Obstetric Emergencies
Obstetric emergencies are the most important aspect of the midwifery role.
Here are some examples of emergencies-
Fetal distress
This can happen at any point during labour, this could be due to a normal reaction from the baby during a contraction or a cord around the baby’s neck or another part of the body. Fetal distress can also be a sign of the placenta not working effectively and a lack of oxygenation to the baby.
Shoulder Dystocia
This is when the baby’s shoulder gets stuck behind the symphysis pubis (this bony part at the front of the pelvis). This can be related to the size of the baby (the bigger the baby the higher the chance). There are manoeuvres that need to be performed to free the shoulder and allow the birth to occur
Post-partum hemorrhage (PPH)
A PPH is a rapid loss of blood after the birth of the baby. The is due to either the placenta or part of the placenta being left in the uterus, the uterus not contracting enough therefore increasing the bleeding, bleeding from a tear in the vagina or perineum, and finally a clotting disorder. PPH is classed as 500mls of blood loss. There are ways to manage the bleeding with medication, procedures and further interventions.
Breech
A breech presentation is when the baby is in a bottom first position. So rather than the head it is the baby’s rump that is coming first. There are manoeuvres that are taught to help the birth of a baby in this position. If this is before labour then the woman will have a discussion about trying to turn the baby to a head down position, opt for a caesarean section or choose a vaginal breech birth.
Cord Prolapse
This is where the cord loops out of the cervix first before the baby is born. This is potentially dangerous as if the head were to restrict the blood flow in the cord then the baby will lack oxygen during this time. There are manoeuvres that involve keeping the baby’s head off the cord until the birth can happen, normally by caesarean section
How would you react to an emergency?
Select which of these actions you may be expected to take in an emergency-
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