The Journal of perinatal & neonatal nursing
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J Perinat Neonatal Nurs · Sep 1991
Review Case ReportsCare of the pregnant patient with a pacemaker.
This article has reviewed cardiovascular adaptations to pregnancy and parturition. It has presented a basic overview of pacemaker supported cardiovascular function and related that to pregnancy. It has summarized 22 previously reported cases of pregnancy among women with pacemakers and reported yet another such case. ⋯ Pregnancy has a high probability of coming to successful conclusion when professionals anticipate potential complications and monitor for early signs of difficulty. Providing care for the woman with a pacemaker presents many challenges to the perinatal nursing staff providing antepartum, intrapartum, and postpartum care. The woman, the fetus or newborn, and the family are best cared for by a multidisciplinary team whose members bring specialized knowledge and skill to bear on the needs she and the fetus present.
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The course of twin pregnancy is most amenable to positive intervention during the antepartal period. However, once a laboring woman arrives on the labor floor, there is still opportunity to influence outcome. The management of multiple gestation is best accomplished through use of a multidisciplinary team. ⋯ It is incumbent on all maternity staff to become acquainted with the issues and acquire the skills necessary to render safe care. Every complication of labor and delivery, including preterm labor, uterine dysfunction, abnormal presentation, prolapse of the umbilical cord, premature separation of the placenta, and immediate postpartum hemorrhage, occurs with greater frequency with multiple gestation. Therefore, the conduct of labor and delivery with twins is an excellent challenge to the skills of the team that provides care for the patient and her fetuses.