Università degli Studi di Perugia

Study-unit ASSISTANCE AT BIRTH, PUERPERIUM, THE INFANT AND NEONATOLOGY

Course name Midwifery
Study-unit Code 50464010
Curriculum Comune a tutti i curricula
Lecturer Simona Freddio
CFU 10
Course Regulation Coorte 2016
Supplied 2017/18
Supplied other course regulation
Type of study-unit Obbligatorio (Required)
Type of learning activities Attività formativa integrata
Partition

NEONATOLOGY

Code 50514002
CFU 2
Lecturer Stefania Troiani
Lecturers
  • Stefania Troiani - Didattica Ufficiale
Hours
  • 30 Hours - Didattica Ufficiale - Stefania Troiani
Learning activities Caratterizzante
Area Scienze medico-chirurgiche
Sector MED/38
Type of study-unit Obbligatorio (Required)
Language of instruction ITALIANO
Contents Fisiopatologia dell'evento nascita e del neonato
Assistenza al neonato fisiologico e critico
Principali patologie neonatali congenite, acquisite e materno-correlate
Reference texts -NEONATOLOGY
Avery's
Seventh Edition
-MANUALE RIANIMAZIONE NEONATALE
7°Edizione Gary M. Weiner
Educational objectives Al termine del modulo lo studente dovrà conoscere le principali caratteristiche fiopatologiche dell'evento nascita fisiologico e a rischio per poter garantire a tale evento skill adeguate e modalità corrette di assistenza attuabili esclusivamente dopo accurato studio di tutti gli aspetti fiologici e patologici che riguardano, feto, evento nascita e neonato.
Si richiede inoltre allo studente di conoscere tutte le responsabilità che il loro futuro lavoro comporta.
Prerequisites Fisiopatologia del feto, evento nascita e periodo transizionale.
Fisiopatologia del neonato
Assistenza all'evento nascita fisiologico e a rischio
Teaching methods Lezioni frontali
Learning verification modality Verifica orale
Extended program Programma delle Lezioni per il Corso di Laurea in Ostetricia


1) VITA FETALE:
- sviluppo dei vari apparati
- psicologia fetale
2) EVENTO NASCITA
- transizione da vita fetale e neonatale
- preparazione sala parto e lettino
- compilazione della cartella
- infezioni gruppo TORCH
- markers epatite B
- infezioni da GBS e PROM
- curva da carico
3) ASSITENZA AL NEONATO SANO
- clampaggio del cordone
- skin to skin
- indice di Apgar
- attacco al seno
- misure, bagnetto
- profilassi
- sorveglianza
4) ASSISTENZA NEONATO PATOLOGICO
- manovre di rianimazione
- EGA cordale
5) ESAME OBIETTIVO DEL NEONATO
6) FENOMENI FISIOLOGICI DEL NEONATO:
- emissione di meconio
- prima minzione
- calo fisiologico
- ittero fisiologico
- tumore da parto
- crisi genitale
I PRIMI GIORNI DI VITA
- cura del cordone
- screening neonatali
7) LE AFFEZIONI NEONATALI LEGATE AL PARTO
-Cefaloematoma
-Ematoma dello sternocleidomastoideo
-Fratture ostetriche ( clavicola, ossa lunghe, cranio)
-Paralisi ostetriche (plesso brachiale, n.facciale, n. frenico)
-Lesioni del midollo e del rachide
-Lesioni delle parti molli
-Emorragie cerebrali
-Asfissia perinatale
8)AFFEZIONI MATERNE CON RIPERCUSSIONI SUL FETO
-figli di madre diabetica
-figli di madre obesa
-figli di madre tossicodipendente
-figli di madre alcolizzata
-figli di madre con malattia autoimmunitaria
9) SEGNALI DI ALLARME- PATOLOGIE NEONATALI PIU’ FREQUENTI
- CIANOSI (Cardiopatie Congenite)
- POLIPNEA (Tachipnea transitoria,Distress respiratorio)
- IPOTONO (Emorragie cerebrali- Encefalopatia ipossico ischemica
- VOMITO (Patologie chirurgiche, malattie metaboliche)
- DIFFICOLTA’ DI ALIMENTAZIONE ( patologie chirurgiche, malattie metaboliche, ittero)
10) SUPPORTO ALLA GENITORIALITA’
- norme di sicurezza per il neonato
- supporto alla genitorialità
PRINCIPI ETICI IN RIANIMAZIONE NEONATALE
- sospensione delle manovre rianimatorie
- cure compassionevoli
- comunicazione in sala parto

