Precipitous Delivery

First, take a deep breath and remember that 90% of babies require no assistance at birth and transition to the extrauterine environment appropriately all on their own - Arika G. Gupta MD

Precipitous Delivery

image by: Maternity Department

HWN Suggests

Clamp the Cord: Emergency Department Deliveries – Part 1

Apply gentle pressure with a sterile towel using your dominant hand to support the perineum, easing the pressure of head descent to prevent vaginal tears. Apply gentle pressure with your non-dominant hand to the head with slight flexion to the infant’s neck as the mother gives small pushes.

The infant will restitute and rotate to face the maternal thigh after the head is delivered. Now is the time to check for a nuchal cord by running your finger around the neck.

To deliver the anterior shoulder, place your palms on the infant’s cheeks and apply gentle downward traction. Oxytocin 10 units IM should be administered after delivery of the anterior shoulder. Use gentle upward…

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 Clamp the Cord: Emergency Department Deliveries – Part 1

Although the incidence of performing ED deliveries is low, the stakes are much higher. The following list outlines the increased rates of various complications: Infant resuscitation → 25%. Infant mortality → 9%. Nuchal cord → 9%. Postpartum hemorrhage → 6%. Shoulder dystocia → 3%. Cord prolapse → 1%.

International Emergency Medicine Education Project

During delivery of the head, gentle upward pressure with a sterile towel or drape to prevent anal contