Managing Complications in Pregnancy and Childbirth: - IAWG

C-50 Operative care principlesMONITORINGMonitor the woman’s condition regularly throughout the procedure.• Monitor vital signs (blood pressure, pulse, respiratory rate), levelof consciousness and blood loss.• Record the findings on a monitoring sheet to allow quickrecognition if the woman’s condition deteriorates.• Maintain adequate hydration throughout surgery.MANAGING PAINMaintain adequate pain management throughout the procedure (pageC-37). Women who are comfortable during a procedure are less likely tomove and cause injury to themselves. Pain management can include:• emotional support and encouragement;• local anaesthesia;• regional anaesthesia (e.g. spinal);• general anaesthesia.ANTIBIOTICS• Give prophylactic antibiotics before starting the procedure. If thewoman is going to have a caesarean section, give prophylacticantibiotics after the baby is delivered (page C-35).MAKING THE INCISION• Make the incision only as large as necessary for the procedure.• Make the incision with great care and proceed one layer at a time.HANDLING TISSUE• Handle tissue gently.• When using clamps, close the clamp only one ratchet (click), whenpossible. This will minimize discomfort and reduce the amount ofdead tissue that remains behind at the end of the procedure, thusdecreasing the risk of infection.