OBSTETRIC-GYNECOLOGIC CARE IN EMERGENCY AND URGENT CARE
oral test
Identification of pregnancy complications: risk definition, medical gestational complications, midwife duties in maternal care.
Recognition of the emergencies in obtetrics.
Identification and management of the hemorrhagic complications.
Knowledge and carrying out of the obstetric guidelines for the main medical conditions in pregnancy.
Acquisition of professional behaviour for pathological delivery of the placenta and postpartum.
Knowledge of the causes of postpartum complications and of the interventions to carry out, to prevent, identify and manage them, referring to the midwife competence.
Description of the main operative delivery: the duty of the midwife.
Shock
- Definition.
- Signs and symptoms.
- Obstetric shock.
- Obstetric care management (fluids infusion, vital signs monitoring).
First-Trimester bleeding
Fetal demise and abortion: definition, symptoms, laws and certifications.
Ectopic pregnancy: definition, presentation, symptoms, evolution, obstetric care management (psychological support, medications, curettage).
Third-Trimester bleeding
- Placenta previa: definition, symptoms, evolution, obstetric care management.
- Abruptio placentae: definition, classification, symptoms, evolution, obstetric care management (identification of the risk factors for hemorrhagic complications, prevention and early diagnosys of the third-trimester bleeding, maternal and fetal well-being assessment).
Primary postpartum hemorragies
- Definition
- Causes and risk factors (uterine atony, lacerations, coagulopathy, retained products of conception).
- Obstetric management (identification of the high-risk patients, recognition and control of vaginal bleeding, vital signs check, carrying out of the appropriate maneuvers to look after abnormal placentation, manual extraction of the placenta).
Obstetric emergencies
- Uterine rupture.
- Uterine inversion.
- Pre-eclampsia and eclamptic seizures.
- Obstetric care planning (identification of the risk women, keeping of the stages and phases of labor, early definition of shock condition, carrying out of the specific care rules).
Main obstetric operations
- VEX.
- Cerclage.
- Rotation of the fetus.
- History of the forceps.
- Obstetric care planning (woman support, help relation, identification of the risk women, carrying out of the specific care rules).
Umbilical cord dystocia
- Overt and occult umbilical cord prolapse.
- Obstetric care planning.
Shoulder dystocia
Definition.
Risk factors.
Physiological delivery of the shoulders.
The maternal and fetal risks.
Obstetric care planning (early identification of the risk women, carrying out of the appropriate maneuvers, maternal and fetal well-being protection).
Puerperal pathology
- Puerperal infections, vaginal-perineal infections and endometritis.
- Superficial, deep and pelvic thrombophlebitis.
- Breast disease (breast engorgement, clogged milk ducts, mastitis).
- Obstetric care planning.
Trasfusions
Manuale di ginecologia e ostetricia – Pescetto,Dececco, Pecorari, Ragni
Ostetricia e Ginecologia – C.Nappi
Manuale di Ostetricia 21^ed. – Wiliams
Manuale di sala parto – Valle, Bottino, Meregalli, Zanini
Distocia delle spalle – E.Beer, G.Mangiante, D.Pecorari
Trattamento delle gravidanze a rischio – James, Steer, Weiner, Gonik
Assistenza infermieristica e ostetrica in area materno-infantile – P.Di Giacomo, L.A.Rigon
Protocolli e linee guida della Clinica Ostetrico-Ginecologica Universitaria dell’Insubria di Varese
slides
team work
clinical cases