Three different obstetrical scenarios, complicated by a Category II Fetal Heart Rate pattern, are presented to illustrate the importance of clinical context when formulating management plans. Emphasis, characteristics, and potential etiologies of Category II fetal heart rate tracings are reviewed. Management of the patient with a Category II fetal heart rate pattern is discussed, with special emphasis on the importance of the clinical context and fetal heart rate pattern evolution.

The National Institute of Child Health and Human Development (NICHD) workgroup standard for fetal heart rate monitoring assessment and categorization, first proposed in 1997 and subsequently updated in 2008 was meant to promote commonality of FHR tracing nomenclature and interpretation. Based on these recommendations, a three-tiered categorization pattern based on the visual assessment of the fetal heart rate pattern was adopted. This module aims to review and apply essential FHR content in several clinical scenarios to highlight an important Clinical Pearl: The Category III tracing is a rare intrapartum FHR pattern that is highly associated with fetal acidemia and adverse neonatal outcomes.

A case of obstetrical hemorrhage due to uterine atony, requiring medical and surgical interventions and blood component replacement therapy is presented. Emphasis: A review of obstetrical hemorrhage, etiologies, and treatments is provided. The importance of early recognition and response to excessive blood loss is stressed. Medical and surgical interventions for uterine atony are reviewed. Current recommendations for blood component replacement therapy for massive hemorrhage are discussed.

This course is intended to review the identification and management of various fetal heart rate patterns in a clinical context to prevent or address potential physiologic stress imposed on the fetus during labor, as evidenced by the fetal heart rate tracing. 

This course provides an introductory overview of intrapartum fetal monitoring, including the maternal-fetal oxygenation pathway, assessing uterine activity, and recognizing, interpreting, and managing FHR patterns.

This is a brief review of how nurses and providers should address maternal hemorrhage in the ED. All emergency departments must be prepared for obstetric hemorrhage, which can cause severe issues or death. 

Maternal obesity has significant implications for both the parent and fetus. This course discusses the risks associated with maternal obesity, updated care guidelines regarding BMI, and maternal, fetal, and neonatal complications associated with increased morbidity and mortality risk. You will also learn about how biases and perceptions related to BMI can affect the quality of care that patients receive and patient outcomes. Strategies to mitigate these risks through interprofessional care involving providers, nurses, and RDNs will also be reviewed.

This course discusses best practices in operative vaginal delivery techniques—forceps-assisted delivery and vacuum-assisted delivery (OAVD), as well as episiotomy.

The course is case-based, so you will have an opportunity to apply the principles covered to particular patient scenarios. The cases are branched, with different outcomes based on different choices.

Use of OAVD techniques vary from organization to organization. You may, for example, work in a hospital in which forceps techniques are no longer taught to residents. Each section has been organized so that you can move through it quickly or delve into it more deeply, depending on its relevance to your clinical practice.
 

Neonatal emergencies are frightening and challenging to almost all acute care providers. This course will focus on the neonate and provide a succinct review of resuscitation issues pertinent to clinical practice and board preparation/review.

Two cases are presented. Risk factors, including recurring and nonrecurring, for obstetrical hemorrhage, are reviewed. Delivery preparations and preventative strategies are discussed. Methodologies that better quantify blood loss, allowing for earlier recognition of excessive blood loss, are presented. Management of the patient experiencing obstetric hemorrhage, including a review of current guidelines for blood component replacement therapy, are reviewed.

This course is intended to provide a summary of the key nursing interventions and considerations when caring for a laboring patient who is experiencing Category III FHR patterns. Whereas this may not be a daily occurrence, it is important for the labor and delivery nurse to refresh their knowledge of this critical situation, as well as have a source for quick reference in the future. This promotes ongoing efforts to maintain the highest levels of patient safety and care.

This course is intended to provide a summary of the key nursing interventions and considerations when caring for a patient who has a delayed postpartum hemorrhage. Whereas this may not be a daily occurrence, it is important for the postpartum nurse to refresh their knowledge of the critical situation, as well as have a source for quick reference in the future. This promotes ongoing efforts to maintain the highest levels of patient safety and care.

This course is intended to provide a summary of the key nursing interventions and considerations when caring for a pregnant patient with eclampsia. Whereas this may not be a daily occurrence, it is important for the labor and delivery and postpartum nurse to refresh their knowledge of this critical situation, as well as have a source for quick reference in the future. This promotes ongoing efforts to maintain the highest levels of patient safety and care.

This course is intended to provide a summary of the key nursing interventions and considerations when caring for a pregnant patient who has severe hypertension. It is important for the labor and delivery and  postpartum nurse to refresh their knowledge of the critical situation, as well as have a source for quick reference in the future. This promotes ongoing efforts to maintain the highest levels of patient safety and care.

Worldwide, postpartum hemorrhage (PPH) accounts for high rates of maternal morbidity and mortality. Early recognition is key to good outcomes. Recognizing PPH, its stages, and how to measure blood loss is essential since treatment is based on the stages of hemorrhage. Additionally, it is important to understand nursing interventions, treatments for PPH, and teamwork and communication needs to improve perinatal outcomes.

This course aims to enhance the knowledge of acute care nurses about postpartum hemorrhage, including its causes, risk factors, and medical and surgical management.

Shoulder dystocia is an obstetric emergency. To prepare for this rare occurrence, your healthcare team should be knowledgeable about the risk factors, potential complications, and the management of shoulder dystocia. In addition, emergency professionals should develop strategies to help their healthcare team prepare for this rare event.

Nearly half of all cases of shoulder dystocia occur in the absence of risk factors, making them largely unpredictable and unpreventable. Perinatal morbidity and mortality rates associated with shoulder dystocia are high, even when properly managed.

Although shoulder dystocia is considered an obstetric emergency, a well-trained obstetric provider and a team of nursing/resuscitation professionals can usually manage it well for the pregnant person and fetus. 

A review of clinical judgment related to the use of primary maneuvers for managing shoulder dystocia.