) of uterine rupture occurred in a scarred uterus and 125 (49.40%) occurred in unscarred uterus. The predisposing factors include cephalopelvic disproportion in 69 cases (27.25%), malpresentation in 20 (7.90%) cases, labour induction in 14 cases (11.64%) and multiparity in 20 cases (7.90%). Repair of uterus was done in 147 cases (58.33%) and hysterectomy in 105 cases (41.51%). The study concluded that there were 7 maternal deaths (2.76%) and perinatal mortality was 94.07%. This study reveals that the warning of the impending complications was not detected and treated in time.Obstetric Nursing Essay

Partamin, Kim..et.al (2010), conducted a study to assess knowledge and performance of skilled birth attendants providing emergency obstetric and newborn care in Afghanistan. Midwives and doctors scored similarly in assessments of decision making and performance of technical skills. Skilled birth attendants showed weakness in specific steps to manage common high risk emergencies. The study concludes that midwives and doctors in Afghanistan are similarly competent. In-service training and job rotation could help skilled birth attendants retain their emergency obstetric care skills.

Sabitha Nayak(2011) – to assess the knowledge on first aid measures of obstetrical emergencies among health members in Natekal PHC(Mangalore). The study finding revealed that majority of the samples 55% were in the age group of 25-30 years and 39 % received information from the teaching programs, 20% from mass media 13% from friends and 17% of them do not have exposure to any source of information about the first aid practices. The results showed that majority of the samples 62% had good knowledge, and 38% had average knowledge about the first aid practice. There is significant association between knowledge and demographic variables like age, educational status, and no significant association with membership in any social organisation, occupation and place of living.

Puri R, Rulisa S.et.al (2012), conducted a study to determine the knowledge, attitude and practice of obstetric care providers in Bugesera District, Rwanda. The study captured 87% of obstetric care provider, most expressed a need to improve their knowledge (60.6%) and skill confidence (72.2%) in safe motherhood. The mean percentage of correct answers for 50 questions assessing overall knowledge was 46.6%, in which 39.3% was correct on normal labour and 37.1% was correct on obstetrical complications. The study had identified that there was a need to improve safe motherhood knowledge and practices of obstetric care providers.Obstetric Nursing Essay

Ameh C, Hofman J..et.al (2012), conducted a study to assess the impact of emergency obstetric care training in Somaliland, Somalia. The study result showed that healthcare providers reacted positively to the training, with a significant improvement in 50% of knowledge and 100% of skills. The study concludes that the training impacted positively on the availability and quality of emergency obstetric care and resulted in “up skilling” of midwives.

The above studies reveal that midwives do lack knowledge on obstetrical emergencies and based on their knowledge training programmes are recommended to improve their level of knowledge to practice effective care during obstetrical emergencies. From these studies the investigator gained in-depth knowledge and thus it helped in discussion and comparing the level of knowledge of the midwives with the present study.

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My patient Madam Suzanna 29years old gravida 4 para 2+1 electively admitted at 32 weeks of period of amenorrhea for expectant management of twin pregnancy with asymptomatic placenta previa type II posterior.

Currently patient is well and has no complain of pervaginal bleeding and fetal movement was good. She has no signs of labour like contraction, leaking liquor or passing show. Her blood pressure was stable and there was no complain of headache, blurred vission or fits. There is also no lethargy or pallor.Obstetric Nursing Essay

Her last normal menstrual period is on 10/8/10 and her estimated date of delivery is on 17/5/11. Currently she is at 35 weeks and 2 days of period of amenorrhea.

She has a background history of secondary subfertility for 7 years. She also has failed intrauterine insemination and intrauterine death in 2007.

Antenatal history :

It is a planned and wanted pregnancy. Urinary pregnancy test was done on 6th week of period of amenorrhea and the initial booking was done on 10th week period of amenorrhea. Dating scan was done on 7th week and it correspond to date. Placenta previa was detected when scan was done on 31 weeks period of amenorrhea.

