Obstetric Emergencies Klarissa Winger Kayla Curtis Jeremiah Clark

Obstetric Emergencies Klarissa Winger Kayla Curtis Jeremiah Clark Cara Clayton

Assessment of Pregnant Patients ● ABC o Aspiration ● Vital Signs ● Find the Emergency o o o Assess the bleeding Asses the trauma Assess for shock ● Assess Fetus o HR: (110 -160)- heard with doppler at 10 -12 weeks and with stethoscope at 17 -20 weeks o Assess for movement Normal Head to Toe Findings Abdomen: purple striae may be present. Extremities: some edema in hands and feet in later pregnancy.

Premature Labor ● labor that begins before 37 weeks (can be as early as 20 -36 weeks) ● preterm birth is the most common cause of infant death and a leading cause of long-term disability in children. ● cause: usually unknown ● women with multiple gestations, previous premature births and/or reproductive tract abnormalities are at increased risk

Signs and symptoms of premature labor. ● contractions every 10 minutes or more ● change in vaginal discharge such as bleeding or leaking fluid ● feel pressure in hip area ● low, dull backache ● cramps that feel like menstrual cramps ● abdominal cramps with or without diarrhea ● It is normal to have contractions throughout the day, but if there are 6 or more an hour the cervix can begin to open. ● get to hospital ASAP- will give tocolytic drugs to slow contractions and corticosteroids to help protect the baby’s premature lungs.

polar bear position

Uterine Rupture ● Most common to women who’ve had a Csection or surgery on their uterus. o Very rare for those who’ve never had C-section. ● Mainly occurs during labor.

Uterine Rupture -- S/S ● First sign is abnormal baby HR. ● Abdominal pain ● Vaginal bleeding ● Increased HR ● Can have referred chest pain

Uterine Rupture -- Treatment ● ● Scheduled C-section before due date. Emergency C-section. Blood transfusion and IV antibiotics. May need hysterectomy is uterus damaged severely. ● Rest, eat nutritious meals, drink lots of water, and take iron.

EMERGENCY DELIVERY: Outside of the Hospital Step 1: Call for help (911)

Step 2: Determine how far labor has progressed ● Dilation: If the cervix is fully dilated (you can see the baby’s head), wash your hands and be prepared to catch the baby! ● Contractions: o o o <5 minutes apart = get to the hospital! <2 minutes apart = buckle down If the mother feels like she’s going to have a bowel movement, the baby is probably in the birth canal and on its way out.

Step 3: Wash/Sanitize Your Hands and arms Step 4: Prepare a Birthing Area ● Gather clean towels, blankets, newspaper, pillows ● Gather scissors, bowl of warm water ● Make the mother comfortable

Step 5: Deliver the Baby ● When she feels the unstoppable pressure to do so, encourage the mom to push ● Encourage deep, slow breathing ● Suport the baby’s head as it emerges o o Do NOT pull on the baby’s head Do NOT pull on the cord ● Prepare for the body to come out o It will be slippery!

Step 5: Deliver the Baby (Cont. ) ● If the baby’s head doesn’t turn to the side, gently turn the head to help the shoulder come out. ● Make sure you support the baby’s neck as the body comes out.

Step 6: Let fluids drain from baby ● Hold the baby so the head is slightly lower than the feet so fluids can drain ● Make sure the baby is breathing (crying) ● Baby can lay on mother’s chest, with face on shoulder

Step 7: Delivering the Placenta ● Place a bowl near the vagina ● Bleeding will occur before, during, and after placental delivery. This is normal. ● Rub the mother’s belly to massage the uterus and reduce bleeding. This will hurt her, but IT IS IMPORTANT. ● Breastfeeding slows bleeding; nipple stimulation

Step 8: Finish Up ● Bag the placenta, a doctor will want to inspect it. ● DO NOT pull on the cord. ● Only cut the cord if help is HOURS away. ● Keep mom and baby warm

Resources ● http: //www. nichd. nih. gov/health/topics/preterm/condition info/Pages/symptoms. aspx ● http: //birthbliss. wordpress. com/2011/11/02/natural-ways -to-stop-and-prevent-pre-term-labourlabor/ ● http: //www. prenhall. com/london 2 e/pages/london_final_c h 10. pdf ● http: //www. sciencedirect. com. byui. idm. oclc. org/science/ article/pii/S 0020138305000732 ● http: //www. babycenter. com/0_uterine-rupture_1152337. bc