A Pocket Guide for Student Midwives, 2nd Edition

About the authors xiii

Preface xiv

Acknowledgements xvi

Section 1

The language of midwifery 1

Section 2

Quick reference topics 27

Abdominal palpation 27

Active management of labour 28

Administration of drugs 29

Admission in labour 32

Adoption 33

Amniocentesis 36

Amniotic Fluid Embolus (AFE) 37

Anaemia 39

Antenatal screening 40

Antepartum haemorrhage 42

Arterial blood pressure recording 45

Artificial feeds – bottle feeding 46

Artificial rupture of membranes (ARM) 47

Aseptic technique 48

Augmentation/acceleration of labour 49

Basic life support (BLS) – adult 52

Birth asphyxia 53

Bladder care in labour 55

Blood glucose monitoring (neonatal) 55

Blood pressure measuring 55

Bowel care in labour 56

Breast expression of milk 57

Breastfeeding 58

Breastfeeding Initiative (BFI) 63

Breech 63

Brow presentation 69

Caesarean section 69

Cardiotocography (CTG) 73

Carpal tunnel syndrome 77

Catheterisation 77

Cephalo-pelvic disproportion (CPD) 78

Changing Childbirth 80

Child protection 81

The Children Act, 1989 81

Cholestasis 82

Chorionic Villus Sampling (CVS) 83

CLAPA 84

Clasp trial 84

Cleft lip and palate 85

Clinical governance 86

Centre for Maternal and Child Enquiries (CMACE) 86

Community Health Councils (CHCs) 86

Complementary therapies 86

Confidential Enquiry into Maternal and Child Health (CEMACH) 89

Confidential Enquiry into Maternal Deaths (CEMD) 89

Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) 90

Congenital dislocation of hips 90

CONI (care of next infant) 91

Contraception advice 91

Convulsions 95

Cord prolapse/presentation 95

Cramp 96

Crying baby 98

Cultural aspects related to childbirth 99

Cup feeding 104

Cystic fibrosis 104

Cystitis 105

Deep vein thrombosis 106

Delivery technique 107

Diabetes mellitus 117

Disseminated intravascular coagulation (coagulopathy) (DIC) 125

Down’s syndrome 126

Drug-addicted mother and neonate 128

Eclampsia 128

Embolism 129

Epigastric pain 132

Epilepsy 132

Epilepsy and pregnancy 134

Episiotomy 134

Erb’s palsy (paralysis) 136

Exchange transfusion 136

Face presentation 139

Fainting 140

Fetal distress 140

Fitting 143

Forceps delivery 143

Frequency of micturition 143

Fundal height estimation (antenatal) 144

Fundal height estimation (postnatal) 145

Haemoglobinopathies 145

Haemorrhagic disease (Vitamin-K-deficient bleeding – VKDB) 152

Haemorrhoids 154

Headaches 155

Heartburn 155

Heel prick – peripheral blood sampling 156

High vaginal swab (HVS)/speculum examination 159

History taking 160

HOOP (Hands On Or Poised) Study 161

Hyperemesis gravidarum 162

Hypoglycaemia – neonatal 162

Hypothermia – neonatal 163

Hypothyroidism 164

Identification of newborn at birth 164

Incontinence 165

Induction of labour – alternative and ‘natural’ 166

Induction of labour – medical: uncomplicated pregnancy 166

Induction of labour – IUD 169

Infection – maternal 169

Infection – neonatal 172

Initial newborn examination 175

Insomnia 177

Instrumental delivery – Forceps delivery 178

Instrumental delivery – Ventouse delivery 179

Intrauterine death (IUD) 181

Intrauterine growth restriction (IUGR) 185

Intravenous cannulation/infusion (IVI) 186

Jaundice 188

Jittery (twitching) baby 191

Ketonuria 192

Local Supervising Authority (LSA) 193

MAGPIE trial 193

Malpresentation – fetus 194

Maternity action 194

Maternity benefits 194

Maternity services liaison committees 195

Meconium liquor 196

Medium chain acyl-CoA dehydrogenase deficiency (MCADD) 197

Mendelson’s syndrome 198

Mid-stream specimen urine (MSSU) 199

Multiple pregnancy/births 200

National Childbirth Trust (NCT) 202

Nausea and vomiting 203

Neonatal screening 205

Neural tube defect (NTD) 205

Obesity in pregnancy 207

Occipito-posterior (OP) position 208

Oligohydramnios 211

Ophthalmia neonatorum 213

ORACLE trial 214

Parent education 214

Partogram completion 216

Perineal repair 216

Perineal/surrounding area trauma 218

Phenylketonuria (PKU) 222

Phototherapy 225

Placental examination 226

