Question

1. Why is careful monitoring necessary for a woman diagnosed with a hematoma of the perineum?

2. What constitutes a precipitous birth?

3. Why is it important to carefully monitor the time between the birth of the head and the birth of the remainder of the body?

Answer 1

1)Hematoma occurs following the escape of blood into the maternal tissue after delivery,increased odema around surrounding tissues or more seriouslt hematoma formation.Hematoma usually develop deeps in the perineal fascia tissues and may not be visible to the obsrever if the perineal tissues are already odedmatous and discoloured.Careful monitoring is necessary because if it is untreated it can lead to acute shock.

The signs and symptoms include severe pain,inability to void,decreased hemoglobin levels and so on

The management is administer antibiotics as prescibedand prepare for incision and evacuation of the hematoma if necessary.

2)Precepitious birth means labour less than 3 hours.The contactions are strong and frequent from the onset of labour .Resistance from the soft tissue is low and resulting in rapid completion of the first and second stages.Soft tissue damage of the cervix and perineum may complicate the birth.

3) Once the head is delivered wait for another contaction to allow the shoulder to rotate or deliver.If the head to body interval is long there is a chancefor shoulder dystocia and asphyxia.It can also lead to brachial plexus injury and fetal hypoxic ischemic injury which leads to permanent brain damage.