Treatments for Breech pregnancy
Treatments for Breech pregnancy
The list of treatments mentioned in various sources
for Breech pregnancy
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Watchful waiting - babies will often turn themselves.
- Certain exercises to turn the baby
- Manipulation to turn the baby
- Vaginal breech delivery
- Foreceps
- Cesarean delivery
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Hospital statistics for Breech pregnancy:
These medical statistics relate to hospitals, hospitalization and Breech pregnancy:
- 0.065% (8,335) of hospital consultant episodes were for obstruct labour due to malposition and malpresentation of fetus in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 94% of hospital consultant episodes for obstruct labour due to malposition and malpresentation of fetus required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 100% of hospital consultant episodes for obstruct labour due to malposition and malpresentation of fetus were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 1% of hospital consultant episodes for obstruct labour due to malposition and malpresentation of fetus required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 4.3 days was the mean length of stay in hospitals for obstruct labour due to malposition and malpresentation of fetus in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Hospitals & Medical Clinics: Breech pregnancy
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Book Excerpts: Treatment of Breech pregnancy
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Cesarean birth:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The most common type of cesarean birth is the lower segment cesarean, in which a transverse incision across the lower abdomen opens the visceral peritoneum over the uterus. The lower anterior uterine wall is then incised (transversely or longitudinally) behind the bladder.
The classic cesarean — in which a longitudinal incision is made into the body of the uterus, extending into the fundus and opening the top of the uterus — is rarely performed because it exaggerates the risk of infection and of uterine rupture in subsequent pregnancies. Cesarean hysterectomy removes the entire uterus and is reserved for such cases as malignant tumors, severe infection, and placenta accreta.
Patients may have general or regional anesthetic for surgery, depending on the extent of maternal or fetal distress. Possible maternal complications of cesarean delivery include respiratory tract infection, wound dehiscence, thromboembolism, paralytic ileus, hemorrhage, and genitourinary tract infection.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cardiovascular disease in pregnancy:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The goal of antepartum management is to prevent complications and minimize the strain on the mother’s heart, primarily through rest. This may require periodic hospitalization for patients with moderate cardiac dysfunction or with symptoms of decompensation, toxemia, or infection. Older women or those with previous decompensation may require hospitalization and bed rest throughout the pregnancy.
Drug therapy is often necessary and should always include the safest possible drug in the lowest possible dosage to minimize harmful effects to the fetus. Diuretics and drugs that increase blood pressure, blood volume, or cardiac output should be used with extreme caution. If an anticoagulant is needed, heparin is the drug of choice. Cardiac glycosides and common antiarrhythmics, such as quinidine and procainamide, are often required. The prophylactic use of antibiotics is reserved for patients who are susceptible to endocarditis.
A therapeutic abortion should be considered for patients with severe cardiac dysfunction, especially if decompensation occurs during the first trimester. Patients hospitalized with heart failure usually follow a regimen of cardiac glycosides, oxygen, rest, sedation, diuretics, and restricted intake of sodium and fluids. Patients in whom symptoms of heart failure don’t improve after treatment with bed rest and cardiac glycosides may require cardiac surgery, such as valvotomy and commissurotomy. During labor, the patient may require oxygen and an analgesic, such as meperidine or morphine, for relief of pain and apprehension without undue depression of the fetus or herself. Depending on which procedure promises to be less stressful for the patient’s heart, delivery may be vaginal or by cesarean birth. Forceps may augment vaginal delivery to minimize the need to push, which strains the heart.
Bed rest and medications already instituted should continue for at least 1 week after delivery because of a high incidence of decompensation, cardiovascular collapse, and maternal death during the early puerperal period. These complications may result from the sudden release of intra-abdominal pressure at delivery and the mobilization of extracellular fluid for excretion, which increase the strain on the heart, especially if excessive interstitial fluid has accumulated. Breast-feeding is undesirable for patients with severely compromised cardiac dysfunction because it increases fluid and metabolic demands on the heart.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Adolescent pregnancy:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The pregnant adolescent requires the standard prenatal care that’s appropriate for an adult. However, she also needs psychological support and close observation for signs of complications.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Low birth weight:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Because low birth weight may be associated with poorly developed body systems, particularly the respiratory system, your priority is to monitor the neonate’s respiratory status. Be alert for signs of distress, such as apnea, grunting respirations, intercostal or xiphoid retractions, or a respiratory rate exceeding 60 breaths/minute after the first hour of life. If you detect any of these signs, prepare to provide respiratory support. Endotracheal intubation or supplemental oxygen with an oxygen hood may be needed.
