Managing Complications in Pregnancy and Childbirth: - IAWG

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P-32 Vacuum extraction• Scalp abrasions (common and harmless) and lacerations may occur.Clean and examine lacerations to determine if sutures arenecessary. Necrosis is extremely rare.• Intracranial bleeding is extremely rare and requires immediateintensive neonatal care.MATERNAL COMPLICATIONS• Tears of the genital tract may occur. Examine the woman carefullyand repair any tears to the cervix (page P-81) or vagina (page P-83) or repair episiotomy (page P-73).
FORCEPS DELIVERY P-33• Review for conditions:- vertex presentation or face presentation with chin-anterior orentrapped after-coming head in breech delivery (page P-41);- cervix fully dilated;- head at +2 or +3 station or 0/5 palpable.At a minimum, the sagittal suture should be in the midline and straight,guaranteeing an occiput anterior or occiput posterior position.• Provide emotional support and encouragement. If necessary, use apudendal block (page P-3).• Assemble the forceps before application. Ensure that the parts fittogether and lock well.• Lubricate the blades of the forceps.• Wearing high-level disinfected gloves, insert two fingers of theright hand into the vagina on the side of the fetal head. Slide theleft blade gently between the head and fingers to rest on the sideof the head (Fig P-10).A biparietal, bimalar application is the only safe application.FIGURE P-10Applying the left blade of the forceps• Repeat the same manoeuvre on the other side, using the left handand the right blade of the forceps (Fig P-11, page P-34).
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WHO/RHR/00.7Distr: GeneralIntegrate
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©World Health Organization, 2000Th
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iiTable of contentsLoss of fetal mo
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ivPreface
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viIntroduction
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viiiHow to use the manualprocedure,
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xAbbreviations
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xiiList of diagnoses
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RAPID INITIAL ASSESSMENT C-1When a
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Rapid initial assessmentC-3Abdomina
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TALKING WITH WOMEN AND THEIR FAMILI
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EMOTIONAL AND PSYCHOLOGICAL SUPPORT
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Emotional and psychological support
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C-16 Emotional and psychological su
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C-16 Emergencies• If the woman is
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C-18 General care principles- after
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C-20 General care principlesaGloves
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C-22 General care principles- weari
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C-24 General care principles• Nev
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C-24 Clinical use of blood, blood p
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ANTIBIOTIC THERAPY C-35Infection du
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ANAESTHESIA AND ANALGESIA C-37Pain
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Anaesthesia and analgesiaC-39• Gi
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Anaesthesia and analgesiaC-41TABLE
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Anaesthesia and analgesiaC-43MANAGE
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Anaesthesia and analgesiaC-45- Give
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Anaesthesia and analgesiaC-47Proced
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OPERATIVE CARE PRINCIPLES C-47The w
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Operative care principlesC-49• Ho
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Operative care principlesC-51HAEMOS
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Operative care principlesC-53- Plac
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Operative care principlesC-55A urin
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NORMAL LABOUR AND CHILDBIRTH C-57NO
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Normal labour and childbirthC-59- E
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Normal labour and childbirthC-61•
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Normal labour and childbirthC-69FIG
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Normal labour and childbirthC-71FIG
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Normal labour and childbirthC-75Not
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Normal labour and childbirthC-77Nev
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NEWBORN CARE PRINCIPLES C-77When a
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PROVIDER AND COMMUNITY LINKAGES C-7
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Provider and community linkagesC-81
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SHOCK S-1Shock is characterized by
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ShockS-3BEDSIDE CLOTTING TEST• As
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ShockS-5• If trauma is suspected
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VAGINAL BLEEDING IN EARLY PREGNANCY
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Vaginal bleeding in early pregnancy
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S-18 Vaginal bleeding in later preg
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S-26 Vaginal bleeding after childbi
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HEADACHE, BLURRED VISION, CONVULSIO
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Headache, blurred vision, convulsio
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UNSATISFACTORY PROGRESS OF LABOUR S
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Unsatisfactory progress of labourS-
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MALPOSITIONS AND MALPRESENTATIONS S
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Malpositions and malpresentationsS-
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S-84 Shoulder dystociaFIGURE S-26As
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S-86 Shoulder dystocia
