- Uncommonly encountered however critical to manage
- Always Type & Cross, difficult to predict complications
- Stage 2 complications include
- Shoulder Dystocia- difficult to predict and morbid. Consider HELPERR mnemonic and know maneuvers
- Umbilical cord prolapse- Elevate fetal parts, tocolysis, and wait for OB
- Uterine rupture- identify by acute pain, vaginal bleeding, and loss of station, wait for OB
- Malpresentation- Best plan is tocolysis and wait for OB. If delivery is unavoidable, delivery is presentation-dependent
- Stage 3 complications include
- PPH- 4T’s (tone, trauma, tissue, and thrombin). Stepwise approach and know rescue measures
- Uterine inversion- replace it early