The ABCs of obstetrics
The following table provides the urgency indicators for obstetrics.
|Urgency||Urgency Indicator||Reason for Caution|
Points to remember
- Hyperdynamic physiological changes occur as early as 6-8 weeks gestation.
- An assessment of urgency must be made on the basis of both the woman and the foetus.
- An elevated BP is an ominous sign: the higher the BP the more urgent the review.
- At 20 weeks the weight of the uterus compresses the inferior vena cava if the woman is lying on her back - a compromise to foetal wellbeing.
- The risk of many conditions is higher in pregnant women than non-pregnant women of child bearing age. These conditions include:
- cerebral haemorrhage or cerebral thrombosis
- severe pneumonia
- atrial arrythmias
- venous thrombosis
- spontaneous arterial dissections, e.g. splenic and subclavian dissections, with no previous medical history.
- Domestic violence is more prevalent during pregnancy. This can mean increased complications for mother and adverse neonatal outcomes.
- In the setting of trauma, maternal signs may remain stable even when the loss of one-third of blood volume may have occured.
- The best initial treatment for the foetus is the optimum resuscitation of the mother.