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Gepubliceerd in:
hoofdstuk lezen eerste hoofdstuk lezen

2024 | OriginalPaper | Hoofdstuk

30. Obstetric emergencies

Auteurs : Dr. Kim Verdurmen, Dr. Eline van den Akker, Dr. Annemarie Fransen, Martijn de Voogd, MSc, Dr. Gerrit-Jan Noordergraaf, Prof. dr. Guid Oei, Dr. Jan Erkamp, Dr. Jérôme Cornette

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

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Summary

Emergencies can occur during pregnancy, childbirth or postpartum, and they can endanger the health of both mothers and their babies. This may result in maternal and/or perinatal mortality or severe morbidity. Adequate management is essential and can substantially improve outcomes for both mother and child. The structured method for assessing critically ill patients consists of a primary and secondary survey. The primary survey follows the ABCDE approach, which is based on the ‘treat first what kills first’ principle. This uniform approach enables the systematic and timely assessment of potential life-threatening conditions during an emergency and facilitates communication between different caregivers. In this chapter, we describe several obstetric emergencies and provide a structured proposal for the management of these emergencies.
vorige hoofdstuk Childbirth and puerperium
volgende hoofdstuk Future perspectives part VI
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Woordenlijst
ABCDE-approach
The ABCDE approach is an almost universally applicable strategy for the initial assessment and resuscitation of critically ill patients. Systems are evaluated and managed simultaneously in the order of their potential threat to the patient’s survival: airway, breathing, circulation, disability and exposure.
Diabetic ketoacidosis
A life-threatening problem that affects people with diabetes. DKA develops when your body does not have enough insulin to allow blood sugar into your cells for use as energy. Anaerobic metabolism causes the blood to become acidic.
Drug toxicity
Formally defined as “a diverse array of adverse effects which are brought about through drug use at either therapeutic or non-therapeutic doses.”
Eclampsia
A severe complication of preeclampsia. It is a rare but serious condition characterised by tonic-clonic convulsions (seizures) during pregnancy or postpartum. It is associated with morbidity and mortality of both the mother and foetus.
Maternal mortality rate
A maternal death is defined by the World Health Organization as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”
Maternal sepsis
A life-threatening condition, where there is organ failure due to an infection during pregnancy, childbirth, post abortion or postpartum.
Perimortem caesarean section
The surgical delivery of the foetus, performed during the cardiac arrest of the mother primarily in order to facilitate return of spontaneous circulation. It is also called a ‘resuscitative caesarean section’ as it is performed for this purpose.
Preeclampsia
A combination of high blood pressure with proteinuria, maternal organ dysfunction or uteroplacental dysfunction.
Respiratory failure
Results from inadequate gas exchange by the respiratory system, meaning that the arterial oxygen, carbon dioxide or both cannot be kept at normal levels.
Shoulder dystocia
A complication of vaginal delivery in which the baby’s shoulder is stuck above the mother’s pubic bone. It is characterised by failure to deliver the foetal shoulders using just gentle downward traction, the need for additional delivery manoeuvres to deliver the baby successfully and/or a documented head-to-body interval of greater than one minute.
Symphysiotomy
A surgical division of the fibres of the pubic symphysis to allow separation of the joint and enlargement of the pelvic dimensions during childbirth.
Prolapse of the umbilical cord
A loop of the cord descends through the cervical ostium into the vagina before the foetal presenting part. Compression of the cord between the foetal presenting part and the pelvis and vasoconstriction compromises foetal oxygenation.
Voetnoten
1
Thanks to Jan Erkamp for helping to shoot and edit the video.
 
Literatuur
1.
Baskett TF, Calder AA, Arulkumaran S. Munro Kerr’s Operative Obstetrics. Eleventh edition 2007. Saunders Elsevier.
2.
Brown et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertension. 13 (2018), 291–310.
3.
Burns and Dent. Managing Medical and Obstetric Emergencies and Trauma. Fourth Edition. Advanced Life Support Group. Wiley Blackwell. ISBN: 9781119645740.
4.
Dörr et al. Obstetrische interventies. Second Edition. Reed Business Education. ISBN: 978-90-352-3475-8.
5.
Fransen AF, Van de Ven J, Banga FR, Mol BWJ, Oei SG. Multi-professional simulation-based team training in obstetric emergencies for improving patient outcomes and trainees’ performance. Cochrane Database Syst Rev. 2020;12:CD011545.
6.
Jeejeebhoy FM, Zelop CM, Lipman S, Carvalho B, Jolar , Mhyre JM, et al. Cardiac arrest in pregnancy. A scientific statement from the American Heart Association. Circulation, 2015;12:1747–1773.
7.
Kallianidis AF, Schutte JM, Schuringa LEM, Beenakkers ICM, Bloemenkamp KWM, Braams-Lisman BAM, Cornette J, Kuppens SM, Rietveld AL, Schaap T, Stekelenburg J, Zwart JJ, Van den Akker T. Confidential enquiry into maternal deaths in the Netherlands, 2006–2018.
8.
9.
Paterson-Brown S, Howell C. Managing Obstetric Emergencies and Trauma. The MOET Course Manual. 3rd Edition.
10.
Royal College of Obstetricians & Gynaecologists. Shoulder Dystocia. Green-top Guideline no. 42. March 2012.
11.
Royal College of Obstetricians & Gynaecologists. Umbilical Cord Prolapse. Green-top Guideline no. 50. November 2014.
Metagegevens
Titel
Obstetric emergencies
Auteurs
Dr. Kim Verdurmen
Dr. Eline van den Akker
Dr. Annemarie Fransen
Martijn de Voogd, MSc
Dr. Gerrit-Jan Noordergraaf
Prof. dr. Guid Oei
Dr. Jan Erkamp
Dr. Jérôme Cornette
Copyright
2024
Uitgeverij
Bohn Stafleu van Loghum
Boek
Textbook of Obstetrics and Gynaecology

Print ISBN: 978-90-368-2993-9

Elektronisch ISBN: 978-90-368-2994-6

Copyright: 2024

DOI
https://doi.org/10.1007/978-90-368-2994-6_30