Emergencies Obs

DEFINE OBSTETRIC EMERGENCIES DESCRIBE THE VARIOUS TYPES OF
OBSTETRIC EMERGENCIES ENLIST THE CAUSES OF OBSTETRIC EMERGENCIES

DESCRIBE THE SIGNS AND SYMPTOMS OF OBSTETRIC EMERGENCIES ENLIST
THE VARIOUS INVESTIGATIONS FOR THE DIAGNOSIS OF OBSTETRIC
EMERGENCIES DISCUSS THE TREATMENT OF VARIOUS TYPES OF OBSTETRIC
EMERGENCIES EXPLAIN THE PREVENTION OF OBSTETRIC EMERGENCIES
INTRODUCTION:-
An emergency is a situation that poses an immediate risk to health, life, property or environment.
Most emergencies require urgent intervention to prevent the worsening of the situation, although
in some situations, mitigation may not be possible and agencies may only be able to offer
palliative care for the aftermath. One such kind of emergency is obstetric emergency. Obstetrical
emergencies may also occur during active labour, & after delivery (postpartum). The first
principal of dealing with obstetric emergencies are the same as for any emergency (see to the
airway, breathing & circulation) but remember that in obstetrics there are two patients; the fetus
is very vulnerable to maternal hypoxia. There are a number of illnesses and disorder of
pregnancy that can threaten the well-being of both mother and child.
DEFINITION:-
Obstetrical emergencies are life- threatening medical conditions that occur in pregnancy or
during or after labor and delivery.
TYPES OF OBSTETRIC EMERGENCIES:-
1)obstetric emergencies of pregnancy
2)obstetric emergencies during labour & delivery
3)obstetric emergencies postpartum
1)obstetric emergencies of pregnancy
Ectopic pregnancy- An ectopic, or tubal, pregnancy occurs when the fertilized egg implants
itself in the fallopian tube rather than the uterine wall. If the pregnancy is not terminated at an
early stage, the fallopian tube will rupture, causing internal hemorrhaging and potentially
resulting in permanent infertility.
Placental abruption- It is also called abruptio placenta, placental abruption occurs when the
placenta separates from the uterus prematurely, causing bleeding and contractions. If over 50%
of the placenta separates both the fetus and mother are at risk.
Placenta previa- When the placenta attaches to the mouth of the uterus and partially or
completely blocks the cervix, the position is termed placenta previa (or low-lying placenta).
Placenta previa can result in premature bleeding and possible postpartum hemorrhage.
Preeclampsia / eclampsia- Preeclampsia (toxemia) or pregnancy induced high blood pressure

causes severe edema(swelling due to water retention) and can impair kidney and liver function.
The condition occurs in approximately 5% of all United States pregnancies. If it progresses to
eclampsia, toxemia is potentially fatal for mother and child.
Premature rupture of membranes Premature rupture of membranes is the breaking of the bag
ofwaters (amniotic fluid)before contractions or labor begins. Thesituation is only considered an
emergency if the break occurs before thirty-seven weeks and results in significant leakage
ofamniotic fluid and/or infection of the amniotic sac.
2)obstetric emergencies during labour & delivery
Amniotic fluid embolism- A rare but frequently fatal complication of labor, this condition
occurs when amniotic fluid embolizes from the amniotic sac and through the veins of the uterus
and into the circulatory system of the mother. The fetal cells present in the fluid then block or
clog the pulmonary artery, resulting in heart attack. This complication can also happen during
pregnancy, but usually occurs in the presence of strong contractions.
Inversion or rupture of uterus During labor, a weak spot in the uterus (such as a scar or a
uterine wall that is thinned by a multiple pregnancy) may tear, resulting in a uterine rupture. In
certain circumstances, a portion of the placenta may stay attached to the wall and will pull the
uterus out with-it during delivery. This is called uterine inversion.
Placenta accreta Placenta accreta occurs when the placenta is implanted too deeply into the
uterine wall, and will not detach during the late stages of childbirth, resulting in uncontrolled
bleeding.
Prolapsed umbilical cord A prolapse of the umbilical cord occurs when the cord is pushed
down into the cervix or vagina. If the cord becomes com pressed, the oxygen supply to the fetus
could be diminished, resulting in brain damage or possible death. Shoulder dystocia Shoulder
dystocia occurs when the baby' s shoulder(s) becomes wedged in the birth canal after the head
has been delivered. ````Vasa previa ````` ‘’’cord polapse’’’
3)obstetric emergencies postpartum
PPH Severe bleeding or uterine infection occurring after delivery is a serious, potentially fatal
situation.
ETIOLOGY:-
Obstetrical emergencies can be caused by a number of factors, including-
 Stress
 Trauma
 Genetic and other variables
 In some cases, past medical history, including previous pregnancies & deliveries, may
help an obstetrician anticipate the possibility of complications.
SIGNS AND SYMPTOMS :-

