Obstetric emergencies Flashcards
What are signs of imminent birth?
Transitional phase - contractions appear to slow down and become less intense. Urges to push or pass BM Grunting Anal pouting Rhomboid of michalis
What are important in obstetric history taking?
Gravida and parity Gestation Foetal position Placental position Contractions in 10mins Urges to push or pass BM Vaginal loss - colour/consistency Previous/current pregnancy complications Foetal movements
What do you need to do immediately after the birth of baby?
Place baby on mother, tactile stimulation, dry baby thoroughly, check pulse at base of umbilical cord, warm baby
What are Oxytocin contra-indications?
KSAR, pre-eclampsia, cord prolapse, undelivered foetuses
What do you need to check after birth of placenta?
Check the 4T's Tone - of the funds Tissue - check placenta Trauma - check mums peri for tears Thrombin - check any blood clots
What are the different types of breech?
Frank - bottom first, hips flexed, knees extended (most common)
Complete - bottom first, hips flexed, knees flexed
Footling - one foot out first
Kneeling - one knee first
What is important first steps in breech birth?
Remember! Hands off approach, mum into position where baby can hang freely
What is the loveset manoeuvre?
Used for delivery of shoulders when one or more arm is extended.
Rotation of foetus when in SOP (back to back)
How do you perform the loveset manoeuvre?
Grab the foetus with two hands holding only the bony prominences of the sacrum.
Exaggerate lateral flexion toward pubic symphysis.
Rotate the body 180 degrees.
Sweep anterior arm down across babies face and across the peri.
Rotate body 180 opposite direction.
Sweep anterior arm down across babies face.
Ensure back is uppermost, allow body to hang freely and await birth of head
What are signs of shoulder dystocia?
Turtle sign (head bobbing, retraction on the peri), standard delivery manoeuvres fail to deliver shoulders. Failure to restitute. After 60 sec if head has not birthed
What are some external manoeuvres for shoulder dystocia?
Mc Roberts, running start, gaskins and rubins (CPR one)
How long do you attempt external manoeuvres in shoulder dystocia?
30 seconds each and then move on to internal manoeuvres
What are the internal manoeuvres used in shoulder dystocia?
Rubins II, Woods screw, reverse woods screw, delivery of posterior arm
Elements of APGAR
Appearance (skin colour), Pulse rate, Grimace (motor response), Activity (muscle tone), Respiratory rate
Scores of Appearance of APGAR
Appearance
Blue/pale 0
Blue (pink extremities) 1
All pink 2
