IGIMS COLLEGE OF NURSING

MATERNAL HEALTH NURSING

SUBMITTED TO:- SUBMITTED BY:-

Ma’am Kri. Julli Rashmi Anushka Priya
Tutor PBBsc. 1st Year
Roll no. - 03
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
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.
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

• Ectopic pregnancy
• Placenta abruptio
• Placenta Previa
• Pre – eclampsia / Eclampsia
• Vasa previa
• Premature rupture of membrane
2.Obstetric emergencies during labor and
delivery
. Amniotic fluid embolism
. Inversion or rupture of uterus
. Placenta accreta
.Cord prolapsed
.shoulder dystocia

3. Obstetrical emergencies postpartum

. Postpartum hemorrhage

.Shock
Causes of obstetrical emergencies

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 of obstetrical emergencies

Signs and symptoms of an obstetrical emergency include, but are n

ot limited to:
• Diminished fetal activity..
• Abnormal bleeding.
• Leaking amniotic fluid
•Severe abdominal pain
•Contraction before 37 weeks of gestation
•Abrupt and rapid increase in B.P and pulse
•Edema
•Foul smell vaginal discharge
•Fever
•Loss of consciousness
•Blurred vision
Diagnosis of obstetrical emergencies

It 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
• Blood & urine tests
• U.S.G
Treatment
1) Obstetrical emergencies of pregnancy
• Ectopic pregnancy - Treatment of an ectopic
pregnancy is laparoscopic
Placental abruption - In mild cases of placental
abruption, bed rest
.Monitor FHS
.Cesarean section
.Blood transfusion
• Placenta previa-
. Hospitalization or highly restricted at home bed rest
. If the fetus is at least 36 weeks old and the lungs are
mature, a cesarean section is performed

Preeclampsia / Eclampsia -
may have labor induced to deliver the child as soon as
possible.
.Monitor vitals
.Maintain intake - output chart
.Administer medications
• Premature rupture of membrane-

. IV fluid, and a course of intravenous antibiotics is started.

.Avoid frequent P.V examination.

. Vasa previa

. Consult the doctor

.Cesarean section
2)Obstetrical emergencies during labour & delivery
• Amniotic fluid embolism -
delivering the fetus as soon as p ossible is the standard
treatment.
.Administer oxygen .
.Administer steroids.

• Inversion or rupture of uterus -

An inverted uterus is either manually or surgical replaced to
the proper position.
.Hysterectomy (removal of the uterus) may be performed.
. blood transfusion
• Placenta accreta -
.Surgically removed placenta after delivery.
.Hysterectomy

• Prolapsed umbilical cord -

.Saline may be infused into the vagina to relieve the
compression.
.If the cord has prolapsed out the vaginal opening, it may
be replaced, but immediate delivery by cesarean section is
usually indicated.
.Stop oxytocin IV drip.
Shoulder dystocia –

The mother is usually positioned with her knees to her

chest, known as the McRoberts maneuver, in an effort to
free the child's shoulder. An episiotomy is also pe rformed
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 –

. Blood transfusion and IV fluids are given.

.Administer uterotonic drugs

.Administer coagulant

.Surgical repair of laceration

. Currettage may be required

.Hysterectomy
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.
Bibliography
1. Anamma Jacob, Midwifery and gynaecological
nursing, 5th edition, Jaypee brothers andmedical
publisher, pp. 347 – 357.

2. Clark SL. New concept of amniotic fluid embolism,

obstetrical and gynecological survey, pp.360-368.

3. Dutta DC. Textbook of obstetric , 5th edition, new

central book company 2001, pp. 441- 446.