9781853158100

Table of Contents


	Foreword	ix
	Preface	xi
	Acknowledgements	xii
	Abbreviations	xiii
	Glossary	xv
	Bleep/Crash Calls	xvii
PART I	APPROACH TO CARE	1
1	Communication	3
2	Documentation	6
3	Admission to, and Discharge Home from, the Delivery Suite	8
4	Learning from Clinical Incidents	9
5	Transfer of Care Between Professionals	12
6	Reviewing What Happened	15
	Further Reading for Part 1	16
PART II	NORMAL AND LOW-RISK LABOUR	17
7	Vaginal Examination	19
8	Intravenous Cannulation	20
9	Management of Normal Labour	21
10	Prelabour Rupture of Membranes at Term (37-42 Weeks)	23
11	Management of the First Stage of Labour	26
12	Fetal Monitoring	30
13	Fetal Scalp Blood Sampling	35
14	Augmentation of Labour	37
15	Cord-Blood Sampling	41
16	Epidural Analgesia in Labour	42
17	Management of the Second Stage of Labour	51
18	Criteria for Paediatric Attendance at Delivery	54
19	Management of the Third Stage of Labour	55
20	Immediate Postpartum Care	57
21	Care of the Newborn	59
22	Meconium-Stained Amniotic Fluid	62
23	Neonatal Resuscitation	64
24	Babies Born Before Arrival at Hospital	68
25	Episiotomy	69
26	The Woman with a History of Childhood Sexual Abuse	70
27	Use of Birthing Pool	71
	Further Reading for Part II	74
PART III	ABNORMAL AND HIGH-RISK LABOUR	79
SECTION 1	POWERS, PASSENGER, PASSAGE	81
28	Caesarean Section	81
29	Recovery of Obstetric Patients	85
30	High-Dependency Care	86
31	Failed Intubation Drill	88
32	Instrumental Delivery	89
33	Trial of Vaginal Delivery After a Previous Caesarean Section	97
34	Induction of Labour	99
35	Antenatal Corticosteroid Therapy	104
36	Preterm Prelabour Rupture of Membranes	105
37	Preterm Uterine Contractions	107
38	Deliveries at the Lower Margin of Viability	112
39	Multiple Pregnancy	114
40	Abnormal Lie in Labour	119
41	Occipitoposterior Position	121
42	Malpresentation	122
43	Breech Presentation	124
44	External Cephalic Version	128
45	The Woman with Genital Mutilation	130
46	The Obese Woman in Labour	132
47	Perinealtear	133
SECTION 2	MEDICAL CONDITIONS	135
48	Heart Disease in Labour	135
49	Peripartum Cardiomyopathy	137
50	Pre-Eclampsia	139
51	Eclampsia	150
52	Diabetes Mellitus	153
53	Asthma (Acute Exacerbation in Labour)	159
54	Epilepsy	161
55	Systemic Lupus Erythematosus	164
56	Other Connective Tissue Disorders	166
SECTION 3	HAEMORRHAGE AND HAEMATOLOGICAL DISORDERS	167
57	The Rhesus-Negative Woman	167
58	Thromboembolism Prophylaxis	169
59	Acute Venous Thromboembolism and Pulmonary Embolism	173
60	Major Haemoglobinopathy	180
61	Inherited Coagulation Disorders: Haemophilia and von Willebrand Disease	183
62	Immune Thrombocytopenic Purpura	185
63	Thrombophilia	187
64	Gestational Thrombocytopenia	189
65	Antepartum Haemorrhage	190
66	Major Placenta Praevia	194
67	Retained Placenta	195
68	Postpartum Haemorrhage	196
69	Disseminated Intravascular Coagulopathy	200
70	Delivery of the Woman at Known Risk of Haemorrhage	201
71	Management of the Woman Who Declines Blood Transfusion	203
SECTION 4	INFECTION	207
72	Prophylactic Antibiotics	207
73	Intrapattum Pyrexia	208
74	Hepatitis B and C	209
75	Intrapartum Antibiotic Prophylaxis for Group B Streptococci	210
76	Genital Herpes	212
77	Human Immunodeficiency Virus	214
SECTION 5	OTHER OBSTETRIC EMERGENCIES	217
78	Cervical Tear and Paravaginal Haematoma	217
79	Rupture of the Uterus	218
80	Shoulder Dystocia	220
81	Cord Prolapse	223
82	Anaphylaxis	225
83	Inverted Uterus	226
84	Amniotic Fluid Embolism	228
85	Sudden Maternal Collapse	230
86	Latex Allergy	232
SECTION 6	STILLBIRTHS AND CONGENITAL ABNORMALITIES	235
87	Checklist for Fetal Loss at 13�23 Weeks	235
88	Intrauterine Fetal Demise	236
89	Mid-Trimester Termination of Pregnancy for Fetal Abnormality	241
90	Protocol for Medical Termination of Mid-Trimester Pregnancy	243
	Further Reading for Part III	245
	APPENDICES	261
Appendix A	Guidance for Obtaining Consent to Treatment	263
Appendix B	Standards for Administering Blood Transfusion	267
	Index	271