Obstetric Emergencies for UPSC CMS: APH, PPH, Eclampsia and Shoulder Dystocia

APH (Antepartum Haemorrhage)#

Placenta previa: Painless bleeding after 28 weeks. USG diagnosis. Treatment depends on type and fetal maturity.

Abruptio placentae: Painful bleeding, tender uterus, shock. Vaginal delivery usually preferred. Fetal distress common.

PPH (Postpartum Haemorrhage)#

4Ts: Tone (atonic uterus - most common), Trauma (lacerations), Tissue (retained placenta), Thrombin (coagulopathy).

Management: Uterine massage, Oxytocin 10 units IV, Misoprostol 800 mcg PR, Balloon tamponade (Bakri), Surgery.

Eclampsia#

Seizures in pre-eclampsia. MgSO4 loading 4g IV over 15 min, then 1-2g/hr maintenance. Monitor: reflexes, respiratory rate, urine output.