Abdominal distension
diagnosis of
early pregnancy, S-9, S-14, 

late pregnancy, S-18

Abdominal pain
diagnosis of 
early pregnancy, S-116

late pregnancy and postpartum, S-120 
general management, S-115, S-119

Abdominal palpation
assessment of descent by, C-61

Abdominal wounds, S-113

Abnormalities of fetus
assessment, S-147
emotional considerations, C-12

Abortion
see also Manual vacuum aspiration; Dilatation and curettage
diagnosis, S-8
management
complete, S-12
incomplete, S-11
inevitable, S-11
threatened, S-10
complications of, S-9
family planning after, S-13
follow-up treatment, S-12
tetanus, unsafe abortions and, S-51
types of abortion, S-10

Abruptio placentae
diagnosis, S-18
management, S-18
prelabour rupture of membranes and, S-136

Abscess
diagnosis, S-108
management
breast, S-113
pelvic, S-110
wound, S-113

Acetone
presence in urine, C-71

Active management
third stage of labour, C-73, P-42
fetal death, S-133

Acute pyelonephritis
diagnosis, S-100
management, S-102
appendicitis, confusion with, S-115

AIDS
see Infection prevention

Allergies
lignocaine, C-41

Amnionitis
diagnosis, S-136
management, S-139
prelabour rupture of membranes and, S-136

Amniotic fluid
see also Prelabour rupture of membranes;
testing for, S-137

Amniotomy
see Artificial rupture of membranes

Anaemia
diagnosis, S-126
management
malaria and, S-56
postpartum, S-26
severe, S-127
haemoglobin or haematocrit determinations, S-26
heart failure and, S-127
malaria and, S-56, S-103
spinal anaesthesia, avoidance of, P-11

Anaesthesia and analgesia
see also Pain management
general principles, C-43
administration, timing of, C-21, C-38
caesarean section, options for,P-7, P-43
emotional support and, C-43
injection techniques, C-41, P-1
ketamine, P-13
local anaesthesia
general discussion, C-38

adrenaline and, C-39
allergic reactions, C-41
caesarean section, use during, P-7
cardiac arrest, C-43
respiratory arrest, C-42
toxicity, C-41, C-42, C-43
vomiting, C-41, C-46

narcotics

during labour, C-59
postoperative, C-46
respiratory depression in newborn and, C-38

options, C-45
paracervical block, P-1
postoperative, C-46
premedication, C-21, C-38
pudendal block, P-3
spinal, P-11

Anal sphincter tears
see Vaginal or perineal tears

Analgesia
see Anaesthesia and analgesia

Antibiotics, C-35

Antidepressants
breast feeding and, C-13

Antiseptics
chlorhexidine, C-22, C-49
iodophors, C-22, C-49

Anxiety
dealing with, C-5
shock and anxiousness, S-1

Appendicitis
diagnosis, S-116
management, S-117
diagnostic confusion, S-115, S-119
gravid uterus and, S-119

Artificial rupture of membranes
see also Rupture of membranes
procedure, P-17

Asthma
see Bronchial asthma

Atelectasis
diagnosis, S-109

Atonic uterus
diagnosis, S-27
management, S-28

Augmentation of labour
see Induction and augmentation of labour

Birth control
see Family planning

Birth defects
emotional considerations, C-12
epilepsy, treatment and, S-51
malformations, S-147

Bladder
catheterization, C-48
infection, S-101
postoperative care, C-54
repair of injury, P-97

Bleeding
see also Haemorrhage; Coagulopathy
diagnosis of

early pregnancy, S-8
labour, S-17, S-18
later pregnancy, S-17, S-18
postpartum, S-27

general management

early pregnancy, S-7
labour, S-17
later pregnancy, S-17
postpartum, S-26

antepartum, S-7, S-17
aorta, compression of, S-30
caesarean section, control during, P-48
light or heavy, S-8
loss measurement, S-25
packing uterus, S-30
postpartum, S-25
shock causation, S-4
uterus, bimanual compression of, S-29