Antenatal screening

Blood pressure : 105/65

Urine : no albumin detected

Hemoglobin :12.9 g/dl

Weight :71-90g

Height :161cm

Blood Group :0 positive

VDRL/HIV/Hep B : negetive

MGTT(modified glucose tolerance test) done at 12 weeks of period of amenorrhea: 4.2/6.0(normal) and repeated on 32 weeks period of amenorrhea showed result 4.1/5.3(normal)Obstetric Nursing Essay

Latest scan was on 23/3/11 with the result of twin 1 and 2 at 32 weeks and 2 days of period of amenorrhea. Twin 1 was on cephalic presentation and twin 2 on tranverse presentation. Twin 1 weighs 1894g and twin 2 weighs 1886g. It is a monochorionic and diamniotic twin. It has only one palcenta. Liquor was adequate and other parameters correspond to date.

Past obstetric history:

In 2004 she delivered a baby girl by full term sponteneous vaginal delivery. The babies weight is 3.3 kg. In 2003 she had complete miscarriage at 5 weeks of period of amenorrhea. In 2007 she had intrauterine death at 26 weeks of period of amenorrhea due to positive toxoplasmosis and cytomegalovirus positive. The babies weight was 980g.

Past gynaecological history:

She had a regular menstrual cycle. She attend age at 12 years old with a regular flow of 3 to 4 days every 1 month. She had no history of dysmenorrhea, menorrhagia, or intermenstrual bleeding. Last pap smear was done on 2010 and it was normal. For contraception, she was previously taking ocp but not really compliance.Obstetric Nursing Essay

Past medical history:

Nil

Past surgical history:

She had done laparoscopic and dye at 2008 and the result was right tubal block.

Family history:

Mother has athma, all other members in the family are fine.

Social history:

She is working as pembantu tabir at PPUKM. She is married for 7 years. Her husband is a instuctor for assistant course.

Relevant clinical examination
General examination

Patient looks well and lying comfortably with one pillow. She is communicative and alert. Her vital signs are as follows:

Blood pressure : 106/58

Pulse rate :82 beats per minute

Temperature :37 degree celcius

On peripheral examination there were no clubbing noted at both of her hands. No pallor and the capillary refill is 2 seconds. There were no palmar erythema noted. Both of her eyes conjunctiva is pink and no yellow discolouration of sclera.

Systemic examination

Abdominal examination

Upon inspection of the abdomen. The abdomen is distended by gravid uterus. There is cutaneous signs of pregnancy which are linea nigra and stria gravidarum. The umbilical is centrally located and flat. Otherwise the abdomen is normal. On palpation the uterus is not irritable and the abdomen is soft and nontender. The symphysio fundal height is 38 cm and it is larger than the date. There is two fetus , one in a cephalic presentation and the second twin in transverse presentation. Liquor was adequate.Obstetric Nursing Essay

Cardiovascular system examination

Radial pulse is 82 beats per minute and it is in good volume and regular rhythm. Apex beat is felt in 5th intercostal space in midclavicular line. Upon auscultation there is dual rhythm and no murmur heard.

Respiratory examination

Trechea is centrally located. There is no respiratory distress. Chest expansion is equal bilaterally. There is vesicular breath sound heard throughout the lungs.

Thyroid examination

Upon inspection of the neck there is no thyroid swelling. On palpation there is no throid swelling either and no cervical lymph nodes palpable.

Breast examination

Upon inspection the breast has everted nipple and hyperpigmented nipple. There is no skin changes noted. There is no mass felt at both of the breast. The axillary lymph node is not palpable.

Diagnosis and differential diagnosis
Provisional diagnosis:
Twin pregnancy complicated with placenta previa type II posterior.Obstetric Nursing Essay

Points for:

She is detected to have multiple pregnancy when she was doing antenatal follow up.

Her uterus is larger than date

There are multiple fetal poles can be palpated.