Signs and symptoms of an obstetrical emergency include, but are n ot limited to:
 Diminished fetal activity. In the late third trimester, fewer than ten movements in a two-
hour period may indicate that the fetus is in distress.
 Abnormal bleeding. During pregnancy, brown or white to pink vaginal discharge is
normal, bright red blood or blood containing large clots is not. After delivery, continual
blood loss of over 500 ml indicates hemorrhage.
 Leaking amniotic fluid. Amniotic fluid is straw- colored and may easily be confused with
urine leakage, but can be differentiated by its slightly sweet odor.
 Severe abdominal pain. Stomach or lower back pain can indicate preeclampsia or an
undiagnosed ectopic pregnancy. Postpartum stomach pain can be a sign of infection or
hemorrhage.
 Contractions. Regular contractions before 37 weeks of gestation can signal the onset of
preterm labor due to obstetrical complications.
 Abrupt and rapid increase in blood pressure. Hypertension is one of the first signs of
toxemia Edema. Sudden and significant swelling of hands and feet caused by fluid
retention from toxemia.
 Unpleasant smelling vaginal discharge. A thick, malodorous discharge from the vagina
can indicate a postpartum infection.
 Fever. Fever may indicate an active infection.
 Loss of consciousness. Shock due to blood loss (hemorrhage) or amniotic embolism can
precipitate a loss of consciousness in the mother.
 Blurred vision and headaches. Vision problems and headache are possible symptoms of
preeclampsia.
DIAGNOSIS OF OBSTETRICAL EMERGENCIES:-

Diagnosis of an obstetrical emergency typically takes place in a hospital or other urgent care
facility. Diagnosis includes:-
 Medical history
 General physical examination
 Pelvic examination
 Mother’s vital sign taken - If preeclampsia is suspected, BP may be monitored over a
period of time.
 Fetal heartbeat assessed with a Doppler stethoscope
 Blood & urine tests
 Abdominal sonography
 Biophysical profile (BPP) may also be performed to evaluate the health of the fetus.
TREATMENT:-
1)Obstetrical emergencies of pregnancy
Ectopic pregnancy - Treatment of an ectopic pregnancy is laparoscopic surgical removal of the

fertilize d ovum. If the fallopian tube has burst or been damaged, further surgery will be
necessary.
Placental abruption - In mild cases of placental abruption, bed rest may prevent further
separation of the placenta and stem bleeding. If a significant abruption (over 50%) occurs, the
fetus may have to be delivered immediately and a blood transfusion may be required.
Placenta previa- Hospitalization or highly restricted at home bed rest is usually recommended if
placenta previa is diagnosed after the twentieth week of pregnancy. If the fetus is at least 36
weeks old and the lungs are mature, a cesarean section is performed to deliver the baby.
Preeclampsia / Eclampsia - Treatment of preeclampsia depends upon the age of the fetus and
the acuteness of the condition. A woman near full term that has only mild toxemia may have
labor induced to deliver the child as soon as possible. Severe preeclampsia in a woman near term
also calls for immediate delivery of the child, as this is the only known cure for the condition.
However, if the fetus is under 28weeks, the mother may be hospitalized and steroids may be
administered to try to hasten lung development in the fetus. If the life of the mother or fetus
appears to be in danger, the baby is delivered immediately, usually by cesarean section.
Premature rupture of membrane- If PROM occurs before 37 weeks and/or results in

significant leakage of amniotic fluid, a course of intravenous antibiotics is started. A culture of
the cervix may be taken to analyze for the presence of bacterial infection. If the fetus is close to
term, labor is typically induced if contractions do not start within 24 hours of rupture.
2)Obstetrical emergencies during labour & delivery

