Intro 2016
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This document outlines the contents and structure of a 2-day obstetric emergency module. The module includes short lectures, workstations to practice skills and scenarios, video presentations, and written and skills assessments. The module covers topics like maternal mortality, abnormal placentation, postpartum hemorrhage, preeclampsia, labor management complications, and more. Workstations allow hands-on practice of skills like resuscitation, breech delivery, shoulder dystocia management, and instrumental delivery. Videos demonstrate procedures like breech delivery, vacuum-assisted delivery, and C-section.
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SALSO Intro 2018
This document outlines a 2-day obstetric emergency skills course containing short lectures on topics such as postpartum hemorrhage, preeclampsia and eclampsia, shoulder dystocia, and cord prolapse. Participants will practice skills through workstations on maternal resuscitation, breech delivery, shoulder dystocia, and obstetric hemorrhage. Videos will demonstrate breech delivery, instrumental delivery, shoulder dystocia, caesarean section, and salpingectomy for ruptured ectopic pregnancy. A written and skills assessment will evaluate learning.
antepartum haemorrhage
This document discusses the causes, presentation, risk factors, complications, and management of antepartum haemorrhage (APH), which is vaginal bleeding after 22 weeks of pregnancy until birth. The main causes of APH are placenta praevia (20%), abruptio placentae (30%), and undetermined causes (45%). Evaluation involves history, examination, ultrasound, and monitoring maternal and fetal stability. Management depends on the cause but may include continuous fetal monitoring, intravenous fluids and blood products, augmentation of labour, or cesarean section for delivery.
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Maternal resuscitation
This document provides guidance on maternal resuscitation. It outlines the goals of understanding issues related to maternal collapse, learning proper resuscitation techniques, and achieving competence in resuscitation skills. Common causes of maternal collapse include thromboembolism, amniotic fluid embolism, anaphylaxis shock, hypovolemic shock, and heart failure. The guidelines recommend assessing the patient's response and airway, providing chest compressions and rescue breaths if not breathing, and continuing resuscitation efforts until advanced life support arrives. Perimortem cesarean section may be considered after 5 minutes of unsuccessful resuscitation to relieve aortocaval compression.
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This document discusses fetal monitoring techniques used at SGH including intermittent auscultation, electronic fetal monitoring, and cardiotocography. It describes the goals of fetal monitoring and provides details on the different monitoring modalities, terminology used in CTG interpretation, guidelines for monitoring based on risk level, and management of abnormal tracings. Fetal scalp blood sampling is also discussed as a technique to determine fetal acid-base status when CTG changes are non-reassuring.
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Cord prolapse occurs when part of the umbilical cord falls in front of the presenting fetal part after rupture of membranes. It is diagnosed by seeing a loop of cord or feeling pulsations on vaginal exam and can cause variable or prolonged fetal decelerations. Management depends on fetal viability - for living fetuses, the most expedient delivery by instrumental delivery or C-section is recommended, while relieving cord compression and replacing it in the vagina. Proper positioning and filling the maternal bladder can help alleviate compression until delivery.
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This document discusses the proper procedures for transferring an ill obstetric patient between hospitals in Sarawak, Malaysia. It outlines 6 key steps: 1) early and appropriate referral to specialists, 2) stabilization of the patient before transfer, 3) determining the best mode of transportation, 4) ensuring necessary drugs and equipment are available, 5) alerting necessary personnel, and 6) proper handover procedures between facilities. Special considerations for Sarawak include its large size, distances between hospitals, and challenges of terrain and transportation infrastructure. The goal is to ensure patient safety during inter-hospital transfers.
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This document outlines a 2-day obstetric emergency skills course containing short lectures on topics such as postpartum hemorrhage, preeclampsia and eclampsia, shoulder dystocia, and cord prolapse. Participants will practice skills through workstations on maternal resuscitation, breech delivery, shoulder dystocia, and obstetric hemorrhage. Videos will demonstrate breech delivery, instrumental delivery, shoulder dystocia, caesarean section, and salpingectomy for ruptured ectopic pregnancy. A written and skills assessment will evaluate learning.
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This document discusses the causes, presentation, risk factors, complications, and management of antepartum haemorrhage (APH), which is vaginal bleeding after 22 weeks of pregnancy until birth. The main causes of APH are placenta praevia (20%), abruptio placentae (30%), and undetermined causes (45%). Evaluation involves history, examination, ultrasound, and monitoring maternal and fetal stability. Management depends on the cause but may include continuous fetal monitoring, intravenous fluids and blood products, augmentation of labour, or cesarean section for delivery.
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Maternal resuscitation
This document provides guidance on maternal resuscitation. It outlines the goals of understanding issues related to maternal collapse, learning proper resuscitation techniques, and achieving competence in resuscitation skills. Common causes of maternal collapse include thromboembolism, amniotic fluid embolism, anaphylaxis shock, hypovolemic shock, and heart failure. The guidelines recommend assessing the patient's response and airway, providing chest compressions and rescue breaths if not breathing, and continuing resuscitation efforts until advanced life support arrives. Perimortem cesarean section may be considered after 5 minutes of unsuccessful resuscitation to relieve aortocaval compression.
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Cord prolapse occurs when part of the umbilical cord falls in front of the presenting fetal part after rupture of membranes. It is diagnosed by seeing a loop of cord or feeling pulsations on vaginal exam and can cause variable or prolonged fetal decelerations. Management depends on fetal viability - for living fetuses, the most expedient delivery by instrumental delivery or C-section is recommended, while relieving cord compression and replacing it in the vagina. Proper positioning and filling the maternal bladder can help alleviate compression until delivery.
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The document discusses postpartum haemorrhage (PPH), defining it as blood loss exceeding 500ml within 24 hours of delivery (primary PPH) or excessive bleeding from 24 hours to 6 weeks postpartum (secondary PPH). PPH is a leading cause of maternal death. Management involves simultaneous resuscitation, identification of cause such as uterine atony or trauma, and treatment including uterotonic drugs, balloon tamponade, or surgery. Early recognition, teamwork, and avoiding delays in care are essential to prevent mortality from massive PPH.
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Intro 2016
- 1. INTRODUCTION
- 2. MODULE 2 days course Short lectures Workstations- skills & scenarios Video presentation Written assessment Skills assessment
- 3. ADAPTED FROM…. RCOG- OLSS (obstetric life saving skill), guidelines OGSM – intensive course in obstetric emergencies BLS (basic life support)
- 4. CONTENTS OF LECTURES… Maternal mortality APH PPH Blood products Maternal resuscitation Pre eclampsia & eclampsia Labour management Shoulder dystocia Cord prolapse Uterine inversion Fetal monitoring Transfer an ill patient
- 5. WORKSTATION… Maternal resuscitation Breech delivery Shoulder dystocia PPH CTG workshop Instrumental delivery PE and eclampsia MRP
- 6. VIDEOS… Breech delivery Instrumental delivery – Vacuum & Forceps Shoulder dystocia Caesarean section