1. OBSTETRICS EMERGENCIES 1. Post-partum haemorrhage 2. Shoulder dystocia 3. Cord prolapse 4. Eclampsia 5. Uterine rupture 6. Uterine inversion 7. Fetal distress 8. APH 9. Delivery of the 2 nd twin 10. Retained placenta

2. RUPTURE UTERUS  INCIDENCE: 1:200 1:5000 deliveries  CAUSES: a. Uterine scar 1. Caesarean section 2. Hysterotomy 3. Myomectomy 4. Uteroplasty 5. Previous perforation 6. Cervical scarring 7. Salpingectomy with cornual resection

3. Cont... Causes b. Excessive Uterine Action 1. Oxytocic drugs 2. Neglected obstructed labour

4.  Cont.. Causes c. Trauma 1. Internal version and breech extraction 2. Forceps delivery 3. Manual removal of the placenta 4. Fetal destructive operations 5. Shoulder dystocia 6. Fundal pressure 7. Criminal abortion 8. Direct trauma

5.  Cont … Causes d. Miscellaneous 1. Multiparity 2. Uterine anomalies 3. Placenta increta and percreta 4. Cornual pregnancy 5. Severe concealed abruptio placenta 6. Gestational trophoblastic disease

6. CORD PROLAPSE  INCIDENCE: 1:200 1:500 deliveries Cord prolapse vs. cord presentation

7. UTERINE INVERSION  FAST FACTS  1 /25,000 deliveries  more common multips  often iatrogenic

8. SHOULDER DYSTOCIA  DEFINITION: Failure of the shoulders to deliver spontaneously with usual methods, secondary to impaction of the anterior shoulder behind the symphysis pubis.  INCIDENCE: 0.5-2.9% of all deliveries  RISK FACTORS:  Maternal obesity diabetes, b/o macrosomic infant.

9.  COMPLICATIONS:  Erb ’ s palsy  Fracture clavicle humerus, cervical spine  Asphyxia brain damage  Fetal death  Internal organ damage (liver, spleen)