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Precipitous Labor and Emergency Department Delivery

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Emergency Department Management of Obstetric Complications

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.

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Author information

Authors and Affiliations

  1. BerbeeWalsh Department of Emergency Medicine, University of Wisconsin, 800 University Bay Drive, Madison, WI, 53705, USA

    Brian Sharp M.D.

  2. Department of Obstetrics and Gynecology, University of Wisconsin, 1010 Mound Street, 4th Floor, Madison, WI, 53715, USA

    Kristen Sharp M.D.

  3. Department of Emergency Medicine, LAC+USC Medical Center, 2051 Marengo Street, C2K115, Los Angeles, CA, 90033, USA

    Eric Wei M.D., M.B.A.

Authors
  1. Brian Sharp M.D.
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  2. Kristen Sharp M.D.
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  3. Eric Wei M.D., M.B.A.
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Corresponding author

Correspondence to Brian Sharp M.D. .

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Editors and Affiliations

  1. MedStar Georgetown University Hospital and MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC, USA

    Joelle Borhart

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Sharp, B., Sharp, K., Wei, E. (2017). Precipitous Labor and Emergency Department Delivery. In: Borhart, J. (eds) Emergency Department Management of Obstetric Complications. Springer, Cham. https://doi.org/10.1007/978-3-319-54410-6_7

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  • DOI: https://doi.org/10.1007/978-3-319-54410-6_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54409-0

  • Online ISBN: 978-3-319-54410-6

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