BACHELOR OF SCIENCE IN MIDWIFERY

Course : M104 (CLINICAL MANAGEMENT I)

Name
Course : This course deals with clinical management of obstetrical emergencies
Description and high risk pregnancies, including the elements of Reproductive
Health.
Course : At the end of the course, the student should be able to:
Objectives 1. Provide midwifery care and supervise women with high risk
pregnancy during pre-natal, internal and post-natal period;
2. Execute emergency measures in OB emergency cases;
3. Attend caesarian section as a scrub assistant;
4. Provide post caesarian section care.
5. Discuss the elements of Reproductive Health
Course : 3 units lecture
Credits
Contact :
Hours 3 hrs lecture/week
Pre- : M-102 (Midwifery Practice 2)
requisites
Course : I. High Risk Client
Outline A. Definition and Scope of the Problem
B. Risk Factors
C. Assessment of the High Risk Factors
1. History and Physical Examination
2. Biophysical Monitoring
3. Biochemical Monitoring
3.1 Maternal urine Assessment
3.2 Maternal Blood Assessment
3.3 Amniotic Fluid Assessment
3.4 Assessment of Fetal Well Being
D. Health Disorders Complicating Pregnancy
1. Diabetes
2. Cardiac Disease
3. Renal Disease
4. Pulmonary Disease and Respiratory Distress
E. Complications During Pregnancy
1. Hemorrhagic Complications
2. Spontaneous Abortion
3. Ectopic Pregnancy
4. Gestational Trophoblastic Disease
5. Disseminated Intravascular Coagulopathy
6.1 Abruptio Placenta 6. Placental Abnormalities
6.2 Placenta Previa
6.3. Invasive Placenta
6.4 Vasa Previa
7. HypertensiveDisorders
 F. Complications During Labor and Birth
1. Dysfunctional Labor
Dystocia
Malpositions/Malpresentations
Multiple Pregnancy
Precipitate Labor
Premature Rupture of Membranes
2. Hemorrhagic
Complications Ruptured uterus
Inversion of the
Uterus Lacerations
3. Infant Complications
Pre-maturity
Post maturity
Birth Injuries
G. Complications During Post Partum period
1. Hemorrhagic Complications
1. Retained Placenta
2. Uterine Atony
3. Inversion of the Uterus
4. Subinvolution of the Uterus
5. Laceration of birth Canal
2. Maternal Infections
II. Emergency Obstetrics
A. Vaginal Bleeding
1. During Early Pregnancy
2. During Later Pregnancy and Labor
3. After Childbirth
B. Shock
C. Malpositions and Malpresentations
D. Shoulder Dystocia
E. Fetal Distress in Labor
F. Prolapsed Cord
G. Difficulty in Breathing
H. Elevated Blood Pressure
I. Unsatisfactory Progress of Labor
III. Operative Obstetrics
1. Analgesia and Anesthesia
2. Operative Care Principles
1. Pre-Operative
2. Intra Operative
3. Post Operative
3. Dressing and Wound Care
4. Operative Procedures
1. Dilatation and Curretage
2. Vacuum Extraction
 3. Forceps Delivery
4. Caesarian Section
5. Post Partum Hysterectomy
IV. Ten Elements of Reproductive Health
Laboratory : OHP, Major and minor OR Set, Operating Room set up, pelvic models,
& birth simulator
Equipment
Texts & : Gilbert and Hamon, High Risk Pregnancy and Delivery, Mosby 2003
References Miles Textbook for Midwives
Managing Complications in Pregnancy and Childbirth, WHO
th
Berek, Jonathan S., Novaks Gynecology, 12 edition 1988
Piliterri, Adelle, Maternal and Child Health Nursing, Lippincott 2003