Maternal Assessment

History taking in pregnancy pts

• number of wks gestation

• multiple/single pregnancy?

• gravida

• parity

• medical conditions

• complications in current/previous pregnancy?

• any bleeding

• any waters broken

• when did they break?

• what’s their pallor

• any concerns voiced by pt/family

Should NEWS2 be used in pregnant pts?

DO NOT use NEWS2 as pregnant pts compensate well

What should be used in pregnant pts instead of NEWS2?

prehospital maternity decision tool

What should be done with 1 amber flag in the PMDT?

consider blue call pre alert via PD09

What should be done with any red flag or 2 amber flags in the PMDT?

go to nearest hospital with obstetrics on site, pre alert via PD09

Summary of maternal assessment

• observations

• symptoms

• clinical findings

• PV loss

• pre alert

• destination

Newborn physiology

• lungs filled with fluid at birth

• transition from foetal circulation to newborn circulation

• no mechanism for producing/conserving heat

• low vitamin K (clotting factors)

• high levels of Hb

What is jaundice?

yellow discolouration of skin and mucous membranes caused by excess bilirubin in blood

When is jaundice time critical?

<24 hrs old

Most common congenital abnormalities

• heart defects

• neural tube defects (cleft palate, spina bifida)

• down syndrome