CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌

   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
TOPIC‌‌9:‌‌PROCESS‌‌OF‌‌BIRTH‌  ‌
 ‌
 ‌ ● beyond‌  ‌30‌  ‌minutes‌  ‌- ‌ ‌referral‌  ‌na‌  ‌ng‌  ‌client‌‌
 
  ‌ to‌‌a‌‌hospital‌  ‌
  ‌ Duncan‌  ‌
  ‌ ● dirty‌‌duncan‌‌    ‌
● side‌‌ng‌‌placenta‌‌mauuna‌‌matanggal‌  ‌
  ‌
● causes‌‌placental‌‌flip‌  ‌
Schultze‌ 
 ‌
● center‌‌siya‌‌magdedetach‌  ‌
 ‌ Placental‌‌expulsion‌  ‌
● pressure‌  ‌of‌  ‌the‌  ‌uterine‌  ‌walls‌  ‌cause‌  ‌it‌  ‌to‌‌  
 ‌ slide‌‌downward‌  ‌
● gentle‌‌   fundal‌‌
  pressure‌‌   and‌‌
  traction‌‌  on‌‌  the‌‌
 
 ‌
cord‌‌complete‌‌its‌‌delivery‌  ‌
 ‌ Brant‌‌Andrews‌‌maneuver‌  ‌
● pressure‌  ‌sa‌  ‌lower‌  ‌uterine‌  ‌while‌  ‌you‌  ‌pull‌‌  
 ‌ the‌‌placenta‌  ‌
Fourth‌‌stage‌ 
Hindi‌‌na‌‌allowed‌‌to‌‌ambulate‌‌pag‌‌ruptured‌‌bag‌‌
  ● first‌‌4‌‌hours‌‌after‌‌expulsion‌‌of‌‌placenta‌  ‌
kasi‌‌prone‌‌to:‌  ‌ ● uterus‌  ‌contracts‌  ‌to‌  ‌control‌  ‌bleeding‌  ‌at‌‌  
placental‌‌site‌  ‌
- cord‌‌prolapse‌  ‌ ● monitor‌‌BP‌‌q15‌‌mins‌  ‌
- infection‌  ‌ ● palpate‌‌uterus‌‌and‌‌massage‌‌(bimanual)‌  ‌
● normal‌‌ang‌‌first‌‌hour‌‌=‌‌check‌‌bp‌‌q30‌‌mins‌  ‌
STAGES‌‌OF‌‌LABOR‌  ‌
 ‌
First‌‌stage‌  ‌
Preeclampsia‌  ‌is‌  ‌caused‌  ‌by‌  ‌the‌  ‌spiral‌  ‌of‌  ‌the‌‌  
● onset‌‌of‌‌labor‌‌to‌‌complete‌‌cervical‌‌dilation‌  ‌ chorionic‌‌villi‌  ‌
● Latent‌‌phase‌‌-‌‌labor‌‌onset‌‌to‌‌3‌‌cm‌‌dilation‌  ‌ Hypertensive‌  ‌mother‌  ‌- ‌ ‌babagsak‌  ‌bp‌  ‌right‌  ‌after‌‌  
○ mommy‌‌   uwi‌‌
  ka‌‌
  muna‌‌
  kasi‌‌
  hindi‌‌
 ka‌‌
  detachment‌‌of‌‌placenta‌ 
pa‌‌manganganak‌  ‌
● Active‌‌phase‌‌-‌‌4-7‌‌cm‌‌dilation‌  ‌
● Transition‌‌-‌‌8-10‌‌cm‌‌dilation‌  ‌
○ strong‌‌contractions‌  ‌
● Fully‌‌dilated‌‌-‌‌10‌‌cms‌  ‌
● 1‌‌cm‌‌per‌‌hour‌‌-‌‌primigravida‌ 
● 1.5‌‌cm‌‌per‌‌hour‌‌-‌‌multigravida‌  ‌
Second‌‌stage‌  ‌
● complete‌‌dilation‌‌to‌‌birth‌‌of‌‌baby‌  ‌
● urge‌‌to‌‌push‌  ‌
● transfer‌‌to‌‌delivery‌‌room‌  ‌
● Primigravida‌‌-‌‌fully‌‌pa‌‌lang‌‌tinatransfer‌‌na‌  ‌
● Multigravida‌  ‌- ‌ ‌tinatransfer‌  ‌pag‌  ‌crowning‌‌  
na‌  ‌
Third‌‌stage‌  ‌
● birth‌‌to‌‌placental‌‌expulsion‌  ‌
● 5-30‌‌minutes‌  ‌

