Adult Imminent Delivery

Question 1

Adult Imminent Delivery - Pt is not crowning and has no urge to push?

Answer 1

Place in left lateral recumbent position and transport

Question 2

Adult Imminent Delivery - Pt is crowning or has a strong urge to push?

Answer 2

Check for breech, limb or cord presentation

Question 3

Adult Imminent Delivery - Signs of true labour?

Answer 3

Regular contractions
Intervals between contractions shorten
Intensity increases with ambulation
Contractions increase in duration and intensity

Question 4

Adult Imminent Delivery - Signs of false labour?

Answer 4

Irregular Contractions
Contractions are irregular and do not shorten in interval
Ambulating has no effect on contractions
No change in duration or intensity

Question 5

Adult Imminent Delivery - Obstetrical history questions?

Answer 5

G (Gravida): number of pregnancies
T (Term): number of term babies born
P (Pre-term): number of pre-term babies born < 37 wks
A (Aborta): Abortions
L (Living): number of living children
M (Multi): number of multiple births

Question 6

Adult Imminent Delivery - 4 Ms obstetrical questions?

Answer 6

Maturity: gestational age, due date
Multipara: number of fetuses
Meconium: presence of meconium
Medications: medications currently being used

Question 7

Adult Imminent Delivery - Delivery procedure? 3 items

Answer 7

• Applying gentle pressure on head and the perineum
• Check if the umbilical cord is wrapped around the neck
• Delay clamping cord for 1-2 minutes in uncomplicated deliveries

Question 8

Adult Imminent Delivery - Care for mother after delivery? 5 items

Answer 8

• Inspect perineum for tears and active bleeding
• Encourage breastfeeding
• Place the placenta in a biohazard bag and bring it to the hospital for evaluation
• Usual maternal blood loss is about 500 mL; if hemorrhage continues, refer to Adult Childbirth - Post–Partum Hemorrhage Protocol
• Perform fundal massage every 10 minutes to reduce blood loss

Question 9

Adult Imminent Delivery - S/S of shoulder dystocia? 3 items

Answer 9

• Failure of the head to advance with crowning
• Slowing of progress of labour and formation of a caput succedaneum that increases in size
• Spontaneous restitution does not occur

Question 10

Adult Imminent Delivery - Treatment of shoulder dystocia? 5 items

Answer 10

• McRoberts Maneuver — knees to shoulders position — -Release legs between pushes
• May try to sit patient up or a squatting position
• Apply downward pressure on suprapubic area
• Deliver anterior shoulder then posterior shoulder

Question 11

Adult Imminent Delivery - post delivery medication for mother?

Answer 11

Oxytocin 10 IU IM

Question 12

Adult Imminent Delivery - Oxytocin indications

Answer 12

Post-partum

Question 13

Adult Imminent Delivery - Oxytocin dose

Answer 13

10 IU IM

Question 14

Adult Imminent Delivery - Oxytocin EMS contraindications

Answer 14

Hypersensitivity
Uterine inversion
Placenta previa
Abruptio placentae

Question 15

Adult Imminent Delivery - Oxytocin precautions

Answer 15

In the setting of multiple gestation births, do not administer until all fetuses have been delivered

Question 16

Adult Imminent Delivery - Delivery preparations? 8 items

Answer 16

Prepare OB kit
Assemble BVM
Prepare oxygen
Adjust powered suction to 80 - 100 mmHg
Turn up heat
Have blankets / towels
Have intubation equipment 
Ensure access to French suction catheter