Obstetric Emergencies
Obstetric Emergencies
THIRD EDITION
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Obstetric Emergencies
First Edition: 2003
Second Edition: 2011
Third Edition: 2020
9789389587197
Printed at
- A Shilpa Reddy MS (Obs & Gyn)
- Fellow in Obstetrics and Gynecology Ultrasound Mediscan, Chennai, Tamil Nadu, India
- Consultant, Lakshmi Kishore Hospital
- Proddatur, Andhra Pradesh, India
- Aishwarya Yerram
- MBBS (Osm) DNB (Obs & Gyn) FRM
- Senior Consultant, Iswarya Fertility Center
- Hyderabad, Telangana, India
- Akhila Vasudeva MD DNB MRCOG
- Professor and Unit Chief
- Chief Consultant, Division of Fetal Medicine
- Department of Obstetrics and Gynecology
- Kasturba Medical College, Manipal
- Manipal Academy of Higher Education
- Udupi, Karnataka, India
- Anju Dogra MBBS MD
- Senior Resident
- Government Medical College
- Jammu, Jammu and Kashmir, India
- Aparna Jha
- MBBS MS (Obs & Gyn) DNB (Obs & Gyn) MRCOG (UK)
- Gynecologist and Obstetrician
- Department of Obstetrics and Gynecology
- Apollo Cradle
- Bengaluru, Karnataka, India
- Arathi Sreedhara MBBS DMCH DGO FMIS
- Consultant, Obstetrician and Laparoscopic Gynecologist
- BSOG, FOGSI
- Karnataka Medical Council, Indian Medical Association
- Neiya Speciality Clinic, Vasvi Hospital
- Visiting Consultant, Cloudnine Hospital
- Aster RV, Apollo Cradle
- Milann—The Fertility Centre
- Bengaluru, Karnataka, India
- Arya Rajendran
- MD (Obs & Gyn) DNB (Obs & Gyn) FNB (Reproductive Medicine)
- Consultant
- Department of Reproductive Medicine
- NIMS Fertility Center
- Palakkad, Kerala, India
- BS Susheela Rani MD PGDMLE FICOG
- Medical Director, Manjushree Speciality Hospital
- Bengaluru, Karnataka, India
- Past President
- Bangalore Society of Obstetrics and Gynecology
- Chairperson, Postgraduate Forum of Bangalore Society of Obstetrics and Gynecology
- Chandana C MBBS MS DNB
- Associate Professor
- Department of Obstetrics and Gynecology
- Vydehi Institute of Medical Sciences and Research Centre
- Bengaluru, Karnataka, India
- CS Sushma Madhuprakash
- MBBS DGO Fellowship in Maternal Fetal Medicine
- Consultant
- Division of Maternal and Fetal Medicine
- Dr Jyothi's Health Care Pvt Ltd
- Mysuru, Karnataka, India
- Deepa Nambiar
- MBBS MS (Obs & Gyn) DNB (Obs & Gyn) PGDMLS PGDHHM CCGDM
- Consultant
- Department of Obstetrics and Gynecology
- Shanthi Women's Healthcare Center
- Bengaluru, Karnataka, India
- Deepa Patil MBBS MS FRM
- Consultant
- Vijayapur-assisted Conception Center
- Bijapur, Karnataka, India
- Haritha Mannem
- MS (Obs & Gyn) FRM
- Consultant Infertility Specialist
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Harleen Kour MBBS MD
- Senior Resident
- Government Medical College
- Jammu, Jammu and Kashmir, India
- Jyothirmayi Kunam
- MBBS MS (Obs & Gyn) FRM (BACC)
- Milann—The Fertility Center
- Bengaluru, Karanataka, India
- Karthigayeni Rathinam
- MBBS MS (Obs & Gyn) DNB (Obs & Gyn) MRCOG FRM
- Consultant
- Department of Reproductive Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Komal Unadkat
- MBBS DNB (Obs & Gyn) Fellowship in Reproductive Medicine
- Consultant
- Poojan IVF Centre
- Ahmedabad, Gujarat, India
- Mahesh Koregol MBBS MS (Obs & Gyn) FICOG Fellowship in Reproductive Medicine
- Consultant Reproductive Medicine Specialist
- Andrologist and Laparoscopic Surgeon
- NOVA IVI Fertility
- Bengaluru, Karnataka, India
- Meghana V Nyapathi MS (Obs & Gyn) FRM
- Consultant
- Department of Reproductive Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Neha Tyagi
- MBBS DNB (Obs & Gyn) FRM
- Infertility Specialist
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Nilofer MBBS MS FMAS
- Assistant Professor
- Dr Pinnamaneni Siddhartha Medical College and Research Center
- DR NTR University of Health Sciences
- Vijayawada, Andhra Pradesh, India
- Nisha Singh
- MBBS MS (Obs & Gyn) DNB (Obs & Gyn) FNB (Reproductive Medicine) PGDMLE
- Consultant
- Reproductive Medicine and Assisted Conception
- Amaira Urology and Fertility Center
- Surat, Gujarat, India
- Priyadharsini S MBBS MS OG FRM
- Consultant, Obstetric, Gynecology and Infertility Specialist
- The Hosur Women's Hospital and Infertility Center
- Hosur, Tamil Nadu, India
- Priyanka Yadav MBBS DGO DNB
- Attending Consultant, Fortis Escorts
- Department of Reproductive Medicine
- Jaipur, Rajasthan, India
