Managing Complications in Pregnancy and Childbirth: - IAWG

RAPID INITIAL ASSESSMENT C-1When a woman of childbearing age presents with a problem, rapidlyassess her condition to determine her degree of illness.TABLE C-1Rapid initial assessment aAssess Danger Signs ConsiderAirway andbreathingCirculation(signs of shock)Vaginalbleeding(early or latepregnancy orafter childbirth)LOOK FOR:• cyanosis (blueness)• respiratory distressEXAMINE:• skin: pallor• lungs: wheezing or ralesEXAMINE:• skin: cool and clammy• pulse: fast (110 or more) andweak• blood pressure: low (systolic lessthan 90 mm Hg)ASK IF:• pregnant, length of gestation• recently given birth• placenta deliveredEXAMINE:• vulva: amount of bleeding,placenta retained, obvious tears• uterus: atony• bladder: fullDO NOT DO A VAGINALEXAM AT THIS STAGE• severe anaemia• heart failure• pneumonia• asthmaSee Difficulty inbreathing, page S-125Shock, page S-1• abortion• ectopic pregnancy• molar pregnancySee Vaginal bleeding inearly pregnancy, page S-7• abruptio placentae• ruptured uterus• placenta praeviaSee Vaginal bleeding inlater pregnancy andlabour, page S-17• atonic uterus• tears of cervix and vagina• retained placenta• inverted uterusSee Vaginal bleeding afterchildbirth, page S-25