Obstetric Emergencies and Complicated Pregnancies

Question 1

At what point in the pregnancy should we start using the pregnancy RDR chart?

Answer 1

20 weeks

Question 2

When can a shoulder dystocia be declared?

Answer 2

Fetal head fails to birth on the next contraction or within 60 sec
Head emerges but retracts (turtle sign)
Head delivers but remains tight against vuvla
Absence of restitution

Question 3

How do we manage a shoulder dystocia?

Answer 3

Mcroberts for 30 secons (no pushing)
Sustained Supre pubic pressure 30 seconds
Rocking suprapubic pressure 30 seconds
All fours position for 30 seconds
Return to Mcroberts

Question 4

How do we transport a breech birth?

Answer 4

Semi-recumbent

Question 5

How do we manage a cord prolapse?

Answer 5

Knee to chest position
Minimise cord stimulus
Clinical support

Question 6

How do we transport a Cord Prolapse birth?

Answer 6

Exaggerated sims

Question 7

How do we manage a suspected miscarriage <20 weeks?

Answer 7

Fluid resuscitation
Transport all blood soaked products

Question 8

How do we manage an En Caul birth?

Answer 8

Await full delivery
Break amniotic sac with fingers

Question 9

What are the signs of a placental abruption or uterine rupture?

Answer 9

Trauma
PV bleeding
Uterine tenderness or tetanic contractions
Uterine hypertonicity
Pain