MIDWIFERY, NURSING AND GYNAECOLOGICAL SCIENCES - MODULE 1

Code 50464004
CFU 4
Lecturer Simona Freddio
Lecturers
  • Simona Freddio - Didattica Ufficiale
Hours
  • 60 Hours - Didattica Ufficiale - Simona Freddio
Learning activities Caratterizzante
Area Scienze ostetriche
Sector MED/47
Type of study-unit Obbligatorio (Required)
Language of instruction Italian Language
Contents THE ATTENDANCE PROCESS TO PHYSIOLOGICAL SUFFERING
THE PROCESS OF ATTENDANCE IN THE SEVERAL PERIODS OF THE DELIVERY
Certifications of competency for the Midwife
Predisposition of the suffering/delivery unit
Reference texts Oxorn – Foote: Il parto – Ed. Piccin
M. Odent – Ecologia della nascita – Ed. Red
J. Balaskas: Manuale di sala parto - L’altra medicina 46 - Ed. Red
J. Balaskas, Y. Gordon: Manuale del parto in acqua - L’altra medicina 46 - Ed. Red
Educational objectives The student must acquire acquaintances and comprehension abilities in regard to the diagnosis, the attendance at delivery and the role, the functions and the activities own by the obstetrician autonomously and in collaboration with the specialist doctor.
Teaching methods Face-to-face
Practical training
Role Playing
VHS and DVD projections
Other information PROFESSIONAL LABORATORY
Learning verification modality Oral exam
Extended program THE ATTENDANCE PROCESS TO PHYSIOLOGICAL SUFFERING: Acceptance of the pregnant, data collection, Diagnosis of suffering, Survey of the needs of the parturient, the fetus and the couple.
PHASE OF PLANNING - REALIZATION Predisposition of the suffering/delivery unit.
THE PROCESS OF ATTENDANCE IN THE SEVERAL PERIODS OF THE DELIVERY
The prodromal phase, the expanding phase, the expulsive phase, the afterbirth.
Cervical maturation: the Bishop score.
Episiotomy: risks - benefits
First cures to the newborn.
Humanization of the birth: places of delivery, centrality of women during the delivery, active delivery, delivery in water.
Certifications of competency for the Midwife.

MIDWIFERY, NURSING AND GYNAECOLOGICAL SCIENCES-MODULE 2

Code 50464104
CFU 4
Lecturer Maria Valentina Bartolucci
Lecturers
  • Maria Valentina Bartolucci - Didattica Ufficiale
Hours
  • 60 Hours - Didattica Ufficiale - Maria Valentina Bartolucci
Learning activities Caratterizzante
Area Scienze ostetriche
Sector MED/47
Type of study-unit Obbligatorio (Required)
Language of instruction italian
Contents notions of physiology of the puerperium
• obstetric care for physiological puerperium
• notions of physiology, anatomy and biology of breastfeeding
• obstetric care for breastfeeding and related problems
• notions of assistance to the newborn baby at birth and in the first month of life (up to three years of life)
• obstetric care in parenting support
• notions of bonding, handling in relation to neonatal massage
Reference texts 1. M. Guana, R. Cappadona, A.M. Di Paolo; M.G. Pellegrini, M.D. Piga, M.
Vicario - La disciplina ostetrica – 2^ Ed. McGraw-Hill
2. A. Valle, S. Bottino, V. Meregalli, A. Zanini – Manuale di sala parto –
2^Edi- Ermes
3.S. Nappi –Ostetricia e Ginecologia- Ed. Idelson Gnocchi
4. WHO-UNICEF- Allattamento al seno: corso pratico di counselling- Ginevra,1993
5. A.Marchi- Midwifery: arte ostetrica ritrovata- Edizione Cantagalli
6. Ladewing-London-Davidson –Assistenza alla Maternità – Ed. Piccin
7. Di Paolo- La professione Ostetrica- EDITEAM,2009
8. Savage King F- Allattamento al seno: come aiutare le madri – AMREF 1992
9.Schmid – Fois – Contin- Onorare la madre- Il puerperio e l’esogestazione-
Quaderni di D&D- Scuola elementale di arte ostetrica srl – 2006 Ed SEAO
10.Schmid – Fois – Contin- Perineo e dintorni- Quaderni di D&D- Scuola elementale di arte ostetrica srl – 2006 Ed SEAO
11. Catanzani- Lavoro e allatto- Bonomi Editore,2012
12. Schmid- Apprendere la maternità- URRA Editore,2010
Lo Studente può avvalersi della consultazione di altri testi attinenti al programma presso la Biblioteca del Corso di laurea in Ostetricia
Educational objectives students in the Graduate Degree in Obstetrics must be provided with adequate preparation in the basic disciplines, such as to allow them both the best understanding of the most relevant elements, also in relation to gender, which are the basis of physiological and pathological processes to what is its preventive, therapeutic and rehabilitation intervention, and its maximum integration with other professions.

