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Midwifery Emergencies at a Glance (eBook)

eBook Download: EPUB
2018 | 1. Auflage
144 Seiten
Wiley-Blackwell (Verlag)
9781119138044 (ISBN)

Lese- und Medienproben

Midwifery Emergencies at a Glance -  Denise Campbell,  Susan M. Carr
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Midwifery Emergencies at a Glance is a succinct, illustrated guide covering the practical skills needed to manage obstetric and midwifery emergencies, as well as high-risk midwifery care. It provides clear guidance on the factors which predispose to complications so that preventative management can be employed whenever possible.  Broad-ranging yet easy-to-read, Midwifery Emergencies at a Glance details the underlying physiology and pathophysiology related to the emergency and explores both the physical and psychological care of the woman, partner and newborn during and following the emergency. 

Key features:

  • Evidence-based, with guidance from the NMC, RCOG, NICE, and The Resuscitation Council
  • Presented in an innovative, visual style that makes the key concepts easy to understand
  • Provides helpful websites that expand on various topics as well as providing information on support groups for the woman and her family

Midwifery Emergencies at a Glance is an ideal guide for practising midwives, pre-registration student midwives, general practitioners and junior doctors to support both revision and clinical practice. 



Denise Campbell, Principal Midwifery Lecturer, University of Hertfordshire, UK.
Susan Carr, Principal Midwifery Lecturer, University of Hertfordshire, UK.

Denise Campbell, Principal Midwifery Lecturer, University of Hertfordshire, UK. Susan Carr, Principal Midwifery Lecturer, University of Hertfordshire, UK.

Preface viii

Abbreviations ix

About the companion website x

Part 1 Professional issues 1

Section 1 Professionalism

1 Professional standards 2

2 Communications during an emergency 4

Part 2 Emergency skills 7

Section 2 Resuscitation

3 Maternal resuscitation 8

4 Neonatal resuscitation 10

Section 3 Haemorrhage

5 Antepartum haemorrhage 14

6 Primary postpartum haemorrhage 16

7 Secondary postpartum haemorrhage 18

Section 4 Malpresentations and multiple pregnancy

8 Occipito posterior positions 20

9 Face and brow presentations 22

10 Breech presentations 24

11 Cord presentation and prolapse 26

12 Twins 28

Section 5 Dystocia

13 Shoulder dystocia 30

14 Uterine dystocia - failure to progress 32

Section 6 Placental separation problems

15 Manual removal of the placenta 34

16 Adhered or partially adhered placenta 36

Section 7 Uterine emergencies

17 Uterine inversion 38

18 Uterine rupture and scar dehiscence 40

Part 3 Medical and psychological emergencies 43

Section 8 Psychological disorders

19 Post-traumatic stress disorder 44

20 Postnatal depression (mood disorder) 46

21 Puerperal (postpartum) psychosis 48

Section 9 Hypertensive disorders of pregnancy

22 Pre-eclampsia 50

23 Eclampsia 52

Section 10 Embolic and coagulation disorders

24 Venous thromboembolism 54

25 Amniotic fluid embolism 56

26 Disseminated intravascular coagulation 58

Section 11 Preterm labour

27 Prelabour rupture of membranes 60

28 Preterm labour and delivery 62

Part 4 Associated skills 65

Section 12 Instrumental and Operative deliveries

29 Instrumental vaginal delivery 66

30 Preparation and transfer to the operating theatre 68

31 Role of the scrub midwife or nurse 70

32 Receiving the baby in the operating theatre 72

33 Immediate care following surgery 74

Section 13 Fetal surveillance

34 Electronic fetal monitoring - actions following a suspicious or pathological trace 76

35 Fetal scalp electrode 78

36 Fetal blood sampling 80

Section 14 Maternal monitoring

37 Recognising the deteriorating woman 82

38 Examination per vaginam 84

39 Speculum examination 86

40 Urinary catheterisation 88

Section 15 Venous skills

41 Venepuncture 90

42 Intravenous cannulation 92

43 Blood transfusion therapy 94

Section 16 Augmentation

44 Artificial rupture of membranes 96

45 Oxytocic augmentation 98

Section 17 Perineal Trauma

46 Third- and fourth-degree tears 100

47 Perineal suturing 102

Section 18 Infection awareness

48 Maternal sepsis 104

49 Source isolation nursing 106

50 Group B streptococcus 108

51 Infection control 110

Part 5 Self-assessment 113

Section 19 Revision and self-assessment

Multiple choice questions 114

Multiple choice answers 121

References 124

Index 131


Multiple choice questions


Chapter 3 Maternal resuscitation


  1. How many women died between 2011 and 2013 due to direct/indirect causes?

    1. 147
    2. 200
    3. 214
    4. 260
  2. Which of the following can complicate the resuscitation of a pregnant woman?

    1. Aortocaval compression/occlusion
    2. Relaxation of the cardiac sphincter
    3. Nasal and pharyngeal oedema
    4. All of the above
  3. During the initial assessment what is the rescuer looking, listening and feeling for?

