Trauma In Pregnancy
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Section 7 - PEDIATRIC / OBSTETRICAL
7.12 Trauma in Pregnancy
- Check for uterine contractions, vaginal bleeding and / or leaking amniotic fluid. Assess for fetal movements.
- Raise right side of backboard approximately 30 degrees.
- If hypotension / shock present, refer to SHOCK PRACTICE PARAMETER (5.13).
- If patient in labor refer to the EMERGENCY CHILDBIRTH PRACTICE PARAMETERS (7.06).
- Maternal health and well being should not be compromised to save a fetus of any gestational age.
- Emergency C-Section should only be considered when maternal death has verified and is determined to be irreversible
- Fetus viability- 24 weeks gestational age or greater.
- For optimal survival C-Section should be performed within 4 minutes of maternal death
- Assess fetal heart tones if possible
- Prepare Equipment- OB kit, trauma pads, and infant resuscitation equipment.
- Locate anatomical landmarks for incision-Xiphoid Process and Pubis
- Using a scalpel, perform vertical incision midline between-Xiphoid Process and Pubis
- Cut through each layer of the abdominal wall with the scalpel and/or scissors.
- Lift skin and pull apart working through the layers
- Using the scalpel make initial incision in the uterus.
- Using scissors cut the uterine wall.
- Remove neonate,
- Suction the neonate’s airway.
- Double clamp the cord
- Keep the infant lower than the mother.
- Wait for the cord to stop pulsating,
- Record APGAR at 1 and 5 minutes.
- Transport to the appropriate facility.