The Problem and its Background

Jun 17th, 2015
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A. T. Still University
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Travelers need the proper decision-making when going on a holiday by considering certain factors, such as product satisfaction and pleasure in traveling before deciding what to do or where to go. These are called travel motivators.

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CHAPTER 9 SHOULDER DYSTOCIA Learning Objectives:Use a systematic approach to the reduction of shoulder dystocia based upon the physical mechanisms of impact and disimpactionA 23 year old primip is induced at 41 and a half weeks with vaginal prostagladins. The first stage was uneventful. You were asked to assess her after 2.5 hours in the second stage as there seemed to be no further descent of the fetal head. Examination confirms that the head is on the pelvic floor in an OA position. Caput is visible at the introitus with contractions. The fetal heart is normal the patient is clearly exhausted. She readily accepts your suggestion regarding the use of a vacuum to effect delivery. What are the problems that may be encountered at this point?__________________________________________________________________________________________________________________________________________________________________________________________Following an easy application, there is moderately good descent during the first pull but this slows down as the head is half out. What are potential causes for this and what is your plan of action at this point?__________________________________________________________________________________________________________________________________________________________________________________________Shoulder dystocia is confirmed. What is your management?_______________________________________________________________________________________

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