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Precipitous Labor and Emergency Department Delivery

  • Brian SharpEmail author
  • Kristen Sharp
  • Eric Wei
Chapter

Abstract

Precipitous or emergency department (ED) delivery is a stressful event that requires preparation to comfortably approach and safely manage—often including development of ED delivery checklists or kits and appropriate expedited consultant notification (i.e., paging lists). Complications are rare but include shoulder dystocia, prolapsed umbilical cord, and breech presentation. If a shoulder dystocia is encountered, an algorithm of maneuvers can be employed and should start with McRoberts maneuver and application of suprapubic pressure and proceed to include rotational or internal maneuvers. Management of a prolapsed umbilical cord should start with elevation of the presenting fetal part to alleviate pressure on the umbilical cord and expedited obstetric assistance for emergent cesarean section. Breech delivery is best managed by allowing the mother to deliver the fetus with no assistance in delivery until the umbilicus is visualized.

Keywords

Precipitous delivery ED delivery Prolapsed cord Shoulder dystocia Breech delivery 

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.BerbeeWalsh Department of Emergency MedicineUniversity of WisconsinMadisonUSA
  2. 2.Department of Obstetrics and GynecologyUniversity of WisconsinMadisonUSA
  3. 3.Department of Emergency MedicineLAC+USC Medical CenterLos AngelesUSA

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