1. Obstetric Emergencies
Klarissa Winger
Kayla Curtis
Jeremiah Clark
Cara Clayton

2. Assessment of Pregnant Patients
ABC
Aspiration
Vital Signs
Find the Emergency
Assess the bleeding
Asses the trauma
Assess for shock
Assess Fetus
HR: ( )- heard with doppler at weeks and with stethoscope at 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.

3. Premature Labor
labor that begins before 37 weeks (can be as early as 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

4. 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.

5. polar bear position

6. 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.

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

8. 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.

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

10. 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.

11. 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

12. 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!

13. 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.

14. 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

15. 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

16. 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

17. Resources