obstetrics emergencies

Question 1

describe shoulder dystocia

Answer 1

anterior fetal shoulder becomes impacted behind the maternal pubic symphysis after delivery of the fetal head

shoulder dystocia would occur in between the stages in image 5 and 6.

Question 2

management of shoulder dystocia

Answer 2

h - help
e - evaluate for episiotomy
l - legs (mcroberts position)
p - suprapubic pressure
e - enter manouvers (internal rotation)
r - remove posterior arm
r - roll the patient (onto all fours)

Question 3

management of PPH

Answer 3

call for help
ABCDE
empty bladder
rub up uterine fundus by massaging above umbilicus

medications

• oxytocin (injection/infusion)
• ergometrine
• tranexamic acid
• carboprost
• misoprostol

surgery

• intrauterine balloon tamponade
• interventional radiology
• b-lynch suture
• hysterectomy

Question 4

management of cord prolapse

Answer 4

call for help

replace cord into vagina (not uterus)

perform digital elevation of presenting part

catheterise and fill bladder to elevate presenting part

mother position - knee chest or left lateral with raised hips

tocolysis