Blood and blood products
see also Transfusion
general principles, C-23
coagulopathy, managment, S-19
compatibility tests, C-25
infection prevention, C-24
plasma transfusions, C-24
prescribing, C-27
screening for infectious agents, C-25
septic shock, C-29
unnecessary use, C-23
whole blood or red cell transfusions, C-24

Blood pressure
see also Hypertension 
diastolic, measuring of, S-36
proteinuria, pre-eclampsia and,S-37, S-39
shock and low blood pressure, S-1

Blurred vision
diagnosis of, C-41, S-38

Breast abscess
diagnosis, S-108
management, S-113
breastfeeding, S-113

Breast engorgement
diagnosis, S-108
management, S-111

Breast infections
see Breast abscess; Mastitis

Breastfeeding
antidepressant drugs and, C-13
complications

breast abscess, S-113
breast engorgement, S-111
mastitis, S-112

delay in initial feeding, C-78
initiating, C-76, C-78

Breathing
techniques during labour, C-58 

Breathing difficulty
see also Cyanosis; Respiratory arrest

diagnosis of, S-126
general management, S-125
newborns, S-141

resuscitation planning, C-73
oxygen administration, S-146, S-147

preterm babies, S-147
shock and rapid breathing, S-1

Breech presentation and delivery
see also Malpresentation or malposition
diagnosis, S-74
management, S-79
delivery procedure, P-37
anaesthesia options, C-45, P-3
caesarean section and, S-80, P-49
complete breech, S-74, S-79, P-37
complications, S-80
craniotomy and, P-58
external version, correction by, S-79, P-15
extraction, P-42
footling breech, P-41
frank breech, S-74, S-79, P-37
head, entrapped, P-41
Lovset's manoeuvre, P-38
Mauriceau Smellie Veit manoeuvre, P-40

meconium-staining and, S-96
multiple pregnancy and, S-90
post-delivery care, P-42

Bronchial asthma
diagnosis, S-126
management, S-129

Bronchitis, S-129

Bronchospasm
bronchial asthma and, S-129
transfusion caused, C-28

Brow presentation
diagnosis, S-73
management, S-76

Caesarean section
procedure, P-43
anaesthesia options, C-45, P-7, P-11, P-43
antibiotics, C-35
bleeding control, P-48

postoperative, P-50

breech presentation and, P-49
classical incision, P-50
closing abdomen, P-48
closing uterus, P-47
heart failure and, P-43, S-128
high-vertical incision, P-50
hysterectomy after, P-103
oxytocin use in subsequent pregnancy, P-21
placenta praevia and, P-49
placenta, delivery of, P-45
postoperative care, P-50, S-97
transverse lie and, P-49
tubal ligation after, P-51

Cannula
infusion, insertion for, C-21
venous cutdown, insertion by, S-3

Cardiac arrest
anaesthesia reactions, C-43

Catheterization
see Bladder

Cellulitis
wound cellulitis, S-114

Cephalohaematoma
vacuum extraction and, P-30

Cephalopelvic disproportion
diagnosis, S-57
management, S-65

Cerebral haemorrhage
hypertension and, S-48

Cervical dilatation
labour, diagnosis and confirmation of, C-60

Cervical tears
repair, P-81
anaesthesia options, C-45
bleeding caused by, S-31
forceps delivery and, P-35
vacuum extraction and, P-31

Cervicitis
diagnosis, S-136
Foley catheter, dangers of use of, P-25

Cervix
see also Tears
induction of labour, assessment of cervix prior to, P-18
paracervical block, P-1
ripening, P-24
ruptured uterus involving, repair, P-96

Clotting disorders
see Coagulopathy

Coagulopathy
diagnosis
bedside clotting test, S-2
management, S-19
eclampsia, caesarean delivery and, S-47
spinal anaesthesia, avoidance of, P-11

Colloid solutions
replacement fluids, use as, C-31

Colpotomy
procedure, P-70
anaesthesia options, C-45

Coma
diagnosis of, S-38

Communication techniques
general principles, C-6
labour and childbirth, C-57

Community linkages, C-79

Companion, support
see Family members

Compound presentation
diagnosis, S-74
management, S-78

Confusion
shock and, S-1

Congenital syphilis
management in newborns,
S-150

Consciousness
see Loss of consciousness

Contractions
false labour and cessation of, S-64
inadequate and prolonged labour, S-63, S-66
partograph, recording of, C-66

