Lightning Learning: Precipitous Delivery

““Precipitous or ‘unexpected’ deliveries are a stressful time, but they are infrequent in most UK Emergency Departments.””

— advice is based on local guidelines & procedures

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What?

Precipitous or ‘unexpected’ deliveries are a stressful time, but they are infrequent in most UK Emergency Departments. These are often the result of a concealed pregnancy, so it can come as a shock for all involved.

If possible, get the patient to the maternity team. But if you need immediate help…

• Stay calm!

• Make sure they are in labour

• Get help to come to you

  • Fastbleep Obstetric Emergency team

• Allocate team available

  • Don’t forget to have a team for the baby

Why?

This is a stressful time for you and mum. Take the time to reassure and explain what is happening.

1. Support the baby's head as it is delivered with a hand

   • This is to slow delivery, and allow for control

2. Perineal hand pulls skin towards middle

   • Reduces risk of tearing

3. Don't pull head once head resituates (faces to side)

4. Guide head downwards to deliver anterior shoulder

5. Then upwards for posterior shoulder

6. Assess baby once it is delivered

7. If everything is fine place on mums abdomen for skin-to-skin time

Further Reading

• RCEM Learning: Call The Midwife!
• First 10 EM: Precipitous Delivery in the ED
• UTSW Simulation: Normal Delivery – OSCE (video)