 ‌
PROPERTY‌‌OF‌‌ODLID‌  ‌
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 ‌
CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
○ supporting‌  ‌the‌  ‌perineum‌  ‌para‌  ‌di‌‌
 
maglacerate‌  ‌
● Avoid‌‌precipitous‌‌delivery‌  ‌
 ‌
EPISIOTOMY‌  ‌
● surgical‌  ‌incision‌  ‌through‌  ‌the‌  ‌perineum‌‌  
made‌  ‌to‌  ‌enlarge‌  ‌the‌  ‌vagina‌  ‌and‌  ‌assist‌  ‌in‌‌
 
child‌‌birth‌  ‌
● 1‌‌cm‌‌above‌‌the‌‌rectum‌  ‌
Median‌‌incision‌  ‌
● mas‌‌mabilis‌‌magheal‌  ‌
Mediolateral‌‌incision‌  ‌
● for‌  ‌short‌  ‌perineum‌  ‌kasi‌  ‌iniiwasan‌  ‌yung‌‌  
rectum‌  ‌
Rectovaginal‌‌fistula‌  ‌
● hindi‌  ‌properly‌  ‌nasuture‌  ‌yung‌  ‌4th‌  ‌degree‌‌  
suture‌  ‌
Episiorrhaphy‌  ‌
● ano‌‌to?‌  ‌
 ‌
FETAL‌‌ASSESSMENT‌  ‌
● Non-stress‌‌test‌‌(NST)‌  ‌
○ Reactive‌‌-‌‌positive‌‌result,‌‌normal‌  ‌
○ Non-reactive‌  ‌
● Contraction‌‌   Test‌‌
  Graph‌‌   (CTG)‌‌
 / ‌‌Contraction‌‌  
Stress‌‌Test‌‌(CST)‌  ‌
○ +‌‌or‌‌-‌‌results‌  ‌
 ‌

 ‌
MECHANISM‌‌OF‌‌LABOR/CARDINAL‌‌  
MOVEMENTS‌‌OF‌‌LABOR‌  ‌
● Engagement‌  ‌
● Descent‌  ‌
● Flexion‌  ‌
● Internal‌‌rotation‌  ‌
● Extension‌  ‌
● Restitution‌‌(rotation)‌  ‌
● Expulsion‌  ‌
○ 9‌  ‌ang‌  ‌perfect‌  ‌score‌  ‌sa‌  ‌APGAR‌  ‌pag‌‌
 
first‌‌minute‌  ‌  ‌
DELIVERY‌  ‌  ‌
● assess‌‌the‌‌position‌‌of‌‌the‌‌baby‌  ‌ ● Conditions‌  ‌requiring‌  ‌External‌  ‌Fetal‌‌
 
● Ritgenz‌‌maneuver‌  ‌ Monitor‌  ‌

 ‌
PROPERTY‌‌OF‌‌ODLID‌  ‌
43‌ 
 ‌
CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
○ previous‌  ‌stillbirth‌  ‌at‌  ‌> ‌ ‌38‌  ‌weeks‌‌  ● intensity‌  ‌
gestation‌  ‌ ● interval‌  ‌
○ preeclampsia‌  ‌ ● regularity‌  ‌
○ placenta‌‌previa‌  ‌ ● degree‌  ‌of‌  ‌uterine‌  ‌relaxation‌  ‌between‌‌
 