Convulsions
diagnosis of, S-38
lignocaine toxicity and, C-42
newborn, S-141, S-149

Cord
see also Prolapsed cord delivery, checking during, C-72
traction, placental delivery by, C-74, S-31
pulsations and prolapsed cord, S-97

Cough
diagnosis of, S-126

Craniocentesis
procedure

breech presentation, P-60
caesarean section and, P-60
closed cervix, P-59
dilated cervix, P-59

emotional considerations, C-11
post-procedure care, P-60

Craniotomy
procedure

breech presentation, P-58
cephalic presentation, P-57

anaesthesia options, C-45, P-3
emotional considerations, C-11
post-procedure care, P-60

Culdocentesis
procedure, P-69
anaesthesia options, C-45

Curettage
see Dilatation and curettage

Cyanosis
see also Breathing and breathing difficulty
diagnosis of, S-126
Cyanosis (cont.)
newborns, S-141, S-146

Cystitis
diagnosis, S-100
management, S-101

Deep vein thrombosis, S-109

Delivery
see Labour and childbirth

Depression
antidepressant drugs, breast feeding and, C-13
postpartum, emotional considerations, C-13

Descent
assessment of, C-61

Dextran
shock and danger of administration, S-2

Dextrose solutions
acetone in urine, used for, C-71
maintenance fluids, use as, C-31
replacement fluids, use as, C-30
subcutaneous, danger of administration, C-33

Dilatation
see Cervical dilatation

Dilatation and curettage
procedure, P-61
see also Vacuum aspiration anaesthesia options, C-45, P-1, P-11
complications, P-63
post-procedure care, P-63

Diuretics
mild pre-eclampsia and danger of administration of, S-42

Drainage
surgical procedures and, C-51

Dressing
surgical procedures and, C-54

Dyspareunia
diagnosis of, S-136

Dysuria
diagnosis of, S-100, S-136

Eclampsia and pre-eclampsia
diagnosis, S-37
general management, S-35, S-39
anticonvulsive drugs, S-44
antihypertensive drugs, S-46
convulsions, S-40, S-43
degrees of pre-eclampsia, S-38
delivery mandates, S-47
mild pre-eclampsia, S-42
oedema and pre-eclampsia, S-39, S-126
proteinuria and pre-eclampsia, S-37, S-39
pulmonary oedema and pre-eclampsia, S-126
severe pre-eclampsia and eclampsia, S-43
spinal anaesthesia, avoidance of, P-11

Ectopic pregnancy
diagnosis, S-8 , S-13
culdocentesis, P-69
management, S-14
appendicitis, confusion with,S-115
salpingectomy or salpingostomy, P-109
vaginal bleeding in early pregnancy and, S-7

Edema
see Oedema

Elevated blood pressure
see Blood pressure

Emergency response procedures
planning for, C-15
rapid initial assessment, C-3

Emotional support
general principles, C-7
labour, anxiety during, C-58
pain management and, C-43

Encephalitis
diagnosis, S-39

Enemas
labour, avoidance of use during, C-58

Epilepsy
diagnosis, S-39
management, S-51

Episiotomy
procedure, P-71
anaesthesia options, C-45, P-3
complications

haematoma, P-74
infections, P-74

repair of, P-73

External version
procedure, P-15
fetal heart rate and, P-15

Face presentation
diagnosis, S-73
management, S-77

False labour
diagnosis, S-57
management, S-64

Family members
emotional reactions of, C-7
labour and childbirth, support during, C-57
mortality, dealing with, C-9
talking with, C-5

Family planning
abortion and, S-12, S-13
methods, S-13
molar pregnancy and, S-15
ruptured uterus, post-repair counselling, P-98
tubal ligation during caesarean section, P-51
salpingostomy, post-procedure counselling, P-111