Upon latest scan there is two fetal poles detected

Ultrasound result showed monochorionic and diamniotic twins(MCDA) so it will lead to larger placental side and lead to placenta previa posterior type II

Ultrasound showed the placenta is at posterior and placental edge of 5mm.

Points against

There is no any pervaginal bleeding ar leaking. She is asymptomatic.

There is no any signs of anemia

There is no any serious maternal discomfort due to compression like shortness of breath.

There is no pregnancy induced hypertension that is common in pregnancy.

There is no any growth restriction.

Differential diagnosis

Any other differential diagnosis for anterpartum hemorrhage like abruptio placenta, vasa previa and local cervical causes

Abruptio placenta

Points for:

Multiple pregnancy can give pressure to placenta and cause it to seperate.

Points against:

It is a emergency condition.

My patient didnt develop any acute bleeding.Obstetric Nursing Essay

She had no history of trauma to abdomen

Vasa previa

Points for:

Multiple pregnancy

Points against

It is rare condition

My patient doesnt have pervaginal bleeding

Local causes like cervical polyps

There is no cervical polyps noted.

Relevant investigation with reasons
I would like to do

Full blood count

This is to see the hemoglobin level of the patient. Twin pregnancy can lead to anemia.

Serum glucose level

This is to see whether patient has hyperglycemia or not. Twin pregnancy can lead to gestational diabetes mellitus.

Urine full examination and microscopic examination

This is to see if there is any infection which may lead to threatened preterm labour.

Ultrasound scan

To see the fetal poles and their lie. To see if there is any abnormally in the twin and to see placental implantation site.Obstetric Nursing Essay

Investigation with result
1)Full blood count

Result
Units
flag
Normal range
White Cell Count

10.4

X109/L

+
4.0-10.0

Red Cell Count

3.89

X1012/L


4.2-5.4

Hemoglobin

11.6

g/dL


12.0-16.0

Hematocrit

34.1

%

39.0-52.0

Mean Cell Volume

87.7

Fl

77.0- 91.0

MCH

29.9

Pg

26.0-32.0

MCHC

34.1

g/dL

32.0-36.0

RDW

15.5

%
++
11.3-14.6

Mean Platelet Volume

9.3

Fl

6.3-10.2

Platelet

184

X109/L

150-400

Neutrophils

6.8

X109/L

2.0-7.0

Eosinophils

0.1

X109/L

0.02-0.5

Basophils

0.0

X109/L


0.0-0.1

Lymphocytes

2.8

X109/L

1.0-3.0

Monocytes

0.6

X109/L

0.2-1.0

Nucleated Red Blood Cells

0

X109/L

0.0-0.0

Impression : my patient has low red cell count and hematocrit value. It suggest anemia which is common in twin pregnancy. She also has elevation of white cell count which is normal in

physiological changes in pregnancy.Obstetric Nursing Essay

2) serum glucose

Flag test

Result

Unit

range

2HPP glucose

5.3

Mmol/L

4.0-7.8

There is no elevation of glucose.

3)UFEME(urinary full examination and microscopic examination)

Flag test

Result

Range

Urine colour

Yellow

Urine clarity

Clear

Specific gravity

1.015

1.015-1.025

Urine PH

8

5-8

Leucocyte
25u/l
Urine nitrate

Neg

Urine protein

Neg

Urine glucose

Norm

Urine ketone

Neg

Urine urobilinogen

Nor

Urine billirubin

Neg

Urine blood

Neg

Impression: there is increased in leucocytes. It may indicate infection.

Ultrasound scan. Done at 32 weeks of POA

Twin 1is 32 plus 2 days of gestation with cephalic presentation . liquor was 4.7. Twin 2 is in 32 plus two days of POA and in transverse position with liquor of 3.9. the placenta is placenta previa type II posterior. First twin weighs 1894g and second twin weighs 1886g. other parameters corresponds to date.

Identify the problems in terms of priority
1) Monochorionic diamniotic twin pregnancy. This may lead to preterm delivery.