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S-88 Labour with an overdistended u
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S-94 Labour with a scarred uterus-
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S-96 Fetal distress in labour- If t
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S-98 Prolapsed cord- If breech pres
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S-100 Fever during pregnancy and la
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FEVER AFTER CHILDBIRTH S-107PROBLEM
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Fever after childbirthS-109Presenti
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Fever after childbirthS-111aGive he
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Fever after childbirthS-113• If t
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Fever after childbirthS-115- apply
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Fever after childbirthS-117• Remo
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ABDOMINAL PAIN IN EARLY PREGNANCY S
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Abdominal pain in early pregnancyS-
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Abdominal pain in early pregnancyS-
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S-120 Abdominal pain in later pregn
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S-126 Difficulty in breathingDIAGNO
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S-128 Difficulty in breathing- Give
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S-130 Difficulty in breathing
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LOSS OF FETAL MOVEMENTS S-131PROBLE
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Loss of fetal movementsS-133• Alt
Page 259 and 260: PRELABOUR RUPTURE OF MEMBRANES S-13
Page 261 and 262: Prelabour rupture of membranesS-137
Page 263 and 264: Prelabour rupture of membranesS-139
Page 265 and 266: IMMEDIATE NEWBORN CONDITIONS OR S-1
Page 267 and 268: Immediate newborn conditions or pro
Page 277 and 278: SECTION 3PROCEDURES
Page 279 and 280: P-2 Paracervical blocktry again. Ne
Page 281 and 282: P-4 Pudendal blockFIGURE P-2Perinea
Page 283 and 284: P-6 Pudendal block• Inject 10 mL
Page 285 and 286: P-8 Local anaesthesia for caesarean
Page 287 and 288: P-10 Local anaesthesia for caesarea
Page 289 and 290: P-12 Spinal anaesthesia• If the n
Page 291 and 292: KETAMINE P-13TABLE P-5Indications a
Page 293 and 294: EXTERNAL VERSION P-15• Review for
Page 295 and 296: INDUCTION AND AUGMENTATION OF LABOU
Page 297 and 298: Induction and augmentation of labou
Page 305 and 306: VACUUM EXTRACTION P-27Figure P-6 sh
Page 307 and 308: Vacuum extractionP-29• With the p
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Page 313 and 314: Forceps deliveryP-35- fetal heart r
Page 315 and 316: BREECH DELIVERY P-37• Review for
Page 317 and 318: Breech deliveryP-39• Hold the bab
Page 319 and 320: Breech deliveryP-41Note: Ask an ass
Page 321 and 322: Breech deliveryP-43extended at hip
Page 323 and 324: CAESAREAN SECTION P-43• Review fo
Page 325 and 326: Caesarean sectionP-45• Use two fi
Page 327 and 328: Caesarean sectionP-47• Hand the b
Page 329 and 330: Caesarean sectionP-49CLOSING THE AB
Page 331 and 332: Caesarean sectionP-51• Women with
Page 333 and 334: Caesarean sectionP-53• Grasp the
Page 335 and 336: P-54 SymphysiotomyAbduction of the
Page 337 and 338: P-56 Symphysiotomy• After separat
Page 339 and 340: P-58 Craniotomy and craniocentesis
Page 341 and 342: P-60 Craniotomy and craniocentesisA
Page 343 and 344: P-62 Dilatation and curettage- Take
Page 345 and 346: P-64 Dilatation and curettage- feve
Page 347 and 348: P-66 Manual vacuum aspiration• Di
Page 349 and 350: P-68 Manual vacuum aspiration• Qu
Page 351 and 352: CULDOCENTESIS AND COLPOTOMY P-69CUL
Page 353 and 354: Culdocentesis and colpotomyP-71•
Page 355 and 356: P-72 EpisiotomyFIGURE P-39Infiltrat
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P-78 Manual removal of placenta•
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P-80 Manual removal of placenta•
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P-2 Repair of cervical tears
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REPAIR OF VAGINAL AND PERINEAL TEAR
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P-84 Repair of vaginal and perineal
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CORRECTING UTERINE INVERSION P-91
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P-92 Correcting uterine inversionHY
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P-94 Correcting uterine inversion-
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P-96 Repair of ruptured uterus• S
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P-98 Repair of ruptured uterus• I
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UTERINE AND UTERO-OVARIAN ARTERY P-
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Uterine and utero-ovarian artery li
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POSTPARTUM HYSTERECTOMY P-103Postpa
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Postpartum hysterectomyP-105FIGURE
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Postpartum hysterectomyP-107• Clo
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Postpartum hysterectomyP-109POSTOPE
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P-110 Salpingectomy for ectopic pre
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P-112 Salpingectomy for ectopic pre
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INDEX A-3Abdominal distensiondiagno
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IndexA-5Atonic uterusdiagnosis, S-2
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IndexS-97transverse lie and, P-49tu
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IndexDescentassessment of, C-61Dext
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IndexFetal skull landmarks, C-62Fev
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Indexpostoperative care, P-108subto
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IndexA-15Maintenance fluid therapy,
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IndexA-17syphilis, management, S-15
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Indexgeneral management, S-25Pre-ec
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IndexA-21Stillbirthemotional consid
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IndexA-23anaesthesia options, C-45b
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Managing Complications in Pregnancy and Childbirth: - IAWG

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