Managing Complications in Pregnancy and Childbirth: - IAWG

More documents

Recommendations

Info

iiTable of contentsLoss of fetal movements S-131Prelabour rupture of membranes S-135Immediate newborn conditions or problems S-141SECTION 3: PROCEDURESParacervical block P-1Pudendal block P-3Local anaesthesia for caesarean section P-7Spinal (subarachnoid) anaesthesia P-11Ketamine P-13External version P-15Induction and augmentation of labour P-17Vacuum extraction P-27Forceps delivery P-33Breech delivery P-37Caesarean section P-43Symphysiotomy P-53Craniotomy and craniocentesis P-57Dilatation and curettage P-61Manual vacuum aspiration P-65Culdocentesis and colpotomy P-69Episiotomy P-71Manual removal of placenta P-77Repair of cervical tears P-81Repair of vaginal and perineal tears P-83Correcting uterine inversion P-91Repair of ruptured uterus P-95Uterine and utero-ovarian artery ligation P-99Postpartum hysterectomy P-103Salpingectomy for ectopic pregnancy P-109SECTION 4: APPENDIXEssential drugs for managing complications in pregnancy andchildbirth A-1Index A-3
PREFACEiiiIn support of the Safe Motherhood Initiative, the WHO MakingPregnancy Safer Strategy focuses on the Health Sector’s contributionto reducing maternal and newborn deaths.The Integrated Management of Pregnancy and Childbirth (IMPAC) isthe technical component of the aforementioned strategy and mainlyaddresses the following:• Improving the skills of health workers through locally adaptedguidelines and standards for the management of pregnancy andchildbirth at different levels of the health care system;• Interventions to improve the health care system’s response to theneeds of pregnant women and their newborns, and to improve thedistrict level management of health services, including theprovision of adequate staffing, logistics, supplies and equipment;• Health education and promotion of activities that improve familyand community attitudes and practices in relation to pregnancyand childbirth.This manual, and a similar one on the management of preterm and sicknewborns, is written for midwives and doctors working in districthospitals. This manual complements and is consistent with theEssential Care Practice Guide for Pregnancy and Childbirth which isprepared mainly for the primary health care level. Together thesemanuals will provide guidance for health workers who are responsiblefor the care of pregnant women and newborns at all levels of care.The interventions described in these manuals are based on the latestavailable scientific evidence. Given that evidence-based medicine is thestandard on which to base clinical practice, it is planned to update themanual as new information is acquired.It is hoped that this manual will be used at the side of the patient, andbe readily available whenever a midwife or doctor is confronted with anobstetric emergency.
Page 1 and 2: WHO/RHR/00.7Distr: GeneralIntegrate
Page 4 and 5: ©World Health Organization, 2000Th
Page 8 and 9: ivPreface
Page 10 and 11: viIntroduction
Page 12 and 13: viiiHow to use the manualprocedure,
Page 14 and 15: xAbbreviations
Page 16 and 17: xiiList of diagnoses
Page 18 and 19: RAPID INITIAL ASSESSMENT C-1When a
Page 20 and 21: Rapid initial assessmentC-3Abdomina
Page 22 and 23: TALKING WITH WOMEN AND THEIR FAMILI
Page 24 and 25: EMOTIONAL AND PSYCHOLOGICAL SUPPORT
Page 26 and 27: Emotional and psychological support
Page 33 and 34: C-16 Emotional and psychological su
Page 35 and 36: C-16 Emergencies• If the woman is
Page 37 and 38: C-18 General care principles- after
Page 39 and 40: C-20 General care principlesaGloves
Page 41 and 42: C-22 General care principles- weari
Page 43 and 44: C-24 General care principles• Nev
Page 45 and 46: C-24 Clinical use of blood, blood p
Page 57 and 58:
ANTIBIOTIC THERAPY C-35Infection du
Page 59 and 60:
ANAESTHESIA AND ANALGESIA C-37Pain
Page 61 and 62:
Anaesthesia and analgesiaC-39• Gi
Page 63 and 64:
Anaesthesia and analgesiaC-41TABLE
Page 65 and 66:
Anaesthesia and analgesiaC-43MANAGE
Page 67 and 68:
Anaesthesia and analgesiaC-45- Give
Page 69 and 70:
Anaesthesia and analgesiaC-47Proced
Page 71 and 72:
OPERATIVE CARE PRINCIPLES C-47The w
Page 73 and 74:
Operative care principlesC-49• Ho
Page 75 and 76:
Operative care principlesC-51HAEMOS
Page 77 and 78:
Operative care principlesC-53- Plac
Page 79 and 80:
Operative care principlesC-55A urin
Page 81 and 82:
NORMAL LABOUR AND CHILDBIRTH C-57NO
Page 83 and 84:
Normal labour and childbirthC-59- E
Page 85 and 86:
Normal labour and childbirthC-61•
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Normal labour and childbirthC-69FIG
Page 95 and 96:
Normal labour and childbirthC-71FIG
Page 97 and 98:
Page 99 and 100:
