Amr Salem
Basildon and Thurrock University Hospitals NHS Foundation Trust United Kingdom
Amr Salem
Chapters authored
Preterm Labour
Preterm delivery is defined as delivery before 37 weeks completed gestation. It represents a major cause of neonatal morbidity and mortality and accounts for 5–10% of all deliveries. Cervical length assessment between 16–24 weeks and positive fetal fibronectin beyond 21 weeks gestation are proved to useful tools in prediction of preterm labour. Treating asymptomatic bacteruia and bacterial vaginosis in high-risk women reduces the incidence of preterm labour. Cervical cerclage is recommended to reduce the incidence of preterm birth in women with 2nd trimester losses and those with cervical length of 25 mm or less on transvaginal ultrasound between 16–24 weks gestation. Atosiban and nifidipine are currently the agents of choice in tocolysis. Antenal steriods in womens with threating preterm labour reduces the perinatal morbidties. Magnisum sulphate role is established for neuroprotection especially in extreme gestations between 24–30 weeks. Vaginal delivery is mode of choice for delivery with consideration to avoid fetal blood sampling, fetal scalp electrodes and ventouse prior to 34 weeks gestations. Caesarean section is considered for obstetric reasons that guide labour management at term.
Part of the book: Empowering Midwives and Obstetric Nurses
Management of Obstetrics and Intrapartum Emergencies
Recent confidential enquires into maternal deaths in the UK have concluded that deaths due to obstetric hemorrhage have nearly doubled during the past triennium. The latest “Each baby Counts “Reported by Royal college of Obstetricians and Gynecologists has noted that approximately 76% of perinatal deaths and brain injuries could have been avoided by an alternative management. Lack of knowledge and human factors were the main contributory factors to poor outcomes. Substandard care is often due to “too little being done too late “, especially while managing emergencies during antepartum, intrapartum, and postpartum. All health care professionals including nurses should be familiar with management of emergencies with pregnancy.
Part of the book: Nursing