Emergent delivery
Revision as of 17:27, 10 January 2015 by Rossdonaldson1 (talk | contribs)
Background
- Prolapsed cord
- Do NOT attempt to reduce
- Instead,elevate the presenting fetal part to reduce compression and transport to OR
- Do NOT attempt to reduce
- Breech presentation
- Try to let the delivery occur spontaneously without touching the fetus
Physical Examination
Digital Examination of the Vagina
- Cervical Dilatation
- 0 cm (closed/fingertip) to 10 cm (complete/fully dilated)
- Effacement
- assessment of the cervical length
- percentage of normal 3-4 cm long cervix
- 4cm cervix = 0%; 0cm (thin) cervix = 100%
- Station (-5 to +5)
- (distance of the presenting body relative to the maternal ischial spines)
- -3 = beginning of second stage of labor
- 0 = in line with the plane of the maternal ischial spines
- +3 = impending delivery
- +4 to +5 = crowning
- (distance of the presenting body relative to the maternal ischial spines)
Differential Diagnosis
3rd Trimester/Postpartum Emergencies
- Acute fatty liver of pregnancy
- Amniotic fluid embolus
- Chorioamnionitis
- Eclampsia
- HELLP syndrome
- Mastitis
- Peripartum cardiomyopathy
- Postpartum endometritis (postpartum PID)
- Postpartum headache
- Postpartum hemorrhage
- Preeclampsia
- Resuscitative hysterotomy
- Retained products of conception
- Septic abortion
- Uterine rupture