Emergent delivery

Background

• Prolapsed cord
  • Do NOT attempt to reduce
    • Instead,elevate the presenting fetal part to reduce compression and transport to OR
• Breech presentation
  • Try to let the delivery occur spontaneously without touching the fetus

Physical Examination

Digital Examination of the Vagina

1. Cervical Dilatation
   1. 0 cm (closed/fingertip) to 10 cm (complete/fully dilated)
2. Effacement
   1. assessment of the cervical length
   2. percentage of normal 3-4 cm long cervix
   3. 4cm cervix = 0%; 0cm (thin) cervix = 100%
3. Station (-5 to +5)
   1. (distance of the presenting body relative to the maternal ischial spines)
      1. -3 = beginning of second stage of labor
      2. 0 = in line with the plane of the maternal ischial spines
      3. +3 = impending delivery
      4. +4 to +5 = crowning