    1. Fetal movements
    2. Evidence of breathing
    3. Oedema of the glottis
    4. Oedema and movement of the lower extremities
  4. Approximately how much of the woman’s total blood volume can be sequestered in the lower limbs during aortocaval compression?

    1. 30%
    2. 20%
    3. 15%
    4. 10%
  5. How quickly should chest compressions be delivered?

    1. 60–80 compressions per minute
    2. 80–100 compressions per minute
    3. 100–120 compressions per minute
    4. 120–140 compressions per minute
  6. To what depth should chest compressions be administered?

    1. 4–5 cm
    2. 5–6 cm
    3. 6–7 cm
    4. No specified depth
  7. What is the ratio of chest compressions to rescue breaths?

    1. 30 compressions to 2 breaths
    2. 15 compressions to 2 breaths
    3. 3 compressions to 1 breath
    4. 30 compressions to 1 breaths
  8. A perimortem Caesarean section should be performed within how many minutes of the decision to resuscitate?

    1. 5 minutes
    2. 3 minutes
    3. 4 minutes
    4. 6 minutes
  9. Which of the following statements is true re: the use of an automated external defibrillator (AED)?

    1. An AED can be used on a pregnant woman
    2. An AED can be used with caution when it is wet or raining
    3. An accidental shock cannot be administered
    4. All of the above
  10. When should efforts to resuscitate the woman cease?

    1. When spontaneous respirations occur
    2. When spontaneous movement is seen
    3. When instructed by a senior member of staff
    4. Any of the above

Chapter 4 Neonatal resuscitation


  1. Which of the following might predispose a newborn infant to require support at birth?

    1. Recent maternal sedation
    2. Precipitate delivery
    3. Obstetric emergency
    4. All of the above
  2. Which four elements are assessed regularly throughout the resuscitation?

    1. Heart rate, respiratory effort, weight, blood glucose level
    2. Heart rate, respiratory effort, pupil reaction, Moro reflex
    3. Heart rate, respiratory effort, colour, tone
    4. Heart rate, respiratory effort, colour, reflexes
  3. Why is it important to dry the neonate?

    1. To stimulate the baby to take a breath
    2. To dry the baby and prevent radiant heat loss
    3. To maintain the baby’s temperature between 36.5°C and 37.5°C
    4. All of the above
  4. What position should the neonate’s head be in to aid resuscitation?

    1. Neutral position
    2. Extended position
    3. Flexed position
    4. Lateral position
  5. What is the purpose of the inflation breaths?

    1. To remove the amniotic fluid in the alveoli in the lungs of the neonate and back-fill with air
    2. To maintain ventilation of the lungs
    3. To make the baby take a breath
    4. To open the airway
  6. Approximately how much fluid may be present in the alveoli after birth in a term baby?

    1. 10–20 mL
    2. 30–50 mL
    3. 60–90 mL
    4. 100–150 mL
  7. How frequently would you assess the baby’s condition?

    1. Every 20 seconds
    2. Every 30 seconds
    3. Every 45 seconds
    4. Every 60 seconds
  8. When is it appropriate to commence chest compressions?

    1. If the heart rate is below 60 beats per minute and you have seen the chest rise
    2. If the heart rate is below 60 beats per minute and you have not seen the chest rise
    3. If the heart rate is below 60 beats per minute, if you have seen the chest rise and if 30 seconds of ventilation breaths have been given
    4. If the chest has risen and if the heart rate is above 90 beats per minute
  9. What is the acceptable preductal SpO2; in a term baby at 3 minutes of age?

    1. 60%
    2. 70%
    3. 80%
    4. 90%
  10. What drugs are likely to be used should the neonate require pharmacological support?

    1. Sodium bicarbonate 4.2% (1–2 mmol per kg); adrenaline 1 in 10 000 solution (10 mcg per kg); dextrose 10% (2.5 mL per kg)
    2. Sodium bicarbonate 4.2% (5 mmol per kg); adrenaline 1 in 10 000 solution (10 mcg per kg); dextrose 10% (2.5 mL per kg)
    3. Sodium bicarbonate 4.2% (1–2 mmol per kg); adrenaline 1 in 10 000 solution (5 mcg per kg); dextrose 10% (2.5 mL per kg)
    4. Sodium bicarbonate 4.2% (1–2 mmol per kg; adrenaline 1 in 10 000 solution (10 mcg per kg); dextrose 5% (2.5 mL per kg)

Chapter 5 Antepartum haemorrhage


  1. Antepartum haemorrhage is defined as:

    1. Bleeding from the gastrointestinal tract after 24 weeks’ gestation and before the birth of the baby
    2. Bleeding from the genital tract during the first trimester of pregnancy
    3. Bleeding from the genital tract after 24 weeks’ gestation and before the birth of the baby
    4. A blood loss from the genital tract of an amount greater than 500 ml
  2. Which is a predisposing factor for antepartum haemorrhage caused by placental abruption?

