Intrapartum emergencies.
Intrapartum emergencies are challenging to all perinatal nurses because of the increased risk of adverse outcomes for the mother and fetus. Perinatal emergencies, such as seizures, amniotic fluid embolus, hemorrhage, and uterine rupture, create physiological challenges and trigger intrinsic survival techniques. The pregnant uterus becomes a vital source of blood volume during hypovolemic events because it is not considered a vital organ. The pregnancy itself may become burdensome, and birth may occur as an intrinsic maternal compensatory mechanism. The resultant fetal hypoxemia may also stress the fetus into initiating labor. During extensive oxygen desaturation and decompensation, the focus should be on maternal stabilization, which will subsequently enhance fetal stabilization. Clinical assessments, critical thinking, decision making, and resource allocation must be quick and appropriate to increase the likelihood of a positive outcome for the mother, fetus, and neonate.
Curran
Carol A
CA
Clinical Nurse Specialists and Associates, Virginia Beach, VA 23452, USA. cnsa@mindspring.com
D000037:Abruptio Placentae / Q000451:nursing; D036861:Delivery, Obstetric / Q000451:nursing*; D004619:Embolism, Amniotic Fluid / Q000451:nursing; D004630:Emergencies; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000517:prevention & control; D007231:Infant, Newborn; D017283:Neonatal Nursing / Q000379:methods* / Q000592:standards; D024802:Nurse's Role; D009730:Nursing Assessment / Q000379:methods; D015404:Nursing Methodology Research; D007744:Obstetric Labor Complications / Q000451:nursing* / Q000517:prevention & control; D009773:Obstetric Nursing / Q000379:methods* / Q000592:standards; D018743:Perinatal Care / Q000379:methods; D006473:Postpartum Hemorrhage / Q000451:nursing; D011247:Pregnancy; D011785:Quality Assurance, Health Care; D012640:Seizures / Q000451:nursing; D014481:United States; D014597:Uterine Rupture / Q000451:nursing