○ abruptio‌‌placentae‌  ‌ contractions‌  ‌
○ multiple‌‌gestation‌  ‌
○ prolonged‌  ‌or‌  ‌premature‌‌   rupture‌‌  of‌‌
 
membranes‌  ‌
○ induction‌‌of‌‌labor‌  ‌
○ PTL‌  ‌
○ decreased‌‌fetal‌‌movement‌  ‌  ‌
○ non-reassuring‌‌fetal‌‌status‌  ‌  ‌
○ meconium‌‌staining‌  ‌ Early‌‌Deceleration‌  ‌
○ trial‌  ‌of‌  ‌labor‌  ‌after‌  ‌cesarean‌  ‌birth‌‌   ● begin‌  ‌with‌  ‌contraction‌  ‌and‌  ‌return‌  ‌to‌‌
 
(VBAC)‌  ‌ baseline‌‌after‌‌the‌‌contraction‌  ‌
Fetal‌‌Heart‌‌Rate‌‌Monitoring‌‌Terminology‌  ‌ ● no‌‌treatment‌‌necessary‌  ‌
 ‌ ● normal‌  ‌
Late‌‌deceleration‌  ‌
Baseline‌  ‌ 110‌‌-‌‌160‌‌bpm‌  ‌
● FHT‌  ‌does‌  ‌not‌  ‌return‌  ‌to‌  ‌baseline‌‌  
Tachycardia‌  ‌ >‌‌160‌‌bpm‌  ‌ contraction‌  ‌
● particularly‌  ‌ominous‌  ‌if‌  ‌coupled‌  ‌with‌‌  
Bradycardia‌‌
   ‌ <‌‌110‌‌bpm‌  ‌ decreased‌‌variability‌  ‌
● Give‌‌O2‌‌at‌‌10Lpm‌  ‌
 ‌ ● Reposition‌‌(off‌‌vena‌‌cava)‌  ‌
● Variability‌  ‌- ‌ ‌minute‌  ‌fluctuations‌  ‌f rom‌‌   ● DC‌‌oxytocin‌‌infusion‌  ‌
baseline‌  ‌triggered‌  ‌by‌  ‌CNS‌  ‌control‌  ‌and‌‌   ● no‌‌improvement‌‌=‌‌immediate‌‌delivery‌  ‌
environmental‌‌changes‌  ‌
● Accelerations‌  ‌- ‌ ‌transient‌  ‌rise‌  ‌in‌  ‌FHR‌  ‌in‌‌
 
response‌‌to‌‌fetal‌‌or‌‌uterine‌‌activity‌  ‌
● Decelerations‌‌  (decels)‌‌
 - ‌‌transient‌‌ decrease‌‌ 
from‌  ‌baseline‌  ‌in‌  ‌response‌  ‌to‌‌
 
environmental‌‌changes‌‌or‌‌stress‌  ‌
Causes‌‌of‌‌Fetal‌‌Tachycardia‌  ‌
● maternal‌‌fever‌‌and‌‌dehydration‌  ‌
● tocolytic‌  ‌agents‌  ‌like‌  ‌terbutaline,‌‌
 
isoxsoprine‌  ‌
● prematurity‌  ‌
● activity‌  ‌
● infection‌  ‌
● maternal‌‌hyperthyroidism‌‌-‌‌increase‌‌BMR‌  ‌
Possible‌‌causes‌‌of‌‌decrease‌‌variability‌  ‌
● sleeping‌‌fetus‌‌(no‌‌movement)‌  ‌
 ‌
● prematurity‌  ‌
Variable‌‌deceleration‌  ‌
● anticholinergics‌  ‌
● V‌  ‌shaped‌  ‌or‌  ‌U ‌ ‌shaped‌  ‌decelerations‌  ‌of‌‌
 
