Physiological response[ edit ] When the face is submerged and water fills the nostrils, sensory receptors sensitive to wetness within the nasal cavity and other areas of the face supplied by the fifth V cranial nerve the trigeminal nerve relay the information to the brain.
Episodic Electronic Fetal Monitoring EEFM for Community-based Midwives For a healthy mother at term with a normal pregnancy and spontaneous onset of progressive labor at term, the parameters of Intermittent Auscultation IA are perfectly adequate and the most appropriate form of fetal surveillance the vast majority of the time.
However, there are a few rare FHR patterns that reflect a serious medical problem that are difficult or impossible to pick up solely from an auditory pattern.
Examples are a sinusoidal rhythm and slight but repetitive late decelerations in a baby with a "silent" baseline variability this combination is considered to be a pathological pattern until proven otherwise. One reason is that it is hard to accurately count the FHR during a uterine contraction UCespecially in advanced active labor.
In the first place it is hard to hear FHT clearly during the UC and secondly the mother often cannot stand or lie still enough to permit the high-level of accuracy necessary with IA to detect slight decels.
Without a printout that spans considerable time Stimulated diving and heart rate may be difficult to determine the significance of a slightly raised or slightly lowered baseline rate which can be either a normal adaptation to mild stress or may be an indicator of increasing levels of fetal distress.
This latter category is a potential concern with post-mature pregnancies. Advantages of Having EEFM Available Without a dependable way to identify other aspects of either reassuring or suspicious factors, the mother will have to be transported, perhaps unnecessarily, for medical care.
Access to episodic EFM can increase the ability to of the midwifery model of care to meet maternal-fetal needs and permits additional latitude in midwifery management. No doubt other companies will follow suit.
Due to the great cost, such a monitor could be owned jointly by the midwives in a geographical area. Use of either system of electronic fetal monitoring permits the community-based midwife to expand the parameters of her care and interface with the obstetrical community in a way more satisfactory to physicians.
In addition some maternal-fetal circumstances benefit from antepartal evaluation of fetal wellbeing particularly mothers who are slightly small for dates, have a high normal or mildly elevated BP and post date pregnancies. There are also intrapartum occasions in which a fetus has a slightly increased risk or situation of concern but not of the order of magnitude requiring transfer of care.
In these circumstances an initial tracing should be obtained when the midwife first arrives at the parents home or the mother is admitted to a OOH birth center to help determine whether it is appropriate to provide intrapartum care in a domiciliary setting. If the increased concern continues through out labor, then episodic re-assessment by EEFM q hours in first stage and the early, middle and late in 2nd stage is useful, assuming the mother does not deliver so rapidly that the baby free-falls through the birth canal, in which case additional EFM is not feasible!
For this reason there are reference to the effect of narcotic and anti-hypertensive medications on EFM tracing. However, it is assumed that these are labors occurring in the hospitals and is in no way a suggestion that they should be used in a domiciliary setting.
These two obstetricians, one from London, England and the other from Singapore, are consultants for hospitals that have 26, birth per year and which enjoys a "shared maternity care" system -- that is, a healthcare system in which midwifery is normative. These authors are specifically supportive of midwifery care for hospitalized patients of all risk levels in collaboration with physicians and they adhere to the WHO guidelines for promoting safe motherhood which are: To optimize the health of the mother, To optimize the health of the offspring To optimize the emotional satisfaction of the mother and her family.
These obstetricians go on to say that "Excessive technology should not be applied to those who are manifestly at low-risk. It may confer no benefit, can generate both non-medical and medical anxiety and through subtle effects may cause significant harm. Such unthinking application is counter- productive.
A relationship of trust and professionalism should bear fruit. It is acknowledged that the introduction of EFM has contributed to an increase in the number of cesarean birth.Since the increased blood pressure would be counteracted by the lower heart rate, the blood pressure is much more variable.
The adaptive value of the diving reflex centers on the conservation of both oxygen and energy by reducing the energetically costly aerobic activity of the heart and periphery.
The goal of our study was to develop a simple and practical method for simulating diving in humans using facial cold exposure and apnea stimuli to measure neural and circulatory responses during the stimulated diving reflex.
The trigeminal nerve and heart are strongly related through somato-autonomic nervous reflexes that induce rapid changes in cardiovascular function.
Several trigeminal reflexes have been described, but the diving and trigeminocardiac reflexes are the most studied. The heart is a target organ dually innervated by the sympathetic and parasympathetic systems.
According to the American Heart Association, 30 to 60 minutes of swimming 4 to 6 days a week can help individuals both lose weight and reduce health risks such as stoke, diabetes and heart disease. Unlike running, biking, and many other forms of cardio, swimming provides a full body workout.
The cardiovascular responses of 24 subjects were investigated under various simulated diving conditions. Muscle blood flow in forearm and calf, arterial pressure, . Circulation Heart Function Chapter 24 Diving Chapter 25 Seminar Summaries?
2 Housekeeping, Wed 24 March Alter heart rate AND blood volume e.g., ANP (Atrial Natruiretic Peptide) alpha adrenoreceptors are stimulated vasoconstriction (to increase BP)-At low levels, beta2 adrenoreceptors are stimulated vasodilation (to increase flow to.