ANTENATAL COMPLICATIONS

UMBILICAL CORD PROLAPSE CHORIOAMNIONITIS PRETERM LABOUR RUPTURE OF MEMBRANES POST-DATE PREGNANCY INTRAUTERINE FETAL DEATH UMBILIC...

1. UMBILICAL CORD PROLAPSE
2. CHORIOAMNIONITIS
3. PRETERM LABOUR
4. RUPTURE OF MEMBRANES
5. POST-DATE PREGNANCY
6. INTRAUTERINE FETAL DEATH

UMBILICAL CORD PROLAPSE

1. descent of the cord to a level adjacent to or below the presenting part causing cord compression between presenting part and pelvis
2. visible or palpable cord FHR changes (variable decelerations, bradycardia or both)
3. increased incidence with prematurity/PROM, fetal malpresentations,low-lying placenta, polyhydramnios, multiple gestation, CPD

Management

1. STAT C-section
2. adjunctive measures
3. alleviate pressure of the presenting part on the cord
4. keep cord warm and moist by replacing it into the vagina and/or applying warm saline soaks

CHORIOAMNIONITIS

Definition: infection of the chorion, amnion and amniotic fluid

Risk factors:

1. prolonged ROM,
2. long labour,
3. multiple vaginal examsduring labour,
4. internal monitoring,
5. bacterial vaginosis and other vaginal infections

Clinical features:

1. maternal fever,
2. maternal or fetal tachycardia,
3. uterine tenderness,
4. foul cervical discharge,
5. leukocytosis,
6. presence of leukocytes or bacteria in amniotic fluid

Management:

1. blood and amniotic fluid cultures,
2. IV antibiotics (ampicillin and gentamycin)
3. expedient delivery regardless of gestational age