• The student must have acquired the necessary knowledge for the autonomous assistance to the physiological birth as well as the knowledge related to the pathophysiology and assistance of the puerperium.
It must deepen, for the part of competence, the methods of prevention and rehabilitation of perineal damage and techniques related to the first treatment of the newborn. It must be able to correctly fill in the documentation relating to the area of ¿¿interest (in particular the partogram); must finally know the provisions in force concerning certification of childbirth assistance
Prerequisites notions of physiology of human reproduction
notions of anatomy
notions of biology
notions of basic nursing techniques
Teaching methods frontal lessons
group work (role play, discussion of clinical cases ...)
viewing and commenting on movies
activities in an educational laboratory
Learning verification modality oral interview with practical demonstrations in the educational laboratory
Extended program PUERPERIUM
- Regulatory framework for obstetric care in puerperium
- Local phenomena
- General phenomena
- The psychic and psychological aspect
- The puerperium as an Esogestazione

PUERPERIO ASSISTANCE
- Objectives of obstetric care
- Specific assistance interventions:
• Uterine involution
• Locations
• Temperature, pulse, breathing
• Evaluation of diuresis
• Directives for the control of bladder function
• Care of the perineum
• Episorographic and suture evaluation
• Hemorrhoids
• Lower limbs
• Supply
• Rest and sleep
• uterine bites
• Sexological counseling
• Early discharge after childbirth
• Home obstetric care
• Sexual activity and contraception (contraceptive methods indicated in puerperium
- The obstetric bag
• The pelvic floor:
• Anatomy
• Pelvic floor health balance
• Guidelines concerning aspects of prevention and treatment of perineum dysfunctions
• The perineum in puerperium
• Exercises for the pelvic floor in puerperium
- Obstetric visit to six weeks from birth
- The medical record of the puerperium

FEEDING TIME

- Current legislation in the field of breastfeeding
- The 10 steps of breastfeeding WHO / UNICEF
- The "More parents" project
- Benefits of breastfeeding
- Anatomy of the mammary gland
- Breast observation
- Lactation physiology
- Characteristics of human milk
• colostrum
• transition milk
• definitive or mature milk
- Practical rules for breastfeeding
- Breastcrawl and skin to skin: the first breastfeed
- Breast feeding positions
- Duration of the feeding
- Frequency of feedings: controlled method, free method or
"On request"
- Evaluation of the feed according to the WHO / UNICEF model
- Hygiene and breast cleansing
- Early Breastfeeding Problems:
- Breast congestion
- Block of duct galattoforo
- Mastite
- Breast abscess
- Nipple problems
- Ragadi
- Breast rejection
- Breastfeeding in special situations: multiple birth, Cesarean cut, cleft and cleft palate, Down syndrome, preterm and low weight babies
- Mixed feeding: complementary / alternating
- Artificial feeding
- Practical rules for artificial feeding
- Presidi and aids for the administration of milk
- Reasons for using breast milk substitutes (WHO 2009)
- International Code for the marketing of breast milk substitutes
- Breast milk extraction and conservation techniques
- Manual squeezing
- Breast massage
- Counseling with the nursing woman
- The feeding of the mother who breastfeeds
- Breastfeeding and work
- Parenting support

THE NEWBORN
- The physiological infant, assessment at birth
- Reflections of the newborn
- The neonatal island
- First care of the newborn
- Hygiene of the newborn and dressing of the umbilical abutment
- Common navel disorders
- The cry of the newborn
- Physiological jaundice


THE NEWBORN MASSAGE
- Bonding and rebonding concepts
- Benefits of massage
- Baby massage: exercises and sequences