Obstetric Emergencies Klarissa Winger Kayla Curtis Jeremiah Clark Cara Clayton

Assessment of Pregnant Patients ABC Aspiration Vital Signs Find the Emergency Assess the bleeding Asses the trauma Assess for shock Assess Fetus HR: (110-160)- heard with doppler at 10-12 weeks and with stethoscope at 17-20 weeks 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 C-section or surgery on their uterus. Very rare for those who’ve never had C-section. Mainly only occurs during labor. http://www.babycenter.com/0_uterine-rupture_1152337.bc

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: <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 4: Prepare a Birthing Area 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 Do NOT pull on the baby’s head Do NOT pull on the cord Prepare for the body to come out 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/conditioninfo/Pages/symptoms.aspx http://birthbliss.wordpress.com/2011/11/02/natural-ways-to-stop-and-prevent-pre-term-labourlabor/ http://www.prenhall.com/london2e/pages/london_final_ch10.pdf http://www.sciencedirect.com.byui.idm.oclc.org/science/article/pii/S0020138305000732 http://www.babycenter.com/0_uterine-rupture_1152337.bc