Managing Complications in Pregnancy and Childbirth: - IAWG

C-48 Operative care principles• Wash the area around the proposed incision site with soap andwater, if necessary.• Do not shave the woman’s pubic hair as this increases the risk ofwound infection. The hair may be trimmed, if necessary.• Monitor and record vital signs (blood pressure, pulse, respiratoryrate and temperature).• Administer premedication appropriate for the anaesthesia used(page C-38).• Give an antacid (sodium citrate 0.3% 30 mL or magnesium trisilicate300 mg) to reduce stomach acid in case there is aspiration.• Catheterize the bladder if necessary and monitor urine output.• Ensure that all relevant information is passed on to other membersof the team (doctor/midwife, nurse, anaesthetist, assistant andothers).INTRA-OPERATIVE CARE PRINCIPLESPOSITIONPlace the woman in a position appropriate for the procedure to allow:• optimum exposure of the operative site;• access for the anaesthetist;• access for the nurse to take vital signs and monitor IV drugs andinfusions;• safety of the woman by preventing injuries and maintainingcirculation;• maintenance of the woman’s dignity and modesty.Note: If the woman has not delivered, have the operating table tilted tothe left or place a pillow or folded linen under her right lower back todecrease supine hypotension syndrome.SURGICAL HANDSCRUB• Remove all jewelry.