2) Placenta previa type II posterior which may cause antepartum hemorrhage(APH) and postpartum hemorrhage(PPH).Obstetric Nursing Essay

3) Admitted for expectant management. Twin pregnancy also can cause complication like gestational diabetes mellitus(GDM), pregnancy induced hypertension(PIH), anemia and hyperemesis gravidarum.

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Immediate and subsequent management
Admitt the patient to ward. This twin pregnancy is considered as a high risk and yellow tagged (needing specialist referral either at hospital or maternal health care). During antenatal follow up complication of twin pregnancy should be noted. Abdominal examination need to done to detect any polyhydramnios and malpresentation. Blood pressure is taken to rule out pregnancy induced hypertension. Urine proteinuria is checked also. However madam suzanna didn’t develop any hypetension, her Bp was normal. Secondly investigation is carried out. Full blood count showed reduced amount of red cell count indicating she has anemia. She was given hematinics on daily basis. As a prophylactic to pregnancy induced hypertension aspirin is given 75mg on daily basis and it stopped on 34 weeks of POA. Modified glucose tolerance test at 12 weeks period of amenorrhea showed result of 4.2/6.0(normal) and it was repeated at 32 weeks of POA showed result of 4.1/5.3. Her fetal kick chart is monitored. She is informed to tell if got any pervaginal bleeding. She is asked to take complete bed rest. Her observation is continued. She is planned to do elective caesarean section on 20/4/11 in 36 weeks and 3 days as planned.Obstetric Nursing Essay

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Critical appraisal(discussion)
Twin pregnancy may arise from monozygotic or dizygotic. Monozygotic is a result of fussion of one ovum with sperm and splitting into two. Dizygotic twins are a result from fertilization of more than 1 oocyte. Usually dizygotic twins has own amniotic and placenta. But the number of placenta and amniotic sac depends on stage of splitting for monozygotic. As for this patient she had carrying monozygotic twins and her monozygotic twins has monochorionic and diamniotic sac this is because spliiting of embryonic mass occur after 3 days.

The risk factors of getting twin pregnancy include positive family history, increased maternal age, increased parity usually after 4 pregnancy, and assisted conception. We can diagnose twin pregnancy by doing clinical examination. In clinical examination the uterus will be larger than date. There will two fetal poles can be palpated and when listening to fetal heart there will be two heart beats with a different rates heard. Signs and symptoms of complication of multiple pregnancy might as well be noted like anemia.Obstetric Nursing Essay

The investigation include ultrasound done early as 7 weeks which will show multiple gestational sac. But the main thing that we must be worried is the complication that may arise from twin pregnancy. There are fetal complication and maternal complication for fetal complication it may give rise to miscarriage, preterm labour, chromosomal abnormalities, and twin-twin transfusion syndrome. So for madam suzanna she has been admitted to wad early because we are afraid of getting preterm labour. So she is monitored at wad. If at all she develops contraction and any leaking liquor, we should manage her. We should give her antibiotics to prevent infection and give tocolysis to ease the contraction pain. Dexamethasone also given to provide lung maturity.Obstetric Nursing Essay

The maternal complication include accentuated signs of pregnancy like hyperemesis gravidarum, pregnancy induced hypertension (PIH), gestational diabetic mellitus (GDM) , anemia, and placenta previa that may lead to anterpartum hemorrhage(APH) and post partum hemorrhage(PPH). As for my patient madam suzanna she has anemia. Anemia is caused by increased plasma volume expansion and increased feto placental demands of ferum and folate. So as a management we have given her hematinics tablet in daily basis. Another serious complication that she had developed are placenta previa. Placenta previa may arise from large placental site. As for madam Suzanna she has monochorionicity(1 placenta) so the placenta is large causes placenta previa.