- Rahul Wani DNB DGO LLM LLB PGDMLS
- Consultant
- Department of Obstetrics and Gynecology
- Archana Maternity Nursing Home
- Navi Mumbai, Maharashtra, India
- Rajitha Yarlagadda MBBS MS (Obs & Gyn) FRM
- Reproductive Medicine Specialist
- Marvel Hospital
- Bengaluru, Karnataka, India
- Ravi Kumar IR MBBS MD
- Consultant Anesthesiologist
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Ravishankar P
- MBBS MS (Obs & Gyn) FRM DMAS (Germany)
- Consultant
- Reproductive Medicine
- The Nest Woman Wellness and Fertility Clinic
- Thiruvananthapuram, Kerala, India
- Rekha Viswanath MBBS MS (Obs & Gyn) DNB (Obs & Gyn) Fellowship in Reproductive Medicine (RGUHS)
- Former Fellow in Reproductive Medicine Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Revathi S Rajan MBBS DGO DNB (Obs & Gyn)
- Fellowship in Fetomaternal Medicine (RGUHS)
- Chief Consultant
- Division of Maternal Fetal Medicine
- Managing Director, Mirror Health
- Bengaluru, Karnataka, India
- Rinke S Tiwari
- FRM (Reproductive Medicine) MS (Obs & Gyn)
- Consultant
- Department of Reproductive Medicine
- Oasis Fertility Center
- Hyderabad, Telangana, India
- Roopa PS MBBS MS
- Associate Professor
- Manipal Academy of Higher Education (MAHE)
- Kasturba Medical College and Hospital
- Manipal, Karnataka, India
- Shalini MA
- MBBS MS (Obs & Gyn) FMAS FRM
- Consultant
- Department of Reproductive Medicine
- Garbhagudi IVF Center
- Bengaluru, Karnataka, India
- Shashikala KT
- MBBS DGO Fellowship in Reproductive Medicine (Fellowship in Minimal Access Surgery)
- Infertility Specialist, Obstetrician and Gynecologist
- Department of Reproductive Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Shravya Tallapureddy
- MBBS MS (Obs & Gyn) FNB (Reproductive Medicine)
- Fellow in Reproductive Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Smitha Avula MBBS DNB FFM
- Consultant, Division of Maternal Fetal Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Sneha MBBS MD DNB FRM
- Consultant
- Department of Reproductive Medicine
- NU Hospitals
- Bengaluru, Karnataka, India
- Sonal Agarwal
- MBBS MS DNB (Obs & Gyn) FMAS MNAMS FNB
- (REP MED)
- Consultant Infertility Specialist
- SMH Infertility IVF Center
- New Delhi, India
- Soumya Mahesh Koregol
- MBBS MS (Obs & Gyn) FIAOG
- Consultant, Fertility Specialist and Gynecologist
- Hospitec Multispecialty Hospital
- Bengaluru, Karnataka, India
- Sowmya Davuluri
- MBBS MS (Obs & Gyn) FRM DMAS
- Consultant
- Department of Reproductive Medicine
- Milann—The Fertility Center
- MS Ramaiah Memorial Hospital
- Bengaluru, Karnataka, India
- Sowparnika SN
- DGO DNB FRM (Reproductive Medicine)
- Fellow in Reproductive Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Srividhya GK MS Fellowship in Fetal Medicine Consultant, Department of Fetal Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Sudeepti Mummadi MBBS MS FRM
- Consultant
- Department of Reproductive Medicine
- Neelima Mom Fertility Center
- Sainath Hospital
- Hyderabad, Telangana, India
- Sumi Maria
- MBBS MS (Obs & Gyn) DNB (Obs & Gyn) FNB (Obs & Gyn)
- Consultant
- Department of Reproductive Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Sunil Gupta
- MD FRCP (Edinburgh) (Glasgow) FACP (USA) FICP FIAMS FIACM
- Managing Director
- Sunil's Diabetes Care n’ Research Centre Pvt Ltd
- Nagpur, Maharashtra, India
- Sunitha B
- MBBS DGO DNB FFMM PGDU PGDHHM PGDMLE
- Senior Consultant
- Department of Maternal Fetal Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
- Executive Committee Member of Bangalore Society of Obstetrics and Gynecology and Society of Maternal Fetal Medicine
- Surbhi Gupta
- MBBS MS (Obs & Gyn) DNB FNB (Reproductive Medicine)
- Consultant
- Reproductive Medicine
- Milann—The Fertility Center
- Gurugram, Haryana, India
- SV Joga Rao ML Mphil PhD Maxplanck Fellowship
- Advocate, Solicitor and Healthcare
- Consultant, Legalexcel
- Visiting Professor
- National Law School of India University (NLSIU)
- Bengaluru, Karnataka, India
- Swetha MBBS DA (DNB)
- Anesthesiologist
- Mallya Hospital
- Bengaluru, Karnataka, India
- Taswin Kaur Reddy MBBS DGO FRM FMAS
- Consultant
- Department of Obstetrics and
- Gynecology, Reproductive Medicine
- Chandra Superspecialty Hospital
- Anantapur, Andhra Pradesh, India
- Thejaswini J MBBS MS PGDRSM
- Consultant Gynecologist
- Columbia Asia Hospital