● analgesics‌  ‌
variable‌‌onset‌  ‌
● hypoxia‌  ‌
● ascertain‌‌type‌  ‌
Uterine‌‌Contractions‌  ‌
● positional‌‌changes‌  ‌
● duration‌  ‌
 ‌
PROPERTY‌‌OF‌‌ODLID‌  ‌
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CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
● pelvic‌‌exam‌‌to‌‌see‌‌if‌‌cord‌‌has‌‌prolapsed‌  ‌ ○ decreasing‌  ‌efficiency‌  ‌of‌  ‌uterine‌‌  
● oxygen‌‌by‌‌mask‌‌at‌‌10Lpm‌  contractions‌  ‌
○ diminishing‌  ‌ability‌  ‌of‌  ‌mom‌  ‌to‌‌  
cooperate‌  ‌
○ causing‌  ‌need‌  ‌for‌  ‌operative‌‌
 
intervention‌  ‌
Parenteral‌‌Analgesia‌  ‌
● Opioid‌‌Analgesic‌  ‌
○ reduce‌  ‌the‌  ‌perception‌  ‌of‌  ‌pain‌‌  
without‌‌loss‌‌of‌‌consciousness‌  ‌
■ meperidine‌‌(demerol)‌  ‌
■ fentanyl‌‌(sublimaze)‌  ‌
■ butorphanol‌‌(stadol)‌  ‌
■ nalbuphine‌‌(nubain)‌  ‌
 ‌ ■ Naloxone‌‌(Narcan)‌  ‌
PAIN‌‌MANAGEMENT‌‌DURING‌‌CHILD‌‌BIRTH‌  ‌ ● Sedatives‌‌-‌‌small‌‌dose‌‌of‌‌short‌‌acting‌  ‌
Non-Pharmacologic‌‌Pain‌‌Management‌  ‌ ○ barbiturates‌  ‌- ‌ ‌thiopental‌‌
 
● Relaxation‌  ‌ (pentothal)‌  ‌
○ environmental‌‌comfort‌  ‌ Vaginal‌‌Birth‌‌Anesthesia‌  ‌
○ general‌‌comfort‌  ‌ ● Local‌  ‌infiltration‌  ‌Anesthesia‌  ‌- ‌ ‌xylocaine‌‌  
○ reducing‌‌anxiety‌‌and‌‌fear‌  ‌ (Lidocaine‌‌2%)‌  ‌
○ specific‌‌relaxation‌‌techniques‌  ‌ Pudendal‌‌Block‌  ‌
■ lamaze‌‌class‌ 
● Cutaneous‌‌stimulation‌  ‌
○ self‌‌massage‌  ‌
○ massage‌‌by‌‌others‌  ‌
○ counter‌‌pressure‌  ‌
○ touch‌  ‌
○ thermal‌‌stimulation‌  ‌
○ acupressure‌  ‌
● Hydrotherapy‌  ‌
● Mental‌‌stimulation‌  ‌
○ imagery‌ 
○ focal‌‌point‌  ‌
● Breathing‌‌techniques‌  ‌
Pharmacologic‌‌Pain‌‌Management‌  ‌
Choice‌‌of‌‌Anesthesia/Analgesia‌  ‌
● patient‌‌condition‌  ‌
● labor‌‌status‌  ‌
● risks‌  ‌
 ‌
● personnel‌  ‌
● local‌‌practice‌  ‌
● physician’s‌‌preference‌  ‌
● patient’s‌‌preference‌  ‌
Goals‌‌of‌‌Anesthesia/Analgesia‌  ‌
● pain‌‌relief‌‌that‌‌is‌‌simple‌‌to‌‌use‌‌without‌  ‌
○ endangering‌‌mother/baby‌  ‌

