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Summary obgyn- obstetrics emergencies royal college of surgeons ireland £4.78   Add to cart

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Summary obgyn- obstetrics emergencies royal college of surgeons ireland

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lecture notes-obstetrics emergencies

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  • March 19, 2023
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OG 2.2
Anatomy of the Female Pelvis


OG 5.5 Intrapartum and Postpartum care
Class Senior Cycle 1
Course Obstetrics and Gynaecology
Code SC1 Obs
Title Obstetric Emergencies
Date April 2020
Department of Obstetrics & Gynaecology
Department of Anatomy
Royal College of Surgeons in Ireland

, Obstetric Emergencies
• Antepartum
– PET/ Eclampsia
– Placental Abruption
– Placenta Praevia
• Intrapartum
– Cord prolapse
– Uterine rupture
– Shoulder dystocia
– Acute uterine inversion
• Postpartum
– Massive obstetric haemorrhage/PPH
– Amniotic fluid embolism



Department of Obstetrics & Gynaecology,
RCSI

, Pre-Eclamspia (PET)
• Hypertensive disorders affect • Mild to moderate
10-15% of pregnancies – Hypertension ≥ 140/90mmHg

• Pre-eclampsia 3-5%; Defined – Proteinuria >0.3g/24hrs

– No biochemical dysfunction
as hypertension and
• Severe (1:200 women)
proteinuria
– BP ≥ 160/100mmHg
• 19 maternal deaths 2006- – Proteinuria often >1g/24hrs
2008 (CMACE) – Biochemical dysfunction (low platelets, raised

• Appropriate management LFTs )

– Clinical signs: oedema, headache, visual
reduces maternal morbidity
disturbances, epigastric pain, vomiting,
and mortality hyperreflexia, clonus



Department of Obstetrics & Gynaecology,
RCSI

, Pre-Eclamspia (PET) Definition
Diagnostic Criteria for Preeclampsia
Blood pressure
Systolic blood pressure of 140 mm Hg or more or diastolic blood pressure of 90 mm Hg or more on two
occasions at least 4 hours apart after 20 weeks of gestation in a woman with a previously normal blood
pressure
Systolic blood pressure of 160 mm Hg or more or diastolic blood pressure of 110 mm Hg or more. (Severe
hypertension can be confirmed within a short interval (minutes) to facilitate timely antihypertensive therapy).
and
Proteinuria
300 mg or more per 24 hour urine collection (or this amount extrapolated from a timed collection) or
Protein/creatinine ratio of 0.3 mg/dL or more or
Dipstick reading of 2+ (used only if other quantitative methods not available)
Or in the absence of proteinuria, new-onset hyper- tension with the new onset of any of the following:
Thrombocytopenia: Platelet count less than 100,000 3 109/L
Renal insufficiency: Serum creatinine concentrations greater than 1.1 mg/dL or a doubling of the serum
creatinine concentration in the absence of other renal disease
Impaired liver function: Elevated blood concentrations of liver transaminases to twice normal concentration
Pulmonary oedema
New-onset headache unresponsive to medication and not accounted for by alternative diagnoses or visual
symptoms

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