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Operational Obstetrics & Gynecology

Labor and Delivery

Watch a PowerPoint Lecture

Watch a Video Showing a Normal Delivery or Cesarean Section

Labor

Contractions

Electronic Fetal Monitors

Latent Phase Labor

Fetal Heart Rate

Pain Relief

Active Phase Labor

Urine

Second Stage Labor

Progress of Labor

Estimated Fetal Weight

Preparing for Delivery

Delivery of the Baby

Dilatation and Effacement

Managing the Delivery

Delivery of the Placenta

Fetal Orientation

Episiotomy

Managing Labor and Delivery

Leopold's Maneuvers

Anesthesia

Initial Evaluation

Fetal Membranes

Clamp the Cord

History

Blood Count

The Placenta

Risk Factors

Early Labor

Uterine Massage

Vital Signs

Monitor the Fetal Heart

Post Partum Care

Uterine Massage

After delivery of the placenta, the uterus normally contracts firmly, closing off the open blood vessels which previously supplied the placenta. Without this contraction, rapid blood loss would likely prove very problematic or worse.

To encourage the uterus to firmly contract, oxytocin 10 mIU IM can be given after delivery. Alternatively, oxytocin 10 or 20 units in a liter of IV fluids can be run briskly (150 cc/hour) into a vein. Breast feeding the baby or providing nipple stimulation (rolling the nipple between thumb and forefinger) will cause the mother's pituitary gland to release oxytocin internally, causing similar, but usually milder effects.

A simple way to encourage firm uterine contraction is with uterine massage. The fundus of the uterus (top portion) is vigorously massaged to keep it the consistency of a tightened thigh muscle. If it is flabby, the patient will likely continue to bleed.


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Operational Obstetrics & Gynecology - 2nd Edition
The Health Care of Women in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMEDPUB 6300-2C
January 1, 2000

This web version of Operational Obstetrics & Gynecology is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMEDPUB 6300-2C, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. All material in this version is unclassified.

This formatting 2006 Medical Education Division, Brookside Associates, Ltd.
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