Amniotic fluid embolism - The stress of contractions can cause this complication, which has a
high mortality rate. Administering steroids to the mother and delivering the fetus as soon as
possible is the standard treatment.
Inversion or rupture of uterus - An inverted uterus is either manually or surgical replaced to
the proper position. A ruptured uterus is repaired if possible, although if the damage is extreme, a
hysterectomy (removal of the uterus) may be performed. A blood transfusion may be required in
either case if hemorrhaging occurs.
Placenta accreta - Women who experience placenta accreta will typically need to have their
placenta surgically removed after delivery. Hysterectomy is necessary in some cases. • Prolapsed
umbilical cord - Saline may be infused into the vagina to relieve the com pression. If the cord has
prolapsed out the vaginal opening, it may be replaced, but immediate delivery by cesarean
section is usually indicated.
Shoulder dystocia - The mother is usually positioned with her knees to he r chest, known as the
McRoberts maneuver, in an effort to free the child's shoulder. An episiotomy is also performed
to widen the vaginal opening. If the shoulder cannot be dislodged from the pelvis, the baby's
clavicle (collarbone) may have to be broken to complete the delivery before a lack of oxygen
causes brain damage to the infant.
3)Obstetrical emergencies postpartum
Postpartum hemorrhage or infection - The source of the hemorrhage is determined, and blood
transfusion and IV fluids are given as necessary. Oxytocic drugs may be administered to
encourage contraction of the uterus. Retained placenta is a frequent cause of persistent bleeding,
and surgical removal of the remaining fragments (curettage) may be required. Surgical repair of
lacerations to the birth canal or uterus may be required. Drugs that encourage coagulation
(clotting) of the blood may be administered to stem the bleeding. Infrequently, hysterectomy is
required. In cases of infection, a course of intravenous antibiotics is prescribed. Most postpartum
infect ions occur in the endometrium, or lining of the uterus, and may be also caused by a piece
of retained placenta. If this is the case, it will also require surgical removal.
PREVENTION:-
 Proper prenatal care is the best prevention for obstetrical emergencies.
 When complications of pregnancy do arise, pregnant women who see their Ob/GYN on a
regular basis are more likely to get an early diagnosis, & with it, the best chances for fast
& effective treatment.
 In addition, eating right & taking prenatal vitamins and supplements as recommended by
a physician will also contribute to the health of both mother & child

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What are the different types of obstetric emergencies?

What are the different types of obstetric emergencies?

What are some causes of obstetric emergencies?

What are some causes of obstetric emergencies?

DEFINE OBSTETRIC EMERGENCIES DESCRIBE THE VARIOUS TYPES OF

OBSTETRIC EMERGENCIES ENLIST THE CAUSES OF OBSTETRIC EMERGENCIES

TYPES OF OBSTETRIC EMERGENCIES:-

1)obstetric emergencies of pregnancy

2)obstetric emergencies during labour & delivery

3)obstetric emergencies postpartum

1)obstetric emergencies of pregnancy

Preeclampsia / eclampsia- Preeclampsia (toxemia) or pregnancy induced high blood pressure

2)obstetric emergencies during labour & delivery

3)obstetric emergencies postpartum

SIGNS AND SYMPTOMS :-

DIAGNOSIS OF OBSTETRICAL EMERGENCIES:-

Ectopic pregnancy - Treatment of an ectopic pregnancy is laparoscopic surgical removal of the

Premature rupture of membrane- If PROM occurs before 37 weeks and/or results in

2)Obstetrical emergencies during labour & delivery

3)Obstetrical emergencies postpartum

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