    1. Maternal cardiac conditions
    2. Raised body mass index (BMI)
    3. Pre-eclampsia
    4. Gestational diabetes mellitus
  3. Which is a predisposing factor for antepartum haemorrhage caused by placenta praevia?

    1. Teenage pregnancy
    2. Primigravid woman
    3. Intrauterine growth retardation
    4. Multiple pregnancy
  4. From the possible complications arising from an antepartum haemorrhage, which one is incorrect?

    1. Postpartum haemorrhage
    2. Disseminated intravascular coagulation
    3. Diabetes mellitus
    4. Renal failure
  5. Which presenting factor is not an indicator of uterine rupture?

    1. Fetal heart rate abnormalities
    2. Constant lower abdominal pain
    3. Vaginal bleeding
    4. Cord prolapse
  6. What other differential diagnoses might present with similar symptoms?

    1. Acute polyhydramnios
    2. Chorioamnionitis
    3. Trauma to the maternal abdomen
    4. All of the above
  7. Which of the following is not part of the role of the midwife?

    1. Reassure the woman and her partner
    2. Undertake an examination per vaginam to ascertain the cause of the bleeding
    3. Make a rapid referral as the woman’s condition can deteriorate quickly
    4. Ascertain as much detail as possible regarding the history of the blood loss
  8. Placenta praevia may be considered when:

    1. There is a lack of vaginal bleeding
    2. The abdomen feels ‘board-like’ on palpation
    3. The presenting part of the fetus is palpated above the pelvis and/or the lie is unstable
    4. The placenta is located in the upper segment of the uterus on ultrasound scanning
  9. How would a woman present when experiencing a placental abruption?

    1. Anxious and in pain
    2. Relaxed
    3. Flushed
    4. Bradycardic
  10. A concealed antepartum haemorrhage may lead to:

    1. The uterus feeling hard on palpation
    2. Difficulty in palpation of the fetus
    3. Auscultation of the fetal heart becoming difficult or impossible
    4. All of the above

Chapters 6 and 7 Postpartum haemorrhage


  1. From the list below of the causes and predisposing factors for primary postpartum haemorrhage which one is incorrect?

    1. Genital tract sepsis
    2. Uterine atony
    3. Genital tract trauma
    4. Preterm labour
  2. From the list below of the causes and predisposing factors for primary postpartum haemorrhage which one is ­correct?

    1. White ethnicity
    2. Mismanagement of the third stage of labour
    3. Active management of the third stage of labour
    4. Maternal haemoglobinopathy
  3. The most common cause of postpartum haemorrhage is:

    1. Uterine atony
    2. Trauma to the genital tract
    3. Retained fragments of the placenta, membranes or retroplacental clot
    4. Maternal clotting disorder
  4. Which pharmacological treatment is not used to manage uterine atony?

    1. Syntocinon 5–10 IU given IM
    2. Syntocinon 40 IU in 500 mL 0.9% sodium chloride IV infusion
    3. Syntometrine 1 mL given...

Erscheint lt. Verlag 30.8.2018
Reihe/Serie At a Glance (Nursing and Healthcare)
Wiley Series on Cognitive Dynamic Systems
Wiley Series on Cognitive Dynamic Systems
Sprache englisch
Themenwelt Medizin / Pharmazie Gesundheitsfachberufe Hebamme / Entbindungspfleger
Medizin / Pharmazie Medizinische Fachgebiete Gynäkologie / Geburtshilfe
Medizin / Pharmazie Medizinische Fachgebiete Notfallmedizin
Medizin / Pharmazie Pflege
Schlagworte Amniotic fluid embolism • antepartum haemorrhage • Artifical rupture of membranes • Assisting with fetal blood sampling • Assisting with Ventouse Kiwi delivery Assisting with forceps delivery • breech birth • Cannulation • Cardiotocograph interpretation • Cord prolapse and presentation • Disseminated intravascular coagulation • Eclampsia • Examination per vaginam • Geburtshilfe • Hebammenpraxis • intravenous drugs • Krankenpflege • Krankenpflege i. d. Frauenheilkunde • Labour dystocia • <p>Guide to midwife emergencies • Management of blood transfusion • Management of deep vein thrombosis • Management of maternal streptococcus B infection intrapartum</p> • Management of Pulmonary Embolism • Manual Removal of Placenta • Maternal resuscitation • Medical Science • Medizin • Midwifery • Neonatal resuscitation • nursing • Obstetrics • of membranes • Perineal suturing • placental abruption • Placenta praevia • Postpartum Haemorrhage • Pre‐eclampsia • Premature rupture • Prolonged pregnancy Application of fetal scalp electrode • Prolonged rupture of membranes • Sepsis • shoulder dystocia • Trauma in childbirth • Urinary catheterisation • Uterine inversion • Uterine Rupture • Venepuncture • Women's Health Nursing
ISBN-13 9781119138044 / 9781119138044
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