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Introduction to emergency situations

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Emergency situation (Wellcome Image Library).

Women's lives are routinely saved on a daily basis throughout the UK. However, when vigilance is relaxed, women die. Complications of childbirth can often not be prevented but they can be treated promptly and effectively, and it is imperative that professionals providing care to pregnant women follow a structured approach to emergencies.

This e-tutorial will cover three obstetric emergencies: maternal cardiopulmonary resuscitation, shoulder dystocia and cord prolapse.

Learning objectives:

Cardiopulmonary resuscitation:

  • appreciate how the physiological changes in pregnancy affect the mechanics of resuscitation in pregnancy
  • describe the CPR drill for any patient and how to adapt this to the obstetric patient
  • understand the concept of primary and secondary survey
  • acknowledge the role of perimortem caesarean section.

Shoulder dystocia:

  • identify cases at risk
  • understand the limitations regarding prediction and prevention
  • appreciate the associated fetal/neonatal and maternal morbidity
  • have a logical approach to manage this emergency and understand the rationale behind the manoeuvres employed to deal with a shoulder dystocia.

Umbilical cord prolapse:

  • be aware of the risk factors for a cord prolapse, including obstetric interventions that predispose to its occurrence
  • have a logical approach to dealing with the emergency.

Last updated: 05/05/10 (tutorial revised and updated by Dr Claire Bailey and Dr Katherine Barber)

24/03/09 (new section on umbilical cord prolapse).

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