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Managing Complications in Pregnancy and Childbirth


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Clinical principles: rapid initial assessment; talking with women and their families; emotional and psychological support; emergencies; general care and principles; clinical use of blood, blood products and replacement fluids; antibiotic therapy; anaesthesia and analgesia; operative care principles; normal labour and childbirth; newborn care principles; provider and community linkages. Symptoms: vaginal bleeding in early pregnancy; vaginal bleeding in later pregnancy and labour; vaginal bleeding after childbirth; headache, blurred vision, convulsions or loss of consciousness, elevated blood pressure; unsatisfactory progress of labour; malpositions and malpresentations; shoulder dystocia; labour with an overdistended uterus; labour with a scarred uterus; foetal distress in labour; prolapsed cord; fever during pregnancy and labour; fever after childbirth; abdominal pain in early pregnancy; abdominal pain in later pregnancy and after childbirth; difficulty in breathing; loss of foetal movements; prelabour rupture of membranes; immediate newborn conditions or problems. Procedures: paracervical block; pudendal block; local anaesthesia for caesarian section; spinal (subarachnoid) anaesthesia; ketamine; external version; induction and augmentation of labour; vacuum extraction; forceps delivery; caesarean section; symphysonotomy; craniotomy and craniocentesis; dilatation and curettage; manual vacuum aspiration; culdocentesis and colpotomy; episiotomy; manual removal of placenta; repair of cervical tears; repair of vaginal and perinetal tears; correcting uterine inversion; repair of ruptured uterus; uterine and utero-ovarian artery ligation; postpartum hysterectomy; salpingectomy for ectopic pregnancy. Appendix: essential drugs for managing complications in pregnancy and childbirth.

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