Obstetrics Book

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Peripartum Risk to the Fetus

Aka: Peripartum Risk to the Fetus
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  1. Indications
    1. Fetal Monitoring intensity (e.g. continuous or intermittent monitoring)
  2. Risk Factors: Antenatal
    1. Fetal factors
      1. Abnormal umbilical artery velocimetry
      2. Breech Presentation
      3. Intrauterine Growth restriction
      4. Multiple pregnancy
      5. Oligohydramnios
      6. Rh Isoimmunization
    2. Maternal factors
      1. Anemia
      2. Antepartum hemorrhage
      3. Maternal cardiac disease
      4. Gestational Diabetes
      5. Pregnancy Induced Hypertension (Preeclampsia)
      6. Hyperthyroidism
      7. Maternal traumatic injury
      8. Morbid Obesity
      9. Maternal renal disease
      10. Maternal vascular disease
  3. Risk Factors: Intrapartum
    1. Fetal factors
      1. Abnormal Fetal Heart Rate on Labor and Delivery Admission
      2. Meconium stained amniotic fluid
    2. Maternal factors
      1. Hypertonic Uterus
      2. Induced labor or augmented labor
      3. Intrauterine infection or Chorioamnionitis
      4. Post-term Pregnancy (>42 weeks gestation)
      5. Preterm Labor (<32 weeks gestation)
      6. Previous ceserean delivery
      7. Prolonged Rupture of Membranes >24 hours (at term)
      8. Regional analgesia
      9. Vaginal Bleeding in labor
  4. Risk Factors: Specific Conditions and their associated risks
    1. Multiple Pregnancy
      1. Breech Presentation
      2. Preterm delivery
      3. Small for Gestational Age
      4. Asphyxia
    2. Blood Group Incompatibility
      1. ABO incompatibility
      2. Rh Sensitization
    3. Abruptio Placenta or Placenta Previa
      1. Fetal Hypoxia
      2. Fetal asphyxia
    4. Preterm (<38 weeks) or Postterm (>42 weeks) delivery
      1. Asphyxia
      2. Hypoglycemia
    5. Premature Rupture of Membranes (PROM)
      1. Neonatal Sepsis
      2. Pneumonia
      3. Meningitis
    6. Prolapsed Cord
      1. Fetal Asphyxia
    7. Cesarean Section
      1. Prematurity
      2. Neonatal Depression
      3. Hypovolemia
      4. Birth Trauma
  5. References
    1. Bailey (2009) Am Fam Physician 80(12): 1388-98
    2. Liston (2007) J Obstet Gynaecol 29(9 suppl 4): S3-56

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