Monitor the neonate’s axillary temperature. Decreased fat reserves may keep him from maintaining normal body temperature, and a drop below 97.8° F (36.5° C) exacerbates respiratory distress by increasing oxygen consumption. To maintain normal body temperature, use an overbed warmer or an Isolette. (If these are unavailable, use a wrapped rubber bottle filled with warm water, but be careful to avoid hyperthermia.) Cover neonate’s head to prevent heat loss.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Cardiovascular disease in pregnancy:
Treatment
(Handbook of Diseases)
Specific treatments vary before, during, and after delivery.
Before delivery
The goal of antepartum management is to prevent complications and minimize the strain on the mother’s heart, primarily through rest. This may require periodic hospitalization for patients with moderate cardiac dysfunction or with symptoms of decompensation, toxemia, or infection. Older women or those with previous decompensation may require hospitalization and bed rest throughout the pregnancy.
Drug therapy is usually necessary and should include the safest drug in the lowest possible dose to minimize harmful effects to the fetus. Diuretics and drugs that increase blood pressure, blood volume, or cardiac output should be used with extreme caution.
If an anticoagulant is needed, heparin is the drug of choice. A cardiac glycoside and an antiarrhythmic are typically required. The prophylactic use of antibiotics is reserved for patients who are susceptible to endocarditis.
A therapeutic abortion may be considered for patients with severe cardiac dysfunction, especially if decompensation occurs during the first trimester. Patients hospitalized with heart failure are usually treated with a cardiac glycoside, oxygen, rest, sedation, and a diuretic; intake of sodium and fluids is also restricted. Patients whose symptoms of heart failure don’t improve after treatment with bed rest and a cardiac glycoside may require cardiac surgery, such as valvotomy and commissurotomy.
During delivery
The patient in labor may require oxygen and an analgesic, such as meperidine or morphine, for pain relief and apprehension without undue depression of the fetus or herself. Depending on which procedure promises to be less stressful for the patient’s heart, delivery may be vaginal or by cesarean section. Operative vaginal delivery (for example, with forceps) is usually preferable to avoid the blood pressure changes that occur with pushing.
After delivery
Bed rest and medications already instituted should continue for at least 1 week after delivery because of a high incidence of decompensation, cardiovascular collapse, and maternal death during the early puerperal period. These complications may result from the sudden release of intra-abdominal pressure at delivery and the mobilization of extracellular fluid for excretion, which increase the strain on the heart, especially if excessive interstitial fluid has accumulated.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Low birth weight:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Initiate feedings as soon as possible and continue to feed the neonate every 2 to 3 hours.
▪ Provide gavage or I.V. nutrition for the sick or very premature neonate.
▪ Check abdominal girth daily or more frequently if indicated, and check stools for blood to detect necrotizing enterocolitis.
▪ Prepare for a sepsis workup if signs of infection are associated with low birth weight.
▪ Check the neonate's vital signs every 15 minutes for the first hour and at least once every hour thereafter until his condition stabilizes.
▪ Be alert for changes in temperature or behavior, feeding problems, respiratory distress, or periods of apnea—possible indications of infection.
▪ Monitor blood glucose levels and watch for signs and symptoms of hypoglycemia, such as irritability, jitteriness, tremors, seizures, irregular respirations, lethargy, and a high-pitched or weak cry.
▪ If the neonate is receiving supplemental oxygen, carefully monitor arterial blood gas values and the oxygen concentration of inspired air to prevent retinopathy.
▪ Monitor the neonate's urine output by weighing diapers before and after voiding.
▪ Check urine color, measure specific gravity, and test for the presence of glucose, blood, or protein.
▪ Watch for changes in the neonate's skin color because increasing jaundice may indicate hyperbilirubinemia.
Patient teaching
▪ Explain disorder and all procedures and treatments to the parents.
▪ Encourage the parents to participate in their neonate's care to strengthen bonding.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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