 ‌
PROPERTY‌‌OF‌‌ODLID‌  ‌
45‌  ‌
 ‌
CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
Subarachnoid‌  ‌Block/Anesthesia‌  ‌(Spinal‌‌
 
Anesthesia)‌  ‌

 ‌

 ‌
Epidural‌‌Anesthesia‌  ‌

 ‌
Epidural‌‌Block‌  ‌
 ‌
Complications‌‌of‌‌Spinal‌‌Anesthesia‌  ‌
● Hypotension‌  ‌
● Bradycardia‌  ‌
● Total‌‌Spinal‌‌Anesthesia‌  ‌
● Neurological‌  ‌Complications‌  ‌- ‌ ‌Cauda‌‌
 
Equina‌‌Syndrome‌  ‌
● Post‌‌Dural‌‌Puncture‌‌Headache‌  ‌
● Infection‌  ‌
● Backache‌  ‌
General‌‌Anesthesia‌  ‌
 ‌
● complete‌  ‌loss‌  ‌of‌  ‌perception‌  ‌and‌‌
 
  ‌
consciousness‌  ‌
  ‌
● fundamental‌‌attributes‌  ‌
  ‌
○ loss‌‌of‌‌consciousness‌‌    ‌
  ‌

 ‌
PROPERTY‌‌OF‌‌ODLID‌  ‌
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CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
■ does‌  ‌not‌  ‌block‌  ‌autonomic‌‌   ○ used‌  ‌often‌  ‌when‌  ‌there‌  ‌is‌  ‌minimal‌‌
 
reflexes‌‌to‌‌painful‌‌stimuli‌  ‌ molding‌  ‌
○ vegetative‌‌stabilization‌  ‌ ○ more‌‌suitable‌‌for‌‌outlet‌‌delivery‌  ‌
○ analgesia‌  ‌
■ loss‌  ‌of‌  ‌pain‌  ‌sensation,‌‌  
suppression‌  ‌of‌  ‌autonomic‌‌  
relaxation‌  ‌
○ muscle‌‌relaxation‌  ‌
● induction‌‌ of‌‌
 all‌‌
 the‌‌
 GA‌‌
 attributes‌‌  facilitated‌‌  
by‌  ‌mosaic‌  ‌assembly‌  ‌of‌  ‌partial‌  ‌effects‌  ‌of‌‌
 
many‌  ‌substances‌  ‌such‌  ‌as‌  ‌anesthetics,‌‌    ‌
analgesics,‌‌tranquilizers,‌‌myorelaxants‌  ‌

 ‌
  ‌
VACUUM‌‌ASSISTED‌‌DELIVERY‌  ‌
 ‌
TYPES‌‌OF‌‌VAGINAL‌‌BIRTH‌ 
NORMAL‌‌SPONTANEOUS‌‌DELIVERY‌‌(NSD)‌  ‌
 ‌
  ‌
FORCEPS‌‌ASSISTED‌‌DELIVERY‌  ‌
● Simpson‌‌Forceps‌  ‌
○ most‌‌   commonly‌‌  used‌‌
 type‌‌ in‌‌
 outlet‌‌
 
delivery‌  ‌
○ elongated‌‌cephalic‌‌curve‌  ‌
○ when‌  ‌there‌  ‌is‌  ‌substantial‌  ‌molding‌‌
   ‌
of‌‌the‌‌fetal‌‌head‌  ‌ Indication‌‌for‌‌Operative‌‌Delivery‌  ‌
 ‌
Maternal‌  ‌ Fetal‌  ‌