As above my patient has placenta previa minor type II posterior. It is common around 32 weeks. The confirmation is done by ultrasound. It can cause anterpartum hemorrhage(APH) which is defined as bleeding from genital tract from period of viability which is from 22 weeks onwards. APH is usually caused by placenta previa, abruption placenta, vasa previa and local causes like cervical polyps.Obstetric Nursing Essay

Placenta previa is low implantation of the placenta in the uterus. Placenta previa is divided into four types. Type 1 is where the is 5cm from internal os, type II is where placenta reaches internal os but doesn’t cover it, type III is where placenta covers the os but not centrally and finally type IV where the placenta covers the os centrally. Type I and II is minor placenta previa, whereby type III and IV is major.To manage patient with placenta previa we must admit the patient and monitor the vital signs. We also must do abdominal examination . But vaginal examination should not be performed unless placenta previa is excluded. Then we must make sure there is enough intravenous excess. The blood should be sent for full blood count, coagulation profile and group cross match. Incase the patient develop acute heavy bleeding and also maternal collapse then red alert team shuold be activated immediately. Otherwise if the patient is asymptomatic. Conservative management with Mc Cafee regime also must be done. Mc Cafee regime include admission to the ward and until delivery, close observation for bleeding, and there must be availability of atleast 2 units of blood at all times, and finally caesarean section is performed when fetal reached maturity. Caesarean section must be performed to major placenta previa and minor placenta previa that is situated posteriorly like in this patient. Usually minor anterior placenta previa can be delivered vaginally and minor placenta previa posterior cannot because in posteriorly placed placenta previa, the head may compress the placenta when it descending down and this may compromise fetal circulation.Obstetric Nursing Essay

The complication of placenta previa include post partum hemorrhage (PPH) and recurrent placenta previa. PPH is divided into two which are primary and secondary. Primary is defined as bleeding within 24 hours following delivery and secondary is defined as bleeding after 24 of deliver. PPH is caused by uterine atony, genital tract trauma, retained placenta, and any bleeding disorder. So as for this patient she has placenta previa that may lead to uterine atony. The initial management of post partum hemorrhage is to give oxygenation then restore the circulation by infusing two large bore branulla. Blood cross match is taken and 2 units of blood is kept standby and drug therapy with oxytocin is given.

So basically management of twin pregnancy in anterpartum include blood pressure monitoring because twin pregnancy has high risk of getting pregnancy induced hypetension. Modified glucose tolerance test(MGTT) to detect any gestational diabetes mellitus is done. We also must ask the patient to do fetal kick chart and monitor for any signs of preterm delivery like leaking liquor and contraction pain because overdistended uterus may cause premature rupture of membrane and lead to preterm delivery. Hematinics and folate should be given to prevent anemia.Obstetric Nursing Essay

Professional component-reflection of the case
Communication issue
Communication is very important between doctors and patient. Without a proper communication a doctor can’t get all the information needed to come for an diagnosis of a patient. Good approach in the beginning itself will show a our professionalism. It is our responsibility to build a good rapport with patient. This will make them to have a trust on us and they will give all the information that we need. I approached my patient with a smile and a good morning wish. I was a bit afraid that she might not let me to clerk her because she looked a bit stressful. But as I bravely approached her, she was nice. After introducing my name I asked her that I wanted to ask some question on why she is admitted. Madam Suzanna was very polite and she let me to sit beside her in a chair. Then I went on asking questions in a open ended way. She answered my question very nicely and I managed to finish my history taking and physical examination on time. It took me about 40 minutes. Madam Suzanna was co operative and willing to spend time with me if I got any more futher questions to ask.

Spiritual issue

My patient Madam Suzanna was very spiritual. Even though she has been in the wad for very long time she is very calm. She believes that good will help her to deliver her twins without any complication. She also has a very strong family support and they also pray for her. As for me a person should have spiritual element in their life. By being spiritual it helps me to overcome any obstacles easily. I have a calm mind and soul.Obstetric Nursing Essay

Ethical issue

As a good doctor we should have a good respect on our patient. We should treat them appropriately. We should apply patient well fare in every move we make. Asking for the patient concern is very important. Especially my patient she is going to have elective cesarean section. So it is important to consult her on the complication for the short time and long time. We should explain to her the importance of doing that procedure, if she still denies we should not force them. With a good ethics we can manage the patient very well. We must take care their privacy also.

