Class 6: Obstetrical Emergencies Flashcards
1
Q
what are examples of obstetrical emergencies (4)
A
- shoulder dystocia
- prolpased umbilical cord
- rupture of the uterus (uterine rupture)
- amniotic fluid embolism
2
Q
what is shoulder dystocia
A
- head is born, but anterior shoulder cannot pass under the pubic arch
3
Q
what are maternal complications of shoulder dystocia (2)
A
- postpartum hemorrhage
- rectal injuries
4
Q
what are neonatal complications of shoulder dystocia
A
- newborn more likely to experience birth injuries
5
Q
what is there a risk of w shoulder dystocia to the newborn/fetus (3)
A
- hypoxia
- neonatal asphyxia
- humerus fracture
6
Q
what are 2 interventions for shoulder dystocia
A
- suprapubic pressure
- McRoberts manuever
7
Q
describe use of suprapubic pressure for shoulder dystocia
A
- head of bed down
- mother in lithotomy position
- apply suprapubic pressure to pop shoulder under symphysis pubis
8
Q
describe use of McRoberts manuever for shoulder dystocia
A
- maternal positioning change
- involves putting knees back as far as can go
9
Q
what is a prolpased umbilical cord
A
- when cord lies below presenting part of fetus = pinched w every contraction
10
Q
what are contributing factors to a prolapsed umbilical cord (3)
A
- long cord (>100 cm)
- malpresentation (breech or transverse)
- unengaged presenting part
11
Q
what type of breech is esp concerning for prolapsed cord
A
- footling
12
Q
what are interventions for prolpased umbilical cords (3)
A
- go straight for c-section
- nurse keeps hand in vagina, pushing up to relieve pressure on the cord for the entire time
- reposition
13
Q
what FHR changes are seen w prolapsed umbilical cord
A
- large variable declerations
