Rupture of the Uterus
Figure 24.1 Types of scar rupture: (a) complete rupture; (b) scar dehiscence. The most important risk factor for uterine rupture is the presence of a previous scar. Other causes are…
Postpartum Haemorrhage
Ethnicity (Black African, Asian)BMIPrevious PPHAssisted conception (multiple pregnancy or abnormal placentation)During pregnancyMultiparityMultiple pregnancyPolyhydramnios uterine fibroidsPre-eclampsiaIntrapartumOperative vaginal deliveryChorioamnionitisProlonged labourAugmented labourPrecipitate labourEpisiotomy Table 15.2 The 4 ‘T’s: the mechanisms by which bleeding…
Management of Severe Pre-Eclampsia/Eclampsia
Figure 25.1 Maternal mortality from eclampsia and pre-eclampsia: England and Wales 1952–84; United Kingdom 1985–2005. Figure 25.2 Maternal mortality from eclampsia (grey) and pre-eclampsia (black) in the United Kingdom. Presentation…
Induction of Labour
≥656 87827 06561 68535 619Multiparous women≤5≥627 63315 63235 15514 488 Position of Vertex Persistent occipito-posterior position has been associated with increased chance of failure of IOL [8]. Body Mass Index…
Antepartum Haemorrhage
Placental abruptionVasa praevia31220.5UnclassifiedMarginal34Genital tractCervicitisTraumaVulvovaginal varicositiesGenital infectionsGenital tumoursOthers8.05.02.00.50.50.5 Diagnosis and Management Antepartum haemorrhage by nature is unpredictable, and the bleeding at presentation can be significant or non-substantial. The management of any…
Team Working, Skills and Drills on the Labour Ward
SBAR – clarify the situation and background, then make an assessment and a recommendation loudly for everyone to hear; including patient and companions who can then be informed in the…
Management of Morbidly Adherent Placenta
Figure 16.1 Placenta percreta with presence of placental lacunae on ultrasound scan. Note the ‘moth-eaten’ appearance. MRI has been shown to be equivalent to ultrasound in the diagnosis of invasive…
Triage and Prioritization in a Busy Labour Ward
Fetal (3F)Postpartum ‘trickling’Prolonged second stage of labour with a normal CTG4. Can wait until other emergencies are under controlMaternal (4M)Fetal (4F)Rupture of membranes with no contractions and normal CTGMeconium staining…
The Immediate Puerperium
html xmlns=”http://www.w3.org/1999/xhtml” xmlns:mml=”http://www.w3.org/1998/Math/MathML” xmlns:epub=”http://www.idpf.org/2007/ops”> Chapter 27 The Immediate Puerperium Shankari Arulkumaran Best Practice in Labour and Delivery, Second Edition, ed. Sir Sabaratnam Arulkumaran. Published by Cambridge University Press. © Cambridge…
The Management of Preterm Labour
Figure 21.1 Non-reassuring preterm cardiotocographic trace. A nulliparous woman presented with contractions and spontaneous rupture of the membranes with maladorous amniotic fluid at 34 + 2/7 weeks’ gestation. The cervical…
