Most emergency operative deliveries (Caesarean section, instrumental delivery, breech and twin deliveries and interventions for fetal distress) together with neonatal resuscitation are mentioned in the relevant chapters, but the management of shoulder dystocia and cord prolapse are indicated in Fig. 18.8 and 18.9 and mentioned here.
Shoulder dystocia is a very serious obstetric emergency. The flow chart in Fig. 18.8 highlights the processes and sequences of its management, but additional points to add are:
• Always remember that the problem is at the pelvic brim and pulling on the baby or pushing down on the fundus are both unhelpful and dangerous.
• Time is deceptive (try to glance at a clock or get someone to note timings).
• There remains a place for symphysiotomy which can be life-saving [39,40].
• Careful and precise documentation is essential after the event.
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.