S/S: (hypovolemic shock) patient c/o acute abdominal pain with a tender mass to palpatation or bloddy vaginal discharge, rapid thready pulse, skin cool clammy and pale, BP decreased.

TX: Airway, high-flow O2, MAST, two large-bore IV lines, EKG monitor, keep patient recumbent and warm

Abortion- loss of pregnancy before 20th week.

Spontaneous abortion: natural

• Threatened
• Inevitable
• Incomplete
• Missed

Criminal abortion

Therapeutic abortion

premature separation of a normally implanted placenta from the uterine wall during the last trimester.

S/S: severe lower abdominal pain, rigid, signs of shock.

TX: lay on side, O2, two large bore IV's & MAST

(placenta presents first) may be massive bleeding without abdominal pain.

TX: O2, IV's, MAST and transport on side

The first stage of toximia produces derangements of the pregnant woman's circulation, especially to the kidneys.

S/S: edema, HTN (Usually above 130/80), headache, blurred vision, abdominal pain

S/S: HTN and diffuse edema.

TX: position the patient on her left side in  a darkened room and keep her calm and quiet. Give O2, IV-NS. Transport as gently as possible- no sirens, no flashing lights.

contractions 2 mins apart or less, bag of waters ruptured, crowning

Questions to ask

• First time
• Frequency and length of contractions
• bag of waters broken or intact
• Urge to move the bowels

when the buttocks presents first rather than the head.

TX: if the head is not delivered within 3 mins action must be taken to prevent suffocation of the baby including forming an air pocked with the hand between the vaginal wall and the face of the baby. Don't pull baby out, nor allow for an explosive delivery

is the appearance of the umbilical cord prior to birth.

TX: place the mother in a knee-chest position or supine with hips elevated on a pillow to relieve pressure off the cord. Apply O2, and gently push the baby up the vigina several inches. Do not attempt to push the cord back. Transport the mother and baby to the hospital at once, maintaining pressure on the baby's head. Place moist towels on exposed cord.

May be caused by retained placental products, inadaquate uterine contractions, or clotting disorders.

TX: continue uterine massage and put baby to the mother's breast for nipple stimulation to expel placenta. Give 10 units of oxytocin IVPB after delivery of the placenta. If bleeding persists, support the circulation with colloid or saline by IV and transport rapidly to the hospital.