Normal labour and childbirthC-75Not
Page 101 and 102:
Normal labour and childbirthC-77Nev
Page 103 and 104:
NEWBORN CARE PRINCIPLES C-77When a
Page 105 and 106:
PROVIDER AND COMMUNITY LINKAGES C-7
Page 107 and 108:
Provider and community linkagesC-81
Page 109 and 110:
SHOCK S-1Shock is characterized by
Page 111 and 112:
ShockS-3BEDSIDE CLOTTING TEST• As
Page 113 and 114:
ShockS-5• If trauma is suspected
Page 115 and 116:
VAGINAL BLEEDING IN EARLY PREGNANCY
Page 117 and 118:
Vaginal bleeding in early pregnancy
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
S-18 Vaginal bleeding in later preg
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
S-26 Vaginal bleeding after childbi
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
HEADACHE, BLURRED VISION, CONVULSIO
Page 147 and 148:
Headache, blurred vision, convulsio
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
UNSATISFACTORY PROGRESS OF LABOUR S
Page 173 and 174:
Unsatisfactory progress of labourS-
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
MALPOSITIONS AND MALPRESENTATIONS S
Page 185 and 186:
Malpositions and malpresentationsS-
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
S-84 Shoulder dystociaFIGURE S-26As
Page 201 and 202:
S-86 Shoulder dystocia
Page 203 and 204:
S-88 Labour with an overdistended u
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
S-94 Labour with a scarred uterus-
Page 211 and 212:
S-96 Fetal distress in labour- If t
Page 213 and 214:
S-98 Prolapsed cord- If breech pres
Page 215 and 216:
S-100 Fever during pregnancy and la
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
FEVER AFTER CHILDBIRTH S-107PROBLEM
Page 225 and 226:
Fever after childbirthS-109Presenti
Page 227 and 228:
Fever after childbirthS-111aGive he
Page 229 and 230:
Fever after childbirthS-113• If t
Page 231 and 232:
Fever after childbirthS-115- apply
Page 233 and 234:
Fever after childbirthS-117• Remo
Page 235 and 236:
ABDOMINAL PAIN IN EARLY PREGNANCY S
Page 237 and 238:
Abdominal pain in early pregnancyS-
Page 239 and 240:
Abdominal pain in early pregnancyS-
Page 241 and 242:
S-120 Abdominal pain in later pregn
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
S-126 Difficulty in breathingDIAGNO
Page 251 and 252:
S-128 Difficulty in breathing- Give
Page 253 and 254:
S-130 Difficulty in breathing
Page 255 and 256:
LOSS OF FETAL MOVEMENTS S-131PROBLE
Page 257 and 258:
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 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
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 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
VACUUM EXTRACTION P-27Figure P-6 sh
Page 307 and 308:
Vacuum extractionP-29• With the p
Page 309 and 310:
Vacuum extractionP-31FAILURE• Vac
Page 311 and 312:
FORCEPS DELIVERY P-33• Review for
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
Page 357 and 358:
P-74 Episiotomy- At the opening of
Page 359 and 360:
P-76 Episiotomy
Page 361 and 362:
P-78 Manual removal of placenta•
Page 363 and 364:
P-80 Manual removal of placenta•
Page 365 and 366:
P-2 Repair of cervical tears
Page 367 and 368:
REPAIR OF VAGINAL AND PERINEAL TEAR
Page 369 and 370:
P-84 Repair of vaginal and perineal
Page 371 and 372:
Page 373 and 374:
Page 375 and 376:
Page 377 and 378:
CORRECTING UTERINE INVERSION P-91
Page 379 and 380:
P-92 Correcting uterine inversionHY
Page 381 and 382:
P-94 Correcting uterine inversion-
Page 383 and 384:
P-96 Repair of ruptured uterus• S
Page 385 and 386:
P-98 Repair of ruptured uterus• I
Page 387 and 388:
UTERINE AND UTERO-OVARIAN ARTERY P-
Page 389 and 390:
Uterine and utero-ovarian artery li
Page 391 and 392:
POSTPARTUM HYSTERECTOMY P-103Postpa
Page 393 and 394:
Postpartum hysterectomyP-105FIGURE
Page 395 and 396:
Postpartum hysterectomyP-107• Clo
Page 397 and 398:
Postpartum hysterectomyP-109POSTOPE
Page 399 and 400:
P-110 Salpingectomy for ectopic pre
Page 401 and 402:
P-112 Salpingectomy for ectopic pre
Page 405 and 406:
INDEX A-3Abdominal distensiondiagno
Page 407 and 408:
IndexA-5Atonic uterusdiagnosis, S-2
Page 409 and 410:
IndexS-97transverse lie and, P-49tu
Page 411 and 412:
IndexDescentassessment of, C-61Dext
Page 413 and 414:
IndexFetal skull landmarks, C-62Fev
Page 415 and 416:
Indexpostoperative care, P-108subto
Page 417 and 418:
IndexA-15Maintenance fluid therapy,
Page 419 and 420:
IndexA-17syphilis, management, S-15
Page 421 and 422:
Indexgeneral management, S-25Pre-ec
Page 423 and 424:
IndexA-21Stillbirthemotional consid
Page 425 and 426:
IndexA-23anaesthesia options, C-45b
show all

Managing Complications in Pregnancy and Childbirth: - IAWG

Create successful ePaper yourself

Delete template?

Save as template?