Fasciitis
necrotizing fasciitis, S-114

Femoral pulse
palpation, S-30

Fetal health and fetal distress
death of fetus, S-132
heart rate

fetal distress and, S-95
abruptio placentae and, S-18
artificial rupture of membranes and, P-17
external version, monitoring
requirements, P-15
normal labour and, C-57
not heard, S-131
prolonged labour and, S-57
sedative administration and, S-131

loss of movement, S-131
malpresentation or malposition, S-69
meconium-staining, S-96

Fetal skull landmarks, C-62

Fever
diagnosis of 
pregnancy and labour, S-100
postpartum, S-108
general management, S-99, S-107
postoperative, C-55

Fluids
see also Infusion
enema, administration by, C-32
malaria and fluid managment, S-55
subcutaneous, administration by, C-33

Foley catheter
induction of labour, P-25

Forceps delivery
procedure, P-33
anaesthesia options, C-45, P-3
breech presentation with entrapped head, P-41
brow presentation, avoidance of use in, S-76
complications

rupture of uterus, P-35
tears, P-35

episiotomy to aid, P-35
failure, P-35
Piper forceps, P-41

Gastrointestinal function
postoperative, C-53

Glove and gown requirements, C-18

Glucose solutions
replacement fluids, use as, C-30

Grieving, C-10

Haematocrit
anaemia and, S-26

Haematoma
broad ligament, S-20, P-96
cephalohaematoma, P-30
episiotomy and, P-74
ruptured uterus involving, repair,P-96
vaginal or perineal tears and, P-89
wound, S-113

Haemoglobin
anaemia and, S-26
transfusion determinations, C-26

Haemorrhage
see also Bleeding
diagnosis

antepartum, S-17
postpartum, S-25

general management

antepartum, S-17
postpartum, S-26

cerebral, pregnancy-induced

hypertension and, S-48

coagulopathy and, S-19
definition of, S-25
delayed postpartum, S-33
immediate postpartum, S-25
IV infusions and, C-30
postpartum, prevention of, S-25, C-73
replacement fluids, C-30
secondary postpartum, S-33
spinal anaesthesia, avoidance of, P-11

Haemostasis, C-51

Halothane
inverted uterus, correction of, P-92

Handwashing
general procedures, C-17
surgical preparation, C-48

Headache
diagnosis of, S-38

Heart attack
see Cardiac arrest

Heart disease
heart failure and, S-128
ketamine, dangers of use of, P-13

Heart failure
diagnosis, S-126
management, S-127
anaemia and, S-127
caesarean section, S-128, P-43
heart disease and, S-128
labour, management during, S-128
spinal anaesthesia, avoidance of, P-11

Hepatitis
diagnosis, S-101
see also Infection prevention

High blood pressure
see Blood pressure

HIV
see Infection prevention
rupture of membranes and danger of perinatal
transmission, P-17

Hookworm
bleeding and, S-26
heart failure management, S-127

Hormones
threatened abortion and, S-10

Hyaline membrane disease in newborns, S-147

Hypertension
see also Blood pressure
diagnosis of, S-36
management

chronic hypertension, S-49
eclampsia, S-43
pre-eclampsia, S-42
pregnancy-induced hypertension, S-41

antihypertensive drugs, S-46
complications, S-48
diuretics, danger of use in, S-42

Hypodermic needles
sharps handling procedures, C-20

Hypothermia
newborn, S-148

Hypovolaemia
see also Shock
spinal anaesthesia, avoidance of use in, P-11
replacement fluids and, C-32

Hysterectomy
procedure, P-103
postoperative care, P-108
subtotal, P-104
total, P-107

Immunizations
tetanus, S-50

Induction and augmentation of labour
procedure, P-17
artificial rupture of membranes, P-17
augmentation, P-25
cervix

assessment of, P-18
ripening, P-24

Foley catheter, P-25
uterine rupture, oxytocin and, P-19

Infection
breast, S-112
newborn sepsis, S-139
sepsis after abortion, S-9
urinary tract, S-101
uterus, S-110, S-139
wound, S-113

