Precipitating Factors:Oligohydramnios, Rupture of Membranes (ROM), ineffective bearing down techniques, Induction of labor,

Placental anomalies, Cord coil, Long/short cord, Post-term neonate, Gestational Diabetes,Pregnancy-Induced Hypertension, Twin Pregnancy, Breech Position

Oligohydramnios Rupture of membranes

Decreased amniotic fluid inside the utero

More space for the cord to move

With each movement of the fetus and contraction of the uterus

Pressure on the cord in the vaginal introitus by the fetal presenting part

Pressure on the cord against the uterine wall

Cord compression

Induction of labor

Hyperstimulation of the uterus compared from the normal

With each contraction, blood vessels constrict

Fetus assumes or stays in an unfavorable position with each

contraction

Inadequate blood flow to the placenta

Inadequate perfusion of the fetus

Fetal distress

Fetal hypoxia

Inadequate oxygenation of the fetus

Stimulation of the vagus nerve

Knowledge deficit: appropriate bearing down technique

Amnioinfusion

Oxygen administration

Altered comfort: Pain

Increases gastrointestinal motility and relaxation of the anal sphincter

Passing out of meconium in the amniotic fluid or inside the utero

Due to inadequate oxygenation, the fetus gasps for breath

With the mouth open, meconium can be inhaled into the lungs

MECONIUM ASPIRATION

Blockage of meconium aspirates in the lung parenchyma

Mechanical obstruction of the airway Inflammatory response Infection (Pneumonitis)

Less oxygen passes to the bronchioles or alveoli

Obstruction of meconium in the alveolar-capillary membrane Increased thickness in the

alveolar-capillary membrane

Poor diffusion of oxygen into the bloodstream

Ineffective airway clearance

Oxygen administration

Antibiotics

Intubation, Suctioning

Poor diffusion of CO2 into the alveoli

Respiratory Acidosis PaO2 of less than 80 mm Hg

PaCo2 of more than 45 mm Hg

Meconium aspirates upon suctioning

Difficulty in breathing/no respiratory effort

Crackles, wheezing upon auscultation

SaO2 of less than 95%

Risk for infection

Impaired gas exchange

Antibiotics

LEGENDS:

Signs and Symptoms Priority Nursing Diagnoses (Newborn) * Nursing Management: discussed w/each diagnosis

Priority Nursing Diagnoses (mother) Medical Management

Hypoxemia

Heart compensates through shunting blood to the vital organs

If not corrected Heart is forced to pump harder and faster

Poor peripheral circulation

Pulmonary hypertension (Cor Pulmonale)

Ventilation-perfusion mismatch

Shock

Fetal Death

Ineffective peripheral tissue perfusion

Heart decompensate