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Samenvatting arbeid en bevalling 1
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een volledige samenvatting van arbeid en bevalling 1ste jaar
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Les 1: CTG............................................................................................................................................................... 51. CTG.................................................................................................................................................................. 5
2. Periodieke (intermitterende) ausculatie............................................................................................................. 5
Doptone......................................................................................................................................................... 5
3. CTG interpretatie.............................................................................................................................................. 6
3.1. Basishartfrequentie........................................................................................................................................ 6
3.2. Variabiliteit.................................................................................................................................................. 6
3.3. Acceleraties................................................................................................................................................ 6
3.4. Deceleraties............................................................................................................................................... 6
Baroreceptoren:............................................................................................................................................. 6
Chemoreceptoren.......................................................................................................................................... 7
3.5. Registratie van contracties......................................................................................................................... 7
Les 2: PICO.............................................................................................................................................................. 8
1. Methodiek EBP................................................................................................................................................. 8
2. Onderzoeksvraag.............................................................................................................................................. 8
2.1. Type onderzoeksvraag............................................................................................................................... 8
2.2. Valkuilen bij formuleren van onderzoeksvraag........................................................................................... 8
2.3. Hulpmiddel................................................................................................................................................. 8
Les 3: Booleaanse operatoren............................................................................................................................... 10
Les 4: verloskundige diagnostiek........................................................................................................................... 11
1. Verloskundig onderzoek durante partu........................................................................................................... 11
Uitwendig onderzoek....................................................................................................................................... 11
Inspectie...................................................................................................................................................... 11
Palpatie........................................................................................................................................................ 11
Percussie..................................................................................................................................................... 12
Auscultatie................................................................................................................................................... 12
Inwendig onderzoek........................................................................................................................................ 13
Vaginaal toucher (VT).................................................................................................................................. 13
Rectaal onderzoek....................................................................................................................................... 14
Les 5: partogram, geboorteplan, fasen................................................................................................................... 16
1. Partogram....................................................................................................................................................... 16
2. Verloskundige registratie................................................................................................................................ 16
3. Midwifery led care........................................................................................................................................... 16
4. voorbereiding op arbeid en baring.................................................................................................................. 16
5. voorbereiding parturiënte/partner.................................................................................................................... 17
6. geboortewens/plan opmaken.......................................................................................................................... 17
Les 6: psychologische veranderingen tijdens de arbeid.........................................................................................17
1. opname meemaken........................................................................................................................................ 17
1.1. beleving opname...................................................................................................................................... 17
1.2. Rol patiënt................................................................................................................................................ 17
2. Beleving van de bevalling............................................................................................................................... 18
2.1. Beleving van de bevalling......................................................................................................................... 18
Belang van de beleving:.............................................................................................................................. 18
Birth experience questionnaire:................................................................................................................... 18
, Baringspijn................................................................................................................................................... 18
beleving papa’s............................................................................................................................................ 18
aanwezigheid papa tijdens geboorte........................................................................................................... 18
2.2. Ondersteunende methoden...................................................................................................................... 19
3. Wat als vroedvrouw betekenen....................................................................................................................... 19
3.1. Tijdens zwangerschap.............................................................................................................................. 19
3.2. Tijdens arbeid........................................................................................................................................... 20
3.3. Tijdens postpartum................................................................................................................................... 20
Les 7: baringskanaal.............................................................................................................................................. 21
1. Beenderige baringskanaal.............................................................................................................................. 21
1.1. Structuren................................................................................................................................................. 21
verloskundig belang begrippen.................................................................................................................... 21
Les 8: foetaal caput................................................................................................................................................ 22
1. Foetaal caput.................................................................................................................................................. 22
1.1. Anatomie.................................................................................................................................................. 22
1.2. Craniometrie............................................................................................................................................. 22
1.3. Verloskundige aspecten........................................................................................................................... 22
preterme, mature en postmature schedel.................................................................................................... 22
Moulage – moulding.................................................................................................................................... 23
Caput succedaneum.................................................................................................................................... 23
2. Ligging, houding, plaatsing, stand................................................................................................................... 23
2.1. Ligging...................................................................................................................................................... 23
soorten......................................................................................................................................................... 23
2.2. Houding.................................................................................................................................................... 23
soorten......................................................................................................................................................... 23
2.3. Plaatsing/stand......................................................................................................................................... 23
Les 9: uitdrijvingsfase baringsmechanisme............................................................................................................ 25
1. Keuzes en wensen.......................................................................................................................................... 25
2. Fysiologie van de baring................................................................................................................................. 25
2.1. Het tweede tijdperk: uitdrijvingsfase............................................................................................................. 25
kenmerken................................................................................................................................................... 25
verloop......................................................................................................................................................... 25
2.2. Mechanisme van de uitdrijving..................................................................................................................... 26
buikpers....................................................................................................................................................... 26
indaling en inwendige spildraai hoofd.......................................................................................................... 26
geboorte hoofd............................................................................................................................................. 27
uitwendige spildraai hoofd........................................................................................................................... 27
inwendige spildraai schouders..................................................................................................................... 27
geboorte schouders..................................................................................................................................... 27