Infection prevention
general discussion, C-17
antibiotic prophylaxis, C-35

blood and blood products, C-24
HIV transmission, perinatal, P-17
hypertension complications, S-48
labour, cleanliness during, C-58
surgical procedures generally, C-47

Informational rights, C-5

Informed consent, C-47

Infusion
procedure, C-21
blood transfusions compared, C-23
cannula insertion, C-21, S-3
fluid balance, S-55
heart failure and, S-128
maintenance fluid therapy, C-31
phenytoin, S-52
replacement fluids, C-30

colloid solutions, C-31
crystalloid solutions, C-30
dextrose solutions, C-30
glucose solutions, C-30
Ringer's lactate, C-21
saline, normal, C-21, C-30

shock

management of, C-30, S-2
plasma substitutes, danger of, C-21

subcutaneous administration of replacement fluids, C-33
transfusion, alternatives to, C-30
venous cutdown, cannula insertion, S-3

Initial assessment, C-1

Injection
injection techniques, C-41, P-1
tetanus, S-50

Instruments
surgery counts, C-51

Inverted uterus
diagnosis, S-27
management, S-33
procedure, correction of, P-91

anaesthesia options, C-45
hydrostatic, P-92
manual, P-91
surgical, P-92
complications, P-94
post-procedure care, P-94

Ketamine
procedure, P-13

Labour and childbirth
see also Prolonged labour; Malpresentation or malposition
diagnosis, C-59
general management, C-57
acetone in urine, C-71
active management, third stage, C-73
augmentation of labour, P-25
bleeding during, S-17
blood pressure during, C-71
caesarean, prior

oxytocin use after, P-21
vaginal delivery after, S-93

cervix

dilatation, C-60
effacement, C-59, C-60

childbirth positions, C-71
cord, checking, C-72
descent, assessment of, C-61
eclampsia, delivery mandates, S-47
head, delivery of, C-72
heart failure during, S-128
induction of labour, P-17
labour positions, C-59
maternal condition during, C-71
multiple pregnancy, S-89
newborn care, initial, C-75
partograph

assessment by, C-65
samples of, C-69, S-59, S-61, S-63

phases of, C-60
placenta, C-73
placenta praevia, delivery mandates, S-23
presentation and position, C-62
previous caesarean

oxytocin use after, P-21
vaginal delivery after, S-93

progress, assessment of, C-64
pulse during, C-37
pushing, S-67
shoulder, delivery of, C-72
show, S-17
stages of, C-60, C-70
third stage, C-60, C-73
umbilical cord, checking, C-72
unsatisfactory progress, S-57

Lacerations
see Tears

Laparotomy
anaesthesia options, C-45

Lethargy
diagnosis of, S-126
newborns, S-141, S-148

Lithotomy position, C-22

Local anaesthesia
see Anaesthesia and analgesia

Loss of consciousness
diagnosis of, S-38
general management, S-35
shock and, S-1

Lovset's manoeuvre, P-38

Maintenance fluid therapy, C-31

Malaria
diagnosis, S-39, S-103
general discussion, S-52, S-103
anaemia and, S-56, S-127
convulsions, S-54
fluid balance, S-55
hypoglycaemia, S-55
drug resistant, S-104, S-105
severe/complicated, S-52
uncomplicated, S-103

Malformations
emotional considerations, C-12
general, S-147

Malpresentation or malposition
see also Breech presentation and delivery
diagnosis, S-72, S-73, S-74, S-75
general management, S-69
breech presentation, S-74, S-79
brow presentation, S-73, S-76
caesarean section and, P-49
chin-anterior position, S-77
chin-posterior position, S-77
compound presentation, S-74, S-78
external version, correction by, P-15
face presentation, S-73, S-77
multiple pregnancy and, S-90
occiput positions, S-70, S-72, S-75
shoulder presentation, S-75, S-81
transverse lie, S-75, S-81

Manual vacuum aspiration
procedure, P-65
anaesthesia options, C-45
complications, P-68
dilatation and curettage compared, P-61
post-procedure care, P-68

Mastitis
diagnosis, S-108
management, S-112

Mauriceau Smellie Veit
manoeuvre, P-40

Meconium
aspiration, prevention of, S-143
breech presentation and, S-96
fetal distress and, S-96
thickness of, C-57, S-96

