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Pregled literature o prepoznavanju in reševanju distocije ramen : diplomsko delo
ID Lorger, Eva (Author), ID Mivšek, Ana Polona (Mentor) More about this mentor... This link opens in a new window, ID Pavel, Nastja (Co-mentor)

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Abstract
Uvod: Distocija ramen je ogrožajoče urgentno stanje v porodništvu, ki ima lahko resne posledice za žensko in otroka. Za optimalen zaključek poroda je zato potreben hiter in organiziran odziv vseh zdravstvenih delavcev. Zastoj ramen nastane takrat, ko se anteriorna rama ploda uklešči za simfizo matere in tako pride do zastoja spontanega poroda. Nekateri avtorji distocijo ramen definirajo glede na čas od poroda glavice do poroda ramen. Dejavniki tveganja so pri tem porodnem zapletu težko opredeljivi. Literatura navaja, da določeni dejavniki tveganja s strani matere ali ploda prispevajo k pojavu distocije ramen. Na začetku poroda se redko opazijo težave in znaki, s katerimi bi lahko napovedali distocijo ramen. Pri reševanju si v Sloveniji najprej pomagamo z mnemoniko HELPERR, ki nas vodi skozi korake, ki so potrebni, da se porod uspešno konča. Namen: Namen diplomske naloge je pregledati literaturo o distociji ramen. Želimo predstaviti, kako distocijo ramen prepoznati na podlagi znakov in simptomov ter bolj podrobno spoznati manevre za reševanje distocije ramen. Metode dela: V diplomskem delu smo uporablili opisno metodo dela, s pregledom znanstvene in strokovne litreture. Za iskanje literature smo uporabili tako domače kot tuje podatkovne baze: DiKul, COBISS, Google Books, Google Učenjak, PubMed, Cochrane Library, Medline. Izbira člankov je bila odvisna od: starosti članka, dostopa do celotnega besedila, vsebinske ustreznosti in jezika članka. Rezultati: S področja babištva in porodništva smo našli veliko literature o distociji ramen. Vsebina je predvsem odvisna od tega, kakšne izkušnje imajo avtorji z njo. Pojavlja se veliko nasprotujočih mnenj glede primarnih manevrov za reševanje tega zapleta. Nestrinjanja so prisotna prav tako glede dejavnikov tveganja. Razprava in zaključek: Znanje o distociji ramen je pomembno za vse zdravstvene delavce, ki sodelujejo pri porodu. Preden se pričnejo izvajati invazivni manevri za reševanje distocije ramen, se najprej izvede neinvazivne posege. Veliko je dejavnikov tveganja, ki lahko vodijo do distocije ramen. Tudi posegi s strani zdravstvenih delavcev lahko vodijo do pojava tega zapleta. Nekateri znaki distocije ramen so specifični in jih z dobrim znanjem prepoznamo, nekateri pa so bolj splošni in jih zato težje prepoznamo.

Language:Slovenian
Keywords:zastoj poroda, porodni zapleti, porodne poškodbe, babištvo, porodništvo
Work type:Bachelor thesis/paper
Organization:ZF - Faculty of Health Sciences
Year:2019
PID:20.500.12556/RUL-113017 This link opens in a new window
COBISS.SI-ID:5739883 This link opens in a new window
Publication date in RUL:29.11.2019
Views:1540
Downloads:371
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Secondary language

Language:English
Title:Literature review of identification and management of shoulder dystocia : diploma work
Abstract:
Introduction: Shoulder dystocia is a life threatening emergency in obstetrics, which can have serious concequnces fot the woman and the child. For a optimum completion of the delivery, a quick and oragnized response from all health professionalis is needed. Shoulder dystocia occurs when the childs anterior shoulder is trapped behind the mothers symphysis pubis and thus spontaneous delivery is halted. Some authors define shoulder dystocia according to the time from the birth of the head to the birth of the shoulders. Risk factors are hard to define with this birth complication. Literature lists that specific risk factors of the mother or the child can contribute to the occurance of shoulder dystocia. At the beginning of the delivery problems or signs that could predict shoulder dystocia are very hard to recognize. In Slovenia for solving shoulder dystocia, we use HELPERR mnemonic for help, which takes us through all the steps that are needed to successfully complete the birth. Purpose: The purpose of this diploma is to better understand shoulder dystocia by literature review. With this work we wish to define how shoulder dystocia can be recognized based on signs and in more detail learn about the maneuvers for solving it. Methods: A descriptive working method was used in the diploma, with an overview of the scientific and professional literature. For collecting data, both domestic and foreign databases where used: DiKul, COBISS, Google Books, Google Scholar, PubMed, Cochrane Library, Medline. The articles were chosen based on the age of the article, access to the whole text, adequacy of the content and the language of the text. Results: A great deal of literature on shoulder dystocia is in the field of midwifery and obstetrics. The content depends mainly on what experiences the authors have with shoulder dystocia. There are many controversial opinions about primary maneuvers to deal with this complication. Opposing thoughts can also be found with risk factors and predictors. Discussion and conclusion: Knowledge of shoulder dystocia is important for all health prefessionals who are involved in childbirth. Non-invasive interventions are conducted before invasive maneuvers are tried for resolving shoulder dystocia. There are many risk factors that can lead to shoulder dystocia. Interventions done by health professionals can also lead to shoulder dystocia. Some symptoms and signs are very specific and are easy to recognize, on the other hand some are generic and are very hard too identify.

Keywords:obstructed labour, birth complications, birth injuries, midwifery, obstetrics

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