geboorte romp, stuit, ledematen.................................................................................................................. 27
2.3. Verloskundige handgrepen...................................................................................................................... 27
damsteun..................................................................................................................................................... 27
3. Linker zijlig...................................................................................................................................................... 27
3.1. Visie (elke baring)..................................................................................................................................... 28
3.2. Praktische uitvoering................................................................................................................................ 28
, barende....................................................................................................................................................... 28
neonaat........................................................................................................................................................ 28
vroedvrouw.................................................................................................................................................. 28
3.3. Voor en nadelen....................................................................................................................................... 28
voordelen..................................................................................................................................................... 28
nadelen........................................................................................................................................................ 28
..................................................................................................................................................................... 29
Les 10: geboorte placenta...................................................................................................................................... 30
1. Het derde tijdperk: nageboortetijdperk of placentaire fase..............................................................................30
duur............................................................................................................................................................. 30
1.1. Fysiologie................................................................................................................................................. 30
1.2. Bloedingscontrole – bloedstolling – hemostase........................................................................................30
1.3. Beleid....................................................................................................................................................... 31
Expectatief (afwachtend) beleid:.................................................................................................................. 31
Actief beleid (nt vr vv).................................................................................................................................. 31
Les 11: eerste aanleggen en skinnen..................................................................................................................... 33
1. Anatomie van de borst.................................................................................................................................... 33
1.1. Anatomie en ontwikkeling......................................................................................................................... 33
embryonale fase.......................................................................................................................................... 33
mammognese: puberteit.............................................................................................................................. 33
mammogenese: 1ste zwangerschap............................................................................................................. 33
1.2. Fysiologie................................................................................................................................................. 33
lactogenese................................................................................................................................................. 33
galactopoiese.............................................................................................................................................. 34
lactatiealenorroe.......................................................................................................................................... 34
samenstelling van moedermelk................................................................................................................... 34
2. skin-to-skin...................................................................................................................................................... 35
1.1. eerste aanleggen en skin-to-skin.............................................................................................................. 35
1.2. De eigenlijke start..................................................................................................................................... 35
Onmiddellijk na de bevalling........................................................................................................................ 35
Direct en vaak voeden................................................................................................................................. 36
Voordelen skin-to-skin................................................................................................................................. 36
het belang van het eerste contact................................................................................................................ 36
de eerste borstvoedingen............................................................................................................................ 37
les 12: psychologische veranderingen na de bevalling..........................................................................................39
1. the golden hour............................................................................................................................................... 39
1.1. Inleiding.................................................................................................................................................... 39
1.2. Huid-op-huidcontact................................................................................................................................. 39
1.3. Borstvoeding............................................................................................................................................ 39
1.4. Uitgesteld afklemmen navelstreng........................................................................................................... 39
1.5. Uitstellen/aanpassen/afzien van golden hour........................................................................................... 40
1.6. Implementeren......................................................................................................................................... 40
2. Ontwikkeling identiteit direct na geboorte....................................................................................................... 40
fase 1: focus op zz....................................................................................................................................... 40
fase 2: zorg opnemen.................................................................................................................................. 40
, fase 3: emotionele labiliteit.......................................................................................................................... 40
3. Babyblues....................................................................................................................................................... 40
4. Beleving van bevalling.................................................................................................................................... 41
4.1. Terugkijken op bevalling........................................................................................................................... 41
Les 13: controle en onderzoek placenta................................................................................................................. 42
1. Methode.......................................................................................................................................................... 42
1.1. Placenta-controle..................................................................................................................................... 42
1.2. Palcenta-onderzoek................................................................................................................................. 42
placenta....................................................................................................................................................... 42
vliezen......................................................................................................................................................... 42
navelstreng.................................................................................................................................................. 42
1.3. Waar naartoe met secundinae?............................................................................................................... 43
1.4. Reden controle en onderzoek.................................................................................................................. 43
Les 13b: baringspijn............................................................................................................................................... 43
1. Pijnstilling – pijn bij de bevalling...................................................................................................................... 43
1.1. Omgaan met pijn?.................................................................................................................................... 43
somatische pijn............................................................................................................................................ 43
viscerale pijn................................................................................................................................................ 43
1.2. Niet-farmacologische pijncontrole............................................................................................................ 44
1.3. Algemene begeleiding.............................................................................................................................. 44
1.4. Begeleiding per fase................................................................................................................................. 45
prodromale fase........................................................................................................................................... 45
latente fase.................................................................................................................................................. 45
overgang latente actieve fase..................................................................................................................... 45
actieve fase: acceleratiefase....................................................................................................................... 45
actieve fase: decelleratiefase...................................................................................................................... 45
Les 14: fysiologie van de neonaat.......................................................................................................................... 46
1. Introductie....................................................................................................................................................... 46
1.1. Transitie................................................................................................................................................... 46
2. Ademhaling..................................................................................................................................................... 46
In utero:....................................................................................................................................................... 46
Uitdrijving..................................................................................................................................................... 46
Na geboorte................................................................................................................................................. 46
Les 15: opvang pasgeborene................................................................................................................................. 48
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