Membranes
see also Rupture of membranes
artificial rupture, P-17

Meningitis
diagnosis, S-39

Metritis
diagnosis, S-108
management, S-110

Migraine
diagnosis, S-39

Miscarriage
see Abortion

Molar pregnancy
diagnosis, S-8
management, S-15
family planning after, S-16

Monitoring labour and childbirth
see Partograph monitoring

Morbidity, dealing with
maternal, C-9
neonatal, C-10

Multiple pregnancy
diagnosis, S-87
Multiple pregnancy (cont.)
management, S-89

Necrotizing fasciitis, S-114

Newborns
general care principles, C-77
asphyxia, S-147
bacterial infections, S-147
breastfeeding, C-76, C-78
breathing check, C-73
breathing difficulty, S-141
breech delivery, care after, P-42
congenital syphilis, management, S-150
convulsions, S-149
cyanosis, S-146
hyaline membrane disease, S-147
hypothermia, S-148
initial care, C-75
lethargy, S-148
low birth weight, S-147, S-149
malformations, S-147
oxygen administration, S-146
premature

preparation for, S-123
breathing difficulties, S-147

preterm rupture of membranes,

management after delivery,S-149

prolonged rupture of membranes,

management after delivery, S-149

resuscitation, S-142
separation from mother, C-76, C-78
sepsis, newborn, S-139
syphilis, management, S-150
transferring, C-78
ventilation, S-143

Not breathing
see Respiratory arrest

Nutrition
acetone in urine, C-71
dextrose, C-71
labour, administration during, C-58

Obstructed labour
diagnosis, S-57
management, S-66
partograph, S-61

Occiput positions
diagnosis, S-70
management, occiput posterior, S-75

Oedema
see also Pulmonary oedema
diagnosis of, S-126
diuretics, danger of administration of, S-42
pre-eclampsia and, S-37, S-39

Operations
general principles, C-47
see also Postoperative care
intra-operative care, C-48
pre-operative care, C-47

Ovarian cysts
diagnosis, S-116, 
management, S-117
appendicitis, confusion with, S-115
ultrasound and, S-14

Overdistended uterus
diagnosis, S-87
excess amniotic fluid, S-88
large fetus, S-88
multiple pregnancy, S-89

Oxygen
newborn, difficulty breathing and, S-146

Pain
see Abdominal pain

Pain management
see also Anaesthesia and analgesia
emotional support and pain management, C-43
healing, pain relief and, C-46
labour, C-58
postoperative, C-46
surgical procedures, C-50

Pallor
shock and, S-1
anaemia and, S-126

Paracervical block
procedure, P-1

Partograph
general use, C-65
samples

breech presentation, S-79
contractions, inadequate, S-63
normal labour and childbirth, C-65
obstructed labour, S-61
prolonged labour, S-59

Pelvic abscess
diagnosis, S-108
management, S-110
colpotomy, P-70
culdocentesis, P-69

Pelvic inflammatory disease
ectopic pregnancy, confusion with, S-7

Pelvis
inadequate, determination of, S-65

Perineal tears
see Vaginal or perineal tears

Peritonitis
diagnosis, S-108
management, S-111
appendicitis and, S-117

Placenta
see also Retained placenta accreta, S-32
controlled cord traction delivery, C-74
delivery, C-74
examination of, C-75
fragments, retained, S-32
manual removal

procedure, P-77
anaesthesia options, C-45, P-3, P-11
complications, P-79
inverted uterus and, P-91
post-procedure care, P-79

membrane tears, C-75
removal at caesarean section, P-45
retained, S-27, S-31

Placenta praevia
diagnosis, S-18
managment, S-21
caesarean section and, P-49

Plasma transfusions
coagulopathy and, S-20
infection risks, C-24
replacement fluid use, C-30

Pneumonia
diagnosis, S-126
Pneumonia (cont.)
management, S-129

Position
see Malpresentation or malposition

Postoperative care
bladder, C-54
bleeding, internal, monitoring for, C-52
fever, C-55
gastrointestinal function, C-53
initial, C-52
pain relief and healing, C-46
suture removal, C-55
wound, C-54

