Obstetric Emergencies Flashcards
1
Q
What is shoulder dystocia?
A
Anterior fetal shoulder becomes impacted behinf maternal pubic symphysis after delivery of fetal head
2
Q
How is shoulder dystocia managed?
A
- Series of manoeuvres
- Senior obstetrician, paediatrician to attend baby when born, scribe to keep note of times
3
Q
Complications of shoulder dystocia?
A
Fetal oxygen levels can drop
4
Q
HELPERR for shoulder dystocia?
A
H - Call for help E - Evaluate for episiotomy L - Legs (McRoberts Position) P - Suprapubic pressure E - Enter Manoeuvres (internal rotation) R - Remove posterior arm R - Roll patient (onto all fours)
5
Q
How is post partum haemorrhage (PPH) managed?
A
- Help
- ABCDE
- Empty bladder
- Rub up uterine fundus by massaging above umbilicus
- Give medication
6
Q
What medications can be used in PPH?
A
- Oxytocin
- Tranexamic acid
- Carboprost
- Misoprostol
7
Q
How is PPH managed surgically?
A
- Intrauterine balloon tamponade
- Interventional radiology
- B-lynch suture
- Hysterectomy
8
Q
What is cord prolapse?
A
The descent of the umbilical cord through the cervix alongside or past the presenting part in the presence of ruptured membrane
9
Q
Why is cord prolapse an issue?
A
It is likely to become compressed and thus reduce oxygen supply to the fetus
10
Q
How is cord prolapse managed?
A
- Call for help!
- Replace cord into vagina (NOT uterus)
- Perform digital elevation of presenting part
- Catheterise and fill bladder to elevate presenting part
- Encourage mother to adopt Knee-chest or left lateral position with raised hips
- Consider tocolysis
- Arrange for Cat I C-section