● Exhaustion‌  ‌ ● failure‌‌of‌‌fetal‌‌head‌‌
 
● Prolong‌‌Second‌  to‌‌rotate‌  ‌
Stage‌‌of‌‌Labor‌  ‌ ● fetal‌‌distress‌  ‌
 ‌ ● Cardiac/pulmonary‌‌   ● should‌‌not‌‌be‌‌used‌‌  
● Elliot‌‌forceps‌  ‌ disease‌  ‌ for‌‌preterm,‌‌face‌‌  
○ adjustable‌‌   pin‌‌
  for‌‌
  regulating‌‌
  lateral‌‌
  presentation‌‌or‌‌  
pressure‌‌on‌‌the‌‌handles‌  ‌
 ‌
PROPERTY‌‌OF‌‌ODLID‌  ‌
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CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
VAGINAL‌  ‌BIRTH‌  ‌AFTER‌  ‌CESAREAN‌  ‌SECTION‌‌  
breech‌  ‌
(VBAC)‌  ‌
 ‌  ‌
Complication‌  ‌  ‌
 ‌ VAGINAL‌‌   DELIVERY‌‌   AFTER‌‌   CESAREAN‌‌  SECTION‌‌  
(VDAC)‌  ‌
Maternal‌  ‌ Fetal‌  ‌
 ‌
● Lacerations‌‌along‌‌   ● cephalhematoma‌  Indication‌‌for‌‌Cesarean‌‌Delivery‌  ‌
birth‌‌canal‌  ‌ ● skull‌‌f racture‌  ‌ ● complete‌‌placenta‌‌previa‌  ‌
● uterine‌‌rupture‌  ‌ ● intracranial‌‌  ● cephalopelvic‌‌disproportion‌  ‌
● hemorrhage‌  ‌ hemorrhage‌  ‌ ● placental‌‌abruption‌  ‌
● bladder‌‌injury‌  ‌ ● paralysis‌  ‌ ● active‌‌genital‌‌herpes‌  ‌
● multiple‌‌gestation‌‌(3‌‌or‌‌more‌‌fetuses)‌  ‌
 ‌ ● umbilical‌‌cord‌‌prolapse‌  ‌
● failure‌‌to‌‌progress‌‌in‌‌labor‌  ‌
● proven‌‌fetal‌‌stress‌  ‌
● previous‌‌classical‌‌incision‌‌on‌‌uterus‌  ‌
● tumors‌‌that‌‌obstruct‌‌birth‌‌canal‌  ‌
 ‌
Advantages‌‌of‌‌Transverse‌‌Lower‌‌Uterine‌‌Incision‌  ‌
● thinnest‌  ‌part‌  ‌of‌  ‌uterus‌  ‌involves‌  ‌less‌‌
  blood‌‌
 
loss‌  ‌
● requires‌  ‌only‌  ‌moderate‌  ‌dissection‌  ‌of‌  ‌the‌‌  
bladder‌‌f rom‌‌the‌‌myometrium‌  ‌
● easier‌‌to‌‌repair‌  ‌
● less‌  ‌likely‌  ‌to‌  ‌rupture‌  ‌with‌  ‌subsequent‌‌  
pregnancies‌  ‌
● decreased‌  ‌risk‌  ‌of‌  ‌adherence‌  ‌of‌  ‌bowel‌  ‌or‌‌ 
omentum‌‌to‌‌incision‌‌line‌  ‌
 ‌
  ‌
PARTIAL‌‌BREECH‌‌EXTRACTION‌  ‌

 ‌
  ‌
COMPLETE‌‌BREECH‌‌EXTRACTION‌  ‌  ‌
 ‌  ‌
  ‌ Uses‌‌of‌‌Vertical‌‌Lower‌‌UTerine‌‌Incision‌  ‌
● multiple‌‌gestation‌  ‌
● abnormal‌‌presentation‌  ‌
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PROPERTY‌‌OF‌‌ODLID‌  ‌
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CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
● placenta‌‌previa‌  ‌
● non-reassuring‌‌fetal‌‌status‌  ‌
● preterm‌  ‌
● macrosomia‌‌fetus‌  ‌
  ‌
  ‌
  ‌
  ‌

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PROPERTY‌‌OF‌‌ODLID‌  ‌
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