Postpartum care
bleeding, S-25
breast engorgement, S-111
breast infections, S-112
caesarean section, postoperative care, P-50
depression, C-12
fever, S-107
haemorrhage, S-25
psychosis, C-14
symphysiotomy, care after, P-56

Postpartum haemorrhage
see also Bleeding; Haemorrhage
general management, S-25

Pre-eclampsia
see Eclampsia and pre-eclampsia

Prelabour rupture of membranes
diagnosis, S-136
managment, S-136
newborn care and, S-149

Premature labour and childbirth
see Preterm labour 

Presentation
see also Malpresentation or malposition
normal presentation, C-62

Preterm labour
diagnosis, S-120
management, S-122
newborn

preterm, care of, S-147, S-149
bacterial infections in, S-147
hyaline membrane disease, S-147
low birth weight, S-147, S-149

rupture of membranes, preterm, S-135

Privacy rights, C-5

Prolapsed cord
management, S-97
breech presentation and, S-80
compound presentation and, S-78
delivery, checking during, C-72
overdistended uterus and, S-88

Prolonged labour
see also Induction and augmentation of labour
diagnosis, S-57
management

latent phase, S-64
active phase, S-65
expulsive phase, S-67

cephalopelvic disproportion, S-65
obstruction, S-66
partograph, samples of S-59, S-61, S-63
uterine activity, inadequate, S-66

Proteinuria
diagnosis of, S-37
measurement of, S-37
pre-eclampsia and, S-37, S-39

Provider linkages, C-79

Psychosis
ketamine, dangers of use of, P-13
postpartum, emotional considerations, C-14

Pubic hair
shaving, C-48

Pudendal block
procedure, P-3

Pulmonary oedema
diagnosis, S-38
pre-eclampsia and, S-44

Pulse
shock and weak pulse rate, S-1

Pyelonephritis
see Acute pyelonephritis

Rales
diagnosis of, S-126
pulmonary oedema, pre-eclampsia and, S-44

Rapid initial assessment, C-1

Referral patterns, C-80

Respiratory arrest
see also Breathing and breathing difficulty
anaesthesia reactions, C-42

Resuscitation
newborn, S-142

Retained placenta
diagnosis, S-27
management, S-31
cord traction delivery, S-31
ergometrine, danger of use of, S-31
fragments, retained, S-32

Rights of women, C-5

Rupture of membranes
artificial rupture, P-17
HIV prevalence and, P-17
normal labour, C-57
prelabour, S-135

Ruptured uterus
diagnosis, S-18
management, S-20
repair, P-95
caesarean section after, S-94
forceps delivery, P-35
impending rupture, S-94
induction of labour and danger of, P-19
oxytocin administration and danger of, P-19
pregnancy risks after, P-98
scars causing, S-93
shoulder dystocia and, S-84
symphysiotomy to avoid, P-53
vaginal delivery after, S-93

Salpingectomy or salpingostomy
procedure, P-109
family planning counselling after, P-111
pregnancy risks after, P-111

Sharps
handling, C-20, C-51
needle-stick injury, pudendal block and, P-5
surgery counts, C-51

Shock
diagnosis, S-1
management, S-1
anaphylactic shock, C-28
causation, S-4
emergency response, C-16
IV infusions, C-21, C-30
replacement fluids, C-30
septic, blood transfusion and,C-29
transfusion caused, C-28
transfusion requirements, C-23

Shoulder dystocia
diagnosis, S-83
managment, S-83
brachial plexus injury and, S-84

Shoulder presentation
diagnosis, S-75
management, S-81

Spinal anaesthesia
procedure, P-11

Stillbirth
emotional considerations, C-10

Supine hypotension syndrome, C-48

Support companion
see Family members

Surgery
see Operations

Suture
removal, C-55
selection, C-52

Symphysiotomy
procedure, P-53
anaesthesia options, C-45
brow presentation, avoidance of symphysiotomy in, S-76
complications, P-56
post-procedure care, P-56
risks, P-53
ruptured uterus, avoidance of, P-53
vacuum extraction and, P-30, P-53

Syphilis
congenital, S-141
death of fetus, S-132
management in newborns, S-150

Tears
see also Cervical tears; Vaginal or perineal tears
bladder, P-97
bleeding caused by, S-31
placenta, examination for, C-75

Tetanus
diagnosis, S-38
management, S-50

Thrombosis
see Deep vein thrombosis

Tocolysis and tocolytic agents
conditions of use, S-122
precautions for use, S-123
threatened abortion and, S-11

Training, C-80

Transfusion
see also Blood and blood products
general principles, C-25
autotransfusion, C-26, S-14
coagulopathy management, S-19
haemoglobin value and, C-26
infection risks, C-24
monitoring, C-27
reactions

anaphylactic shock, C-28
bronchospasm, C-28
monitoring for, C-27

replacement fluid alternatives, C-30

Transverse lie
diagnosis, S-75
management, S-81
caesarean section and, P-49
external version, P-15
internal podalic version, S-90

Trauma
shock management, S-4

Tubal ligation
caesarean section and, P-51
ruptured uterus repair and, P-96

Tuberculosis
pneumonia and, S-129

Typhoid
diagnosis, S-109

Ultrasound
confirmation of diagnosis

ectopic pregnancy, S-14
fetal death, S-132
ovarian cyst, S-14
overdistended uterus, S-87
placenta praevia, S-22

Umbilical
see Cord; Prolapsed cord

Unconsciousness
see Loss of consciousness

Unsatisfactory progress of labour
see Prolonged labour

Ureter
protection during surgical procedures, P-96, P-99, P-104

Urinary tract infections
diagnosis of, S-100
management
acute pyelonephritis, S-102
cystitis, S-101 
false labour and, S-65

Urine
proteinuria and pre-eclampsia, S-37, S-39
scanty output

magnesium sulfate administration and, S-45

malaria and, S-55

shock and, S-1

testing

proteinuria, S-37

urinary tract infection, S-101

Uterine and utero-ovarian artery
ligation
procedure, P-99

Uterine atony
see Atonic uterus

Uterine inversion
see Inverted uterus

Uterus
see also Atonic uterus; Inverted uterus; Ruptured uterus
appendicitis and gravid uterus, S-119
artery ligation, P-99
bimanual compression of, S-29
caesarean section, closing, P-47
dilatation and curettage, P-61
inadequate uterine activity and prolonged labour, S-66
manual vacuum aspiration, P-65
massage after placenta delivery, C-75
overdistended, S-87
packing, S-30
scarred uterus and vaginal delivery, S-93

Vacuum aspiration
see Manual vacuum aspiration

Vacuum extraction
procedure, P-27
anaesthesia options, C-45
brow presentation, avoidance of use in, S-76
complications

cephalohaematoma, P-30
tears, P-31

episiotomy to aid, P-28
face presentation, avoidance of use in, S-78
failure, P-30
preterm labour, avoidance of use in, S-123
symphysiotomy and, P-30, P-53

Vaginal bleeding
see Bleeding

Vaginal examination
bleeding danger, C-1, S-17, S-21
descent assessment by, C-61
placenta praevia and, S-21
progress of labour, assessment of, C-64

Vaginal or perineal tears
repair, P-83
anaesthesia options, C-45, P-11
anal sphincter tears

detection, P-83
neglected cases, P-89
repair, P-86

bleeding caused by, S-31
complications, P-89
degrees of tears, P-83
forceps delivery causing, P-35
haematoma, P-89
post-procedure care, P-88
ruptured uterus involving, repair, P-96

Vaginitis
diagnosis, S-136
Foley catheter, dangers of use of, P-25

Ventilation
newborns, S-143

Vision
see Blurred vision

Vomiting
diagnosis of, S-8, S-39, S-100, S-108, S-116
anaesthesia administration and, C-46
shock management, S-2

Waste disposal, C-20

Water, breaking
see Prelabour rupture of
membranes

Wounds
infections of, S-113
surgical wound care, C-54

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