Polyhydramnios 232

Postnatal care/examination – baby 234

Postnatal care – mother 236

Postnatal depression 238

Postnatal exercises 240

Post-partum haemorrhage – primary 241

Post-partum haemorrhage – secondary 243

Pregnancy-induced hypertension (PIH) and pre-eclampsia 245

Pre-labour or premature rupture of membranes (PROM) 251

Preterm baby 254

Preterm labour 259

Primary Care Trusts (PCTs) 261

Prolonged labour – first stage 262

Prolonged labour – second stage 263

Pruritus 264

Pudendal nerve block 266

Pulse taking 267

Relaxation techniques 267

Respiratory distress syndrome (RDS) (Surfacant deficiency syndrome [SDS]) 269

Resuscitation of newborn 271

Retained placenta 271

Retinopathy of the newborn 275

Safe Motherhood Initiative 277

Sexually transmitted infection (STI) 277

Sheehan’s syndrome 277

Shoulder dystocia 278

Sickle cell disease 281

Small-for-gestational-age baby (SGA) 281

Smoking and pregnancy 284

Stillbirth 288

Stillbirth and Neonatal Death Society (SANDS) 288

Strategic Health Authorities (SHAs) 289

Substance-abusing mother and baby 289

Sudden infant death syndrome (SIDS) 293

Symphysis pubis pain/sacro-iliac pain 295

Talipes equinovarus 296

Teenage pregnancy 298

Temperature-taking 299

Tentorial tear 301

Term breech trial 303

Thalassaemia 303

Thrombosis and Thromboembolism 303

Thrombophlebitis 303

Transverse/oblique lie 304

Twins 305

Urinary tract infection – UTI 305

Uterine inversion 306

Uterine rupture 307

Vaginal examination (VE) 312

Varicose veins 314

Venepuncture 316

Ventouse delivery 317

Vomiting 317

Winterton report (1992) 317

Figures

Figure 1 Antepartum haemorrhage 44

Figure 2 Apgar score 53

Figure 3 Neonatal resuscitation 54

Figure 4 Cord prolapse – presentation at home 96

Figure 5 Cord prolapse – presentation in hospital 97

Figure 6 Management of third stage of labour – physiological and active 110

Figure 7 Management of third stage of labour – alternative active management 111

Figure 8 Persistent occipito-posterior position – landmarks on vaginal examination 113

Figure 9 Persistent occipito-posterior position – delivery of the occiput 114

Figure 10 Persistent occipito-posterior position – delivery of the chin 115

Figure 11 Face presentation – landmarks on vaginal examination 115

Figure 12 Face presentation – delivery of the chin 116

Figure 13 Face presentation – delivery of the occiput 116

Figure 14 Disseminated intravascular coagulation (DIC) 127

Figure 15 Eclampsia 130

Figure 16 Haemoglobin composition 145

Figure 17 Normal adult haemoglobin HbA 146

Figure 18 Normal adult haemoglobin HbA2 146

Figure 19 Normal fetal haemoglobin 147

Figure 20 Abnormal haemoglobin – sickle cell trait 148

Figure 21 Abnormal haemoglobin – sickle cell disease 148

Figure 22 Abnormal haemoglobin – alpha thalassaemia minor or trait 150

Figure 23 Abnormal haemoglobin – alpha thalassaemia major 151

Figure 24 Abnormal haemoglobin – beta thalassaemia minor 151

Figure 25 Abnormal haemoglobin – beta thalassaemia major 152

Figure 26 Foot with sites for heel prick 157

Figure 27 Genetic inheritance, e.g. PKU 223

Figure 28 Normal placenta at term –maternal surface 227

Figure 29 Normal placenta at term – fetal surface 228

Figure 30 Normal placenta – lateral view showing two membranes 228

Figure 31 Abnormal insertion of the cord: Battledore insertion 229

Figure 32 Abnormal insertion of the cord: velamentous insertion 229

Figure 33 Abnormal placenta – bipartite placenta 230

Figure 34 Abnormal placenta – succenturiate lobe 230

Figure 35 Abnormal placenta – circumvallate placenta 231

Figure 36 Lateral view of circumvallate placenta showing the amnion and the double fold of the chorion 231

Figure 37 Post-partum haemorrhage – primary 244

Figure 38 Post-partum haemorrhage – secondary 246

Figure 39 Retained placenta – at home 273

Figure 40 Retained placenta – in hospital 274

Figure 41 Shoulder dystocia 280

Figure 42 Uterine inversion 308

Figure 43 Uterine rupture 311

Figure 44 Stations of the head in the pelvis 313

References 319