Friday, September 30, 2016

Complicated Delivery

emDocs - September 29, 2016 - Authors: Linker J, Christopher Tems and Scott K
Edited by: Santistevan J and Koyfman A
"Take-Home Points for complicated Deliveries
  • Complicated deliveries are infrequently performed, high-stress procedures. Call for OB and neonatology early, in addition to extra ED team members. Make sure someone prepares to care for the neonate.
  • To relieve shoulder dystocia, avoid excess traction, hyper flex the mothers legs and apply suprapubic pressure, then progress to fetal maneuvering as needed.
  • During breech delivery, allow the delivery to happen spontaneously without traction while supporting the fetal body, then prevent excess neck extension while delivering the head.
  • If cord prolapse occurs, do not manipulate the cord. Minimize pressure on the cord with maternal knee-chest positioning and elevation of presenting parts while preparing for emergency cesarean section."