- Bengaluru, Karnataka, India
- Vignata N MBBS MS (Obs & Gyn) FRM Dip in USG
- Fertility Consultant
- Janardani Hospital
- Guntur, Andhra Pradesh, India
- Vinay Kumar
- MBBS MD Fellowship in Reproductive Medicine Diploma in Minimal Access Surgery
- Consultant
- Government Medical College
- Jammu, Jammu and Kashmir, India
- Vyshnavi A Rao
- MBBS MS (Obs & Gyne) Fellowship in Reproductive Medicine
- Infertility Specialist, Gynecologist and
- Obstetrician
- Department of Reproductive Medicine
- Milann—The Fertility Center
- Bengaluru, Karnataka, India
The word “emergency” means a serious, unexpected and dangerous event, which requires immediate medical attention. Although pregnancy and labor are physiological processes, obstetric emergencies are often unexpected and can develop rapidly. Obstetric Emergencies provides the obstetrician with insights regarding optimum care for the mother and the unborn child and how to deal with emergency situations in obstetric practice.
With the advent of technology, practicing obstetricians need to keep updating themselves with current advances in their clinical practice. The book will serve as an indispensable reference guide to all the clinicians and postgraduate students, since it provides a practical and accessible guide to all emergency situations from the immediately life-threatening to the smaller but urgent problems that could arise, thus ensuring a better prognosis.
Special topics that include medicolegal issues in obstetrics, pregnancy as a result of rape, diabetic ketoacidosis in pregnancy and labor and role of imaging modalities in obstetric emergencies are some of the topics which have been covered.
Evidence-based knowledge and current scientific evidence form the cornerstone for any successful treatment. The contributors have taken time out from their busy schedule in order to do thorough research into their topic thus, putting each topic into proper perspective and providing readers with unambiguous practice guidelines to help them achieve their goals.
The first and second editions of this book was well received. With the third edition we have updated the contents, keeping in mind the algorithm of the topic to help in easy understanding of the subject.
It is our hope that the book will be a reference guide for all busy practitioners, providing a scientific and evidence-based approach, leading to best clinical practices.
Kamini A Rao
Vyshnavi A Rao
PREFACE TO THE FIRST EDITION
The dictum “A healthy mother and a healthy baby” has been spearheading advances in the field of Obstetrics and Gynecology, into areas thought implausible in yesteryears. At this stage, it would do well to review the basics of treatment, many of which have stood the test of time and continue to be the gold standards in obstetric care.
This handbook, without much ado addresses the obstetric problems faced in daily practice. It encompasses the basic principles of diagnosis and management in practical detail.
This book has been conceived as an aid to doctors working at the primary health centers and at institutions where no sophisticated facilities exist. Theoretical details have intentionally been omitted, so as to serve as a quick reference when encountered with a problem.
I hope that this handbook serves as a guide to all those involved in the care of the pregnant woman, so as to make unsafe obstetric practices a thing of the past.
Kamini A Rao
ACKNOWLEDGMENTS
This book is a culmination of the sincere efforts of all the authors who very enthusiastically came forward to write the chapters. We would like to express our sincerest thanks to all of them for their time, effort and commitment to sharing their knowledge and expertise. As always, the publication team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India has gone out on a limb to bring out the book and ensure its timely release. We thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director–Content Strategy) for their constant support in making this happen. Special thanks to Mrs Kala Diwakar for coordinating the entire effort, interacting with both the contributors and the publishers at every stage, and generally following up with all stakeholders until the book becomes finally a reality. Lastly of course to our families—thank you for standing by us and supporting our every effort.