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Department of Reproductive Health and Research (RHR), World Health Organization

Managing Complications in Pregnancy and Childbirth

A guide for midwives and doctors 

 


Section 1 - Clinical Principles


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Anaesthesia and Analgesia -  Table C- 6

Procedure Analgesia/Anaesthesia Options

Breech delivery

General methods of labour support

Pudendal block

Caesarean section

Spinal anaesthesia

Local anaesthesia

Ketamine

• General anaesthesia

Cervical tears (extensive)

Pethidine and diazepam

Ketamine

Colpotomy/Culdocentesis

Local anaesthesia

Craniotomy/Craniocentesis

Emotional support and encouragement

Diazepam

Pudendal block

Dilatation and curettage

Paracervical block

Pethidine

Episiotomy

Local anaesthesia

Pudendal block

Forceps delivery

Emotional support and encouragement

Pudendal block

Labour and childbirth

General methods of labour support

Pethidine and promethazine

Laparotomy

General anaesthesia

Spinal anaesthesia

 

Manual removal of placenta

Pethidine and diazepam

Ketamine

Manual vacuum aspiration 

Paracervical block

Pethidine

Perineal tears (first and second degree)

Local anaesthesia

Pudendal block

Perineal tears (third and fourth degree)

Pudendal block

Ketamine

Local anaesthesia plus pethidine and diazepam 

Spinal anaesthesia

Symphysiotomy

Local anaesthesia

Uterine inversion (correction of)

Pethidine and diazepam

• General anaesthesia

Vacuum extraction

Emotional support and encouragement

Pudendal block

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Clinical principles

Rapid initial assessment

Talking with women and their families

Emotional and psychological support

Emergencies

General care principles

Clinical use of blood, blood products and replacement fluids

Antibiotic therapy

Anaesthesia and analgesia

Operative care principles

Normal Labour and childbirth

Newborn care principles

Provider and community linkages

Symptoms

Shock

Vaginal bleeding in early pregnancy

Vaginal bleeding in later pregnancy and labour

Vaginal bleeding after childbirth

Headache, blurred vision, convulsions or loss of consciousness, elevated blood pressure

Unsatisfactory progress of Labour

Malpositions and malpresentations

Shoulder dystocia

Labour with an overdistended uterus

Labour with a scarred uterus

Fetal distress in Labour

Prolapsed cord

Fever during pregnancy and labour

Fever after childbirth

Abdominal pain in early pregnancy

Abdominal pain in later pregnancy and after childbirth

Difficulty in breathing

Loss of fetal movements

Prelabour rupture of membranes

Immediate newborn conditions or problems

Procedures

Paracervical block

Pudendal block

Local anaesthesia for caesaran section

Spinal (subarachnoid) anaesthesia

Ketamine

External version

Induction and augmentation of labour

Vacuum extraction

Forceps delivery

Caesarean section

Symphysontomy

Craniotomy and craniocentesis

Dilatation and curettage

Manual vacuum aspiration

Culdocentesis and colpotomy

Episiotomy

Manual removal of placenta

Repair of cervical tears

Repair of vaginal and perinetal tears

Correcting uterine inversion

Repair of ruptured uterus

Uterine and utero-ovarian artery ligation

Postpartum hysterectomy

Salpingectomy for ectopic pregnancuy

Appendix

 

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