Curran Carol A
Clinical Nurse Specialists and Associates, Virginia Beach, VA 23452, USA.
J Obstet Gynecol Neonatal Nurs. 2003 Nov-Dec;32(6):802-13. doi: 10.1177/0884217503258425.
Intrapartum emergencies are challenging to all perinatal nurses because of the increased risk of adverse outcomes for the mother and fetus. Perinatal emergencies, such as seizures, amniotic fluid embolus, hemorrhage, and uterine rupture, create physiological challenges and trigger intrinsic survival techniques. The pregnant uterus becomes a vital source of blood volume during hypovolemic events because it is not considered a vital organ. The pregnancy itself may become burdensome, and birth may occur as an intrinsic maternal compensatory mechanism. The resultant fetal hypoxemia may also stress the fetus into initiating labor. During extensive oxygen desaturation and decompensation, the focus should be on maternal stabilization, which will subsequently enhance fetal stabilization. Clinical assessments, critical thinking, decision making, and resource allocation must be quick and appropriate to increase the likelihood of a positive outcome for the mother, fetus, and neonate.
产时紧急情况对所有围产期护士来说都是一项挑战,因为母亲和胎儿出现不良结局的风险增加。围产期紧急情况,如癫痫发作、羊水栓塞、出血和子宫破裂,会带来生理挑战并触发内在的生存技能。在低血容量事件中,妊娠子宫成为血容量的重要来源,因为它不被视为重要器官。妊娠本身可能会变得负担沉重,分娩可能作为母亲的一种内在代偿机制而发生。由此产生的胎儿低氧血症也可能促使胎儿发动分娩。在广泛的氧饱和度降低和失代偿期间,重点应放在母亲的稳定上,这随后将增强胎儿的稳定。临床评估、批判性思维、决策和资源分配必须迅速且恰当,以增加母亲、胎儿和新生儿获得良好结局的可能性。