Managing Complications in Pregnancy and Childbirth: - IAWG

Operative care principlesC-53- Place the upper arm in front of the body for easy access tocheck blood pressure;- Place legs so that they are flexed, with the upper leg slightlymore flexed than the lower to maintain balance.• Assess the woman’s condition immediately after the procedure:- Check vital signs (blood pressure, pulse, respiratory rate) andtemperature every 15 minutes during the first hour, then every30 minutes for the next hour.- Assess the level of consciousness every 15 minutes until thewoman is alert.Note: Ensure the woman has constant supervision untilconscious.• Ensure a clear airway and adequate ventilation.• Transfuse if necessary (page C-23).• If vital signs become unstable or if the haematocrit continues tofall despite transfusion, quickly return to the operating theatrebecause bleeding may be the cause.GASTROINTESTINAL FUNCTIONGastrointestinal function typically returns rapidly for obstetricalpatients. For most uncomplicated procedures, bowel function should benormal within 12 hours of surgery.• If the surgical procedure was uncomplicated, give the woman aliquid diet.• If there were signs of infection, or if the caesarean was forobstructed labour or uterine rupture, wait until bowel sounds areheard before giving liquids.• When the woman is passing gas, begin giving her solid food.• If the woman is receiving IV fluids, they should be continued untilshe is taking liquids well.• If you anticipate that the woman will receive IV fluids for 48 hoursor more, infuse a balanced electrolyte solution (e.g. potassiumchloride 1.5 g in 1 L IV fluids).