How do you assess a pregnant womans uterine contractions?
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Under a Creative Commons license Open access AbstractMore than one in ten babies are born prematurely worldwide, resulting in nearly one million deaths each year. Furthermore, surviving babies face lifelong health-related disabilities, such as difficulties in learning or hearing and vision loss. Monitoring uterine contractions can evaluate the health and progress of the pregnancy. This monitoring can help in determining if the pregnant woman is in labour, thus assisting them to go to the hospital, which will help in reducing premature birth issues. In this paper, we aim to mitigate the consequences of premature birth for both the pregnant woman and the fetus by proposing a safe, simple, home-comfortable, low-cost, and reliable monitoring framework. The system uses a non-invasive method to monitor the uterine electrohysterography (EHG) contractions using a wireless body sensor (WBS) and a smartphone. The smartphone will analyze uterine EHG contractions readings, and if they contain a premature labour pattern, a warning notification will be triggered. A proof-of-concept prototype of the smartphone application was designed and tested for reliability, performance and power consumption using three uterine contractions databases. The results show that the application was able to meet the framework objectives in detecting the labour pattern. KeywordsWireless body sensor networks Pregnancy Uterine contractions Labour pattern Premature birth Electrohysterography Cited by (0)© 2020 The Author(s). Published by Elsevier Ltd. Pregnancy - LaborNot what you're looking for? OverviewLabor is a series of rhythmic contractions of the uterus that get steadily stronger. They cause the cervix (the opening of the uterus) to open up. No one knows what causes labor to start. It usually begins within two weeks before or two weeks after a woman's estimated due date. If it is the first time that a woman is having a baby, labor usually lasts between 12 and 14 hours; in pregnancies that follow, labor is often shorter, averaging between six and eight hours. SymptomsA woman should talk to her doctor about what the signs of the start of labor are. These include:
When a woman in labor arrives at the hospital, her blood pressure, heart and breathing rates, temperature and weight are recorded. She will be checked for signs of swelling. Blood and urine tests will be given. A physical examination will be done. The doctor will estimate the size, position and orientation of the baby. He or she will check for the baby's heart sounds. Additionally, the doctor will take note of how long, how intense and how often the contractions are coming. If labor is active and the baby is due, a labor-and-delivery nurse or a doctor will do an internal examination with a gloved hand to evaluate how the labor is going. This exam maybe delayed if there is heavy bleeding. If the waters have broken (the amniotic sac's membranes have broken), the doctor or nurse will look for any greenish discoloration that might be a sign of fetal distress. DiagnosisThe woman in labor will be admitted to the labor suite for regular monitoring until delivery. Monitoring will include:
While in the delivery suite, a woman will be given little to eat or drink to avoid vomiting or choking during delivery. An intravenous infusion may be started to prevent dehydration during labor. This also provides an immediate way to provide drugs or blood in an emergency. Drugs to relieve pain may be given during labor if needed. As little as possible is given to avoid depressing the newborn's breathing. Having had childbirth classes before going into labor helps reduce anxiety and the need for pain relievers. The first stage of labor goes from the beginning of labor until the cervix is fully open (about 10 centimeters). As this stage continues, a woman may begin to feel the urge to bear down as the baby drops lower in her pelvis. She should avoid doing this, however, until her cervix is fully open to prevent tearing the cervix and using up energy. The second stage goes from full dilation (opening) of the cervix to delivery of the baby. This stage usually lasts about two hours in a woman who has never had a baby before and one hour in a women has previously had children. During this time, the woman must add to the contractions her body is doing naturally by bearing down to push the baby toward delivery. During labor, both the mother's heart rate and blood pressure and the baby's heart rate should be checked continuously by electronic monitor. TreatmentAt such a special time in their lives, many women prefer to have their babies in a less institutional environment. Having a baby at home is not recommended because of the possibility of unexpected complications that can occur. In response to women's desire to have a more home-like birthing experience, special maternity suites are available. Having the baby's father or other support person during labor is helpful. The moral support, encouragement and expressions of affection make the process of labor less frightening and anxious. Sharing the experience of labor, seeing their own child for the first time and the sound of its crying tends to create strong bonds between the parents and between the parents and child. It is particularly important to monitor the baby's heart rate during labor and delivery. Between a third to half of the babies who develop fetal distress or die during delivery do so without any significant signs beforehand. Electronically monitoring the baby can help pinpoint fetal distress before it becomes dire. Pain relief may be needed during labor. It must be carefully done to assure a safe delivery for both baby and mother. Better preparation for childbirth and training in giving birth without anesthesia has reduced the need for this except in cases where it is necessary to use forceps, deliver a breech baby or twins or to have a cesarean section. The usual forms of anesthesia given during labor are:
The next phase of pregnancy is delivery. © 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. Not what you're looking for? How do you manually assess uterine contractions?When timing contractions, start counting from the beginning of one contraction to the beginning of the next. The easiest way to time contractions is to write down on paper the time each contraction starts and its duration, or count the seconds the actual contraction lasts, as shown in the example below.
Where should you apply pressure to assess uterine contractions?Physicians can measure intrauterine pressure externally, on the abdomen, or internally, in the uterus. External monitors placed on the abdomen can detect the length and frequency of contractions during labor.
How do nurses palpate uterine contractions?Assist the patient into a comfortable side-lying position. Drape the patient with a sheet. Place the palmar surface of your fingers on the uterine fundus, and palpate lightly to assess contractions. Each contraction has three phases: increment (rising), acme (peak), and decrement (letting down or ebbing).
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