Professional judgement

Decision making skills is very important in medicine. Because it is a life and death matter. We must carry out all the important investigation and discuss with our specialist to come for an diagnosis. We must apply multidisciplinary role in managing the patient. We must think out of box and manage the patient as a whole. As for my patient she is well taken care of my specialists and she had gotten the best treatment.Obstetric Nursing Essay

Life long learning&Critical appraisal(what I have learnt from this case)
First of all I would like to thank Dr Nasir for giving me a opportunity for doing this case write up. I have learnt many things from this case write up. First of all I learnt that this case is not like an ordinary pregnancy. It is twin pregnancy, so twin pregnancy has a greater risk of developing gestational diabetes mellitus, pregnancy induced hypertension anemia and so on. So I learnt that I must manage the patient as a whole. I must give her iron tablet to prevent anemia and give her prophylactic aspirin to prevent hypertension and so on. I also learnt that twin pregnancy has a higher risk or developing preterm delivery. So I must be alert of any signs of leaking liquor or any contraction pain. Moreover my patient is having a complication of a twin pregnancy which are placenta previa type II posterior. So she can’t go through a normal delivery. She must do cesarean section.

I have learnt that placenta previa can cause anterpartum hemorrhage and also postpartum hemorrhage. I have also learnt how to manage the patient if she develop any of this complications as I have discussed in the discussion above. I have a complete knowledge on what is twin pregnancy all about and the complications that may arise from twin pregnancy.Obstetric Nursing Essay

As long as women exist there will be a need for gynecologists, obstetricians and gynecology and obstetrics nurses. An interesting career is an obstetrics and gynecology nurse. Obstetrics and gynecology nurses follow the lead of a physician. They work with the female reproductive system. A gynecology and obstetrics nurse does many things ranging from delivering babies to treating deceases of the female reproductive system. In this paper you will learn about the history of gynecology, the steps it takes to pursue a career in gynecology, a brief description of a career in gynecology, and the job outlook of gynecologists.
Obstetrics and gynecology dated back to the 17th century and were known as midwives or birth attendants. They had no training in this area. Because of their lack of training, most mothers died giving birth. It wasn’t until the 20th century that there was a higher rate of women living after giving birth. Today, obstetrics and gynecology is practice in private businesses or in hospitals. More sterile and safe techniques were also developed in order to give the mother comfort.
In 1825, James Blundell, a British obstetrician performed the first successful blood transfusion. He conducted many surgical experiments that later opened doors to ovariotomy and the caesarean section. An ovariotomy is a surgical incision made to remove the ovary. The caesarean section which is commonly referred to as the c-section is an incision made through the mother’s lower abdomen to deliver a baby. It is thought that the first c-section was performed in 1881.
In order to become an obstetrics and gynecology nurse, you must obtain a degree in nursing. It is best to choose a school that offers OBGYN nursing Obstetric Nursing Essay

OB/GYN Nurse There are many types of nursing careers you can decide to take, the type of nursing career I chose is an OB/GYN nurse. OB/GYN is used as an abbreviation for the actual name of this career. The “OB” is short for obstetrics or for an obstetrician, which is a physician who specializes in delivering babies. “GYN” is short for gynecology or for gynecologist, which is a physician who specializes in treating diseases which develop in the female reproductive system. Therefore an OB/GYN Nurse is a type of nurse who helps deliver babies and which also helps treat diseases of the female reproductive system. An OB/GYN nurse can be in the delivery room helping out the doctor when the baby is born, or the nurse can also, while the patient is pregnant, take vital signs and do ultrasounds. OB/GYN nurses help women during pregnancy, labor, and childbirth. They also help women with health issues in their reproductive system.  Obstetric Nursing Essay

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