Pregnancy, ensuring delivery, motherhood and rearing children are some of the most beautiful phases in a person’s life. During all these phases, women as well as children including neonates require special attention and care. This article intends to act as a guide for family, particularly women, regarding emergency healthcare needs for women during pregnancy /delivery, emergency care for neonates and paediatric emergencies.
An obstetric emergency is a health problem, which, if not treated on time, could lead to loss of life for both pregnant women and their babies. Such an emergency may occur at any time – during pregnancy, labour and post-delivery. In matters of obstetric emergencies, expert care and hospital stays are mandatory. Negligence is highly likely to result in loss of baby, premature birth or increased risk to the woman’s health. The following Obstetric Emergencies can occur during Pregnancy:
- Miscarriage: One of the most common obstetric emergencies, miscarriage is a term used to suggest the loss of a baby before the 20th week of pregnancy. Once started, it’s impossible to stop a miscarriage. After a miscarriage, treatment for infection or to rid of remaining tissues may be required.
- Ectopic Pregnancy: When a fertilised egg grows outside the uterus instead of inside, the pregnancy cannot be continued. If pregnancy ruptures, it will result in pain, bleeding, shock and can be fatal for mother. Loss of damage can impair a woman’s chance of getting pregnant in the future.
- Placental Abruption: If the placenta is separated from the uterus before birth, the condition leads to bleeding, pain, contractions and intrauterine foetal death.
- Placenta Praevia: When the placenta attaches to the lower part of the uterus, thus blocking the neck of the womb, either partially or completely, it causes complications such as vaginal bleeding, perinatal and maternal morbidity and mortality.
- Pre-eclampsia and Eclampsia: The term indicates high blood pressure, which is caused by pregnancy. While severe swelling is one of its characteristics, the condition can also lead to high blood pressure, kidney, liver or multiple organ failure. If it is progressed to eclampsia or convulsions, it can be fatal for both mother and child.
- Premature rupture of membrane (PROM): As the name suggests, it’s a condition in which the bag of amniotic water breaks even before contractions of labour begins. What makes the condition serious is the time – if this happens before week 37 of pregnancy, it can lead to premature birth or infection of the amniotic sac.
The following Obstetric Emergencies can occur during Labour
- Shoulder Dystocia: If the baby’s head come out and the shoulders get stuck in the birth canal, it may lead to the baby getting deprived of oxygen, can lead to fracture & might be fatal to the baby
- Prolapsed Umbilical Cord: If before the baby is born, the umbilical cord is pushed down to the cervix or vagina, leading to severe lack of oxygen, which can result in brain damage or in worst case death.
- Placenta Accreta: The placenta is way too deep inside the uterine wall and doesn’t come out even after the baby is born, so may require hysterectomy after delivery
- Rupture of the Uterus: Previous caesarean scar gives away
Neonatal & Paediatric Emergencies:
Some of the most common neonatal emergencies are as follows:
- Trauma (accidental or non-accidental)
- Heart disease / hypovolemia / hypoxia
- Endocrine (congenital adrenal hyperplasia, thyrotoxicosis)
- Metabolic (electrolyte imbalance)
- Inborn errors of metabolism: Metabolic emergencies
- Sepsis (meningitis, pneumonia, urinary tract infection)
- Formula mishaps (under or over dilution)
- Intestinal catastrophes (volvulus, intussusception)
- Respiratory distress syndrome
- Meconium aspiration syndrome
- Hyaline membrane disease
- Neonatal convulsions
- Birth asphyxia
- Birth trauma
- Complicated cardiac problems
- Surgical emergency
- Tracheo-oesophageal fistula
- Congenital diaphragmatic hernia
Once children started moving around – whether they are three or thirteen – they are prone to many kinds of accidents. While younger children get themselves into trouble because of their innate curiosity, the older children tend to be more adventurous, hurting themselves during play. It could vary from fracture to drowning or electrocution to poisoning. With children around, parents need to be extra cautious. For instance, make sure that medicines are kept away from the reach of children or they have no access to electrical equipment. While all these can guarantee safety to an extent, children may still get involved in accidents.
Whether it’s big or small, what really matters is to provide treatment without time-lapse.