Name Course : This course deals with clinical management of obstetrical emergencies Description and high risk pregnancies, including the elements of Reproductive Health. Course : At the end of the course, the student should be able to: Objectives 1. Provide midwifery care and supervise women with high risk pregnancy during pre-natal, internal and post-natal period; 2. Execute emergency measures in OB emergency cases; 3. Attend caesarian section as a scrub assistant; 4. Provide post caesarian section care. 5. Discuss the elements of Reproductive Health Course : 3 units lecture Credits Contact : Hours 3 hrs lecture/week Pre- : M-102 (Midwifery Practice 2) requisites Course : I. High Risk Client Outline A. Definition and Scope of the Problem B. Risk Factors C. Assessment of the High Risk Factors 1. History and Physical Examination 2. Biophysical Monitoring 3. Biochemical Monitoring 3.1 Maternal urine Assessment 3.2 Maternal Blood Assessment 3.3 Amniotic Fluid Assessment 3.4 Assessment of Fetal Well Being D. Health Disorders Complicating Pregnancy 1. Diabetes 2. Cardiac Disease 3. Renal Disease 4. Pulmonary Disease and Respiratory Distress E. Complications During Pregnancy 1. Hemorrhagic Complications 2. Spontaneous Abortion 3. Ectopic Pregnancy 4. Gestational Trophoblastic Disease 5. Disseminated Intravascular Coagulopathy 6.1 Abruptio Placenta 6. Placental Abnormalities 6.2 Placenta Previa 6.3. Invasive Placenta 6.4 Vasa Previa 7. HypertensiveDisorders F. Complications During Labor and Birth 1. Dysfunctional Labor Dystocia Malpositions/Malpresentations Multiple Pregnancy Precipitate Labor Premature Rupture of Membranes 2. Hemorrhagic Complications Ruptured uterus Inversion of the Uterus Lacerations 3. Infant Complications Pre-maturity Post maturity Birth Injuries G. Complications During Post Partum period 1. Hemorrhagic Complications 1. Retained Placenta 2. Uterine Atony 3. Inversion of the Uterus 4. Subinvolution of the Uterus 5. Laceration of birth Canal 2. Maternal Infections II. Emergency Obstetrics A. Vaginal Bleeding 1. During Early Pregnancy 2. During Later Pregnancy and Labor 3. After Childbirth B. Shock C. Malpositions and Malpresentations D. Shoulder Dystocia E. Fetal Distress in Labor F. Prolapsed Cord G. Difficulty in Breathing H. Elevated Blood Pressure I. Unsatisfactory Progress of Labor III. Operative Obstetrics 1. Analgesia and Anesthesia 2. Operative Care Principles 1. Pre-Operative 2. Intra Operative 3. Post Operative 3. Dressing and Wound Care 4. Operative Procedures 1. Dilatation and Curretage 2. Vacuum Extraction 3. Forceps Delivery 4. Caesarian Section 5. Post Partum Hysterectomy IV. Ten Elements of Reproductive Health Laboratory : OHP, Major and minor OR Set, Operating Room set up, pelvic models, & birth simulator Equipment Texts & : Gilbert and Hamon, High Risk Pregnancy and Delivery, Mosby 2003 References Miles Textbook for Midwives Managing Complications in Pregnancy and Childbirth, WHO th Berek, Jonathan S., Novaks Gynecology, 12 edition 1988 Piliterri, Adelle, Maternal and Child Health Nursing, Lippincott 2003