PROMPT provides evidence-based multi-professional training in the UK and worldwide. Making Childbirth Safer, Together
PROMPT training: - reduces preventable harm from obstetric emergencies, including shoulder dystocia - reduces the risk of babies being born in poor condition - reduces birth-related brain injury and cerebral palsy
Hello, why does the midwife decided to administer only oral nifedipine after seeing all the symptoms, BP, hyperreflexia? Why not giving hydralazine and MgSO4 to prevent seizures?
I wish someone would make a first person from the mums view.. What do the visual disturbances look like first person ? How does she feel? I think i may have developed preclampsia
As a registered midwife here in jamaica I was diagnosed with shoulder dystocia 12 years ago. It was a traumatic experience however the team was there right through it all. I recieved bilateral episiotomy among vaginal tears. My baby weighed4.16kg. I ended up having symphysis pubis diastasis and could barely move my lower limbs for a few days. I thanks the lord everyday for the care I recieved as it could have been another way.
I understand this is the way it’s been done and still is done in hospitals around the world. I agree that it works very well in most cases to dislodge the baby. My question would be this: If baby is stuck on maternal pelvis (most often, but not always on the pubic bone), wouldn’t it be easier, safer, and faster to just have mom move rather than trying to move baby. I guess the Mcroberts maneuver technically moves the mom, but I’m thinking more like getting mom into hands and knees or anything that moves her pelvis to allow baby to slip off the bone. Maybe it has something to do with the fact that many moms have epidurals and are unable to move much. I enjoyed the video 😊
Yes we check the patellar reflex for accessing mgso4 toxicity. In the case of toxicity there is loss of patellar reflex. But they checked it before administration of mgso4 because they wanted to check for hyperreflexia. Deep tendon reflexes are increased in many women prior to seizures. That's why. Hope it clears your doubt😊😉
Hi Rosie yang...I'm a final year mbbs student. To the best of my knowledge, in this condition, although there is hypovolemia but tissues are overloaded. Also the urine output is severely decreased. So Excessive fluids or iv infusion will cause tissue overload and circulatory overload leading to pulmonary edema and adult Respiratory distress syndrome.
Thanks Rosie, we're glad you're finding them useful. As Jasmine says the reason we restrict fluid in severe pre-eclampsia is the risk of of pulmonary oedema, which used to be a leading cause of death in these women. Pre-eclampsia can lead to leaky capillaries, and to renal impairment, both of which predispose to pulmonary oedema unless fluids are carefully managed.
Thank you so much for this content. I'm still a bit confused about how filling the bladder of the mother helps in the management of cord prolapse. Please share some light on this. Thank you.
The bladder sits anteriorly to the uterus so a full bladder can cause displacement of the uterus and thus relieve pressure on the presenting part. The reverse of why you want an empty bladder for delivery.
The management of APH is described within the PROMPT course materials. Your maternity unit can access the PROMPT online course, or apply for PROMPT's 2021 Annual Update, by emailing us on
If I want to contact professor Tom draycott then how can I contact him? Any email? I have prompt mannual and I work as ST3 trainee in UK but I do not have these prompt updates about caesarean section in my mannual. How can I get these guidelines whatever he is teaching?
Hi Saima Many thanks for your interest. PROMPT covers the management of obstetric emergencies, and so caesarean section is not covered as part of our course. In terms of updates regarding impacted fetal head at CS, this is an emerging field in terms of clinical research, and we will produce guidance once the evidence regarding best practice becomes available.
This happened to me. I had no idea what was going on at the time. Thank god I had a great team of medics and my baby boy was born healthy weighing 9lb 10.5 oz. Hes 16 now!
Many thanks for sharing your story Lucy. That must have been scary at the time. But it's great to hear that, thanks to a well-trained team, he's done so well.
@@promptmaternityfoundation8950 Thankyou for letting me tell my story on this channel. Nothing was properly explained to me at the time. I cannot fault anyone though as they saved his life. Thankyou so much for your videos. They’ve helped me make sense of what happened to us. As I said, Harvey is 16 now and a healthy teenager. Thanks to my midwife Barbara who raised the alarm and the team at Yeovil women’s hospital x
Many thanks Salma. As you say, delivery of the baby will be the team's ultimate goal. However, it is vital to stabilise the mother first. The team's key clinical aims in severe pre-eclampsia will be: - senior review, and involve the multi-professional team - manage the blood pressure - prevent seizures (with MgSO4) - restrict fluids - make a plan for delivery All the while remembering good team-working in terms of: - communication within the team (e.g. using SBAR and 'closed-loop' communication), and with the mother - situational awareness (maintaining a clear overview, thinking ahead) - team roles and leadership
I'd have to disagree with this protocol on some issues: (1) Do you want to say that upon knowing that you've got a confirmed case of covid-19 on the ward, the emergency responders were not on (at least)face masks, not talk of face shields. (2) The first responder touched the the door knob ungloved, for a room with a confirmed case! (3) An obstetric patient should have an IV access, no better period for such practice than in this pandemic (4) Even though we may understand that this is just a guide, did folks see one of the responders touch her face during donning? (4) some one else picked up the pack without gloves on and no face masks on. I guess that area where the pack was picked up is supposed to be for sterile materials. I'll like to get your response to the observations highlighted above.
Stanley Chinaka 1. They all had masks and googles. 2. The outside of the door is not in contact with Covid 19 (it’s a normal birth unit ward, not a Covid ward) therefore opening the door is okay followed by hand hygiene 3. The team were likely putting in a 2nd IVC as part of PPH response though there’s an argument that a low risk woman with mild symptoms still doesn’t necessarily warrant an IVC 4. Didn’t notice that. Hopefully that person washes there hands after touching their face before moving onto the next step. 5.The person who got the pack was outside the Covid room. The packs are grabbed by a ‘runner’ and passed into the room OR taken from they are stored to just outside the room, individual dons, then brings the PPH pack in with them. Not affiliated with PROMPT just my interpretation to your observations :)
