China
Africa
Explore chapters and articles related to this topic
Management of Labour
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
The components of AMTSL include administering a uterotonic agent at or after delivery of the fetus (avoid after the birth of the first child in multiple pregnancies), late cord clamping, and placental delivery by controlled cord traction. In addition, assessment of the fundus for tone is necessary, but routine fundal massage is not recommended any more.
Postpartum hemorrhage
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Wade D. Schwendemann, William J. Watson
Initial treatment after all deliveries includes removal of placental tissue, either expectantly or through the use of the Crede maneuver (18), as well as fundal massage. This also allows for assessment of uterine contraction. A fundus that is not firm should be vigorously massaged both abdominally and vaginally to increase uterine tone.
Primary Postpartum Haemorrhage
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Malik Goonewardene
Fundal massage, which is the first step in managing uterine atony, should be applied with circular movements of the left hand on the fundus of the uterus. Only gentle rubbing is needed to initiate uterine contractions. Vigorous rubbing is unnecessary and could possibly even be counterproductive. Blood clots within the lower uterine segment, the cervical canal and in the vagina should be simultaneously removed with the index and middle fingers of the right hand in the vagina (Figure 14.1). If these blood clots are not removed, then the uterus would not be able to contract adequately, in spite of high and repeated doses of uterotonics. It is important to identify the uterine fundus carefully in obese women because a roll of abdominal fat may be mistaken for the uterus. A two-handed technique of applying fundal massage is also described.
Epidemiology of Oxytocin Administration in Out-of-Hospital Births Attended by Paramedics
Published in Prehospital Emergency Care, 2021
Brendan V. Schultz, Shonel Hall, Lachlan Parker, Stephen Rashford, Emma Bosley
We retrieved all obstetric related incidents between the 1st January – 31st December 2018 from the QAS Data Warehouse. Paramedics prospectively complete a Digital Ambulance Report Form (DARF) for attended patients, which documents the primary complaint of the patient, pertinent scene findings, routinely collected vital signs, any management provided and a summary case narrative. Incidents were considered to involve an OOH birth if the attending paramedic provided obstetric specific management e.g. assisted with childbirth, cord clamping, or fundal massage, as coded in variable fields within the DARF or within the free-text case narrative. Incidents involving childbirth were included if the birth occurred prior to or after the arrival of paramedics. Births that occurred in the presence of a midwife (homebirth) or involved the birth of a non-viable fetus (less than 20 weeks gestation) were excluded to remain consistent with previous literature on OOH births (5,21).