PERTOLONGAN PERSALINAN DENGAN DISTOSIA BAHU

Summary

This detailed transcript outlines the steps involved in assisting a delivery with dystocia. It covers preparations for delivery, including sterilizing equipment, ensuring proper safety measures, and administering necessary medications. The process involves assisting the mother through labor with specific maneuvers for difficult deliveries, such as McRoberts, Massanti, and Rubit techniques, and handling situations like shoulder dystocia. It emphasizes safety, emotional support for the mother, and post-delivery care for both the mother and baby, ensuring a smooth and controlled birth process.

Takeaways

• 😀 Ensure that all delivery tools are prepared and sterilized, including gloves, clamps, scissors, and other essential items for the delivery process.
• 😀 Introduce yourself to the patient and explain the process, obtaining informed consent before proceeding with the delivery.
• 😀 Perform a thorough vaginal examination to confirm the readiness for delivery, ensuring full cervical dilation and monitoring fetal heart rate.
• 😀 Use proper hand hygiene practices by washing with soap and water, followed by drying with tissue or a towel, before wearing sterile gloves.
• 😀 Clean the perineum and vulva using sterilized materials to reduce infection risks before delivery.
• 😀 When the baby's head is visible, use sterile gloves and assist in guiding the baby’s head through the birth canal, while protecting the perineum.
• 😀 If the baby’s head faces difficulties during delivery, assist with gentle guidance and episiotomy if necessary to prevent tearing.
• 😀 Employ various maneuvers (e.g., McRobert's, Massanti, Rubit, Watch) to help ease shoulder dystocia during difficult shoulder deliveries.
• 😀 When shoulder dystocia occurs, assist in rotating the baby's shoulders, performing lateral pressure, and applying appropriate manual assistance to free the stuck shoulder.
• 😀 After the baby's shoulders are delivered, continue to support the delivery of the baby's body, ensuring that the placenta is managed actively during the third stage of labor.

Q & A

What is the first step in preparing for a delivery with shoulder dystocia?

The first step involves preparing the necessary delivery tools, such as two pairs of gloves, a set of coherent clamps, scissors for cutting the umbilical cord, sterilized gauze, a catheter, and a surgical scalpel for episiotomy.

What personal protective equipment (PPE) is required for the delivery process?

The required PPE includes an apron, mask, head covering, protective glasses, and boots to ensure safety and hygiene during the procedure.

How should the healthcare provider introduce themselves during the procedure?

The healthcare provider should introduce themselves to the mother and explain that they will be assisting with the delivery, ensuring informed consent is obtained before proceeding.

What are the signs that indicate the second stage of labor has begun?

The second stage of labor is indicated by the mother's strong urge to push, increased pressure on the rectum and vagina, and the visible bulging of the perineum and vulva, with the anal sphincter beginning to open.

What is the purpose of cleaning the vulva and perineum during the delivery process?

Cleaning the vulva and perineum helps ensure proper hygiene, removing any potential contaminants before performing internal examinations and assisting with the delivery.

How is the baby's head and shoulders delivered in cases of shoulder dystocia?

The baby's head is carefully delivered first, followed by the anterior and posterior shoulders. Techniques like gentle pulling and supporting the perineum are used to guide the shoulders safely out.

What are some maneuvers used to assist in the delivery of the shoulders in cases of shoulder dystocia?

Maneuvers like McRoberts' maneuver (flexing the mother's legs towards her chest), Massanti maneuver (pressure on the suprapubic area), Rubit maneuver (pressing the shoulder to reduce diameter), and Watch maneuver (rotating the shoulders) are performed to help deliver the shoulders.

How is the baby's body delivered after the shoulders?

Once the shoulders are delivered, the healthcare provider gently guides the rest of the body out by applying steady traction and supporting the baby’s body as it passes through the birth canal.

What should be done if the baby shows signs of being distressed during the delivery?

If signs of distress appear, immediate steps should be taken, such as checking the umbilical cord for any entanglement around the baby’s neck, and using techniques like gentle rotation or careful maneuvering to free the baby.

What is the management protocol for the third stage of labor?

The third stage involves active management, which includes ensuring that the placenta is delivered properly and monitoring the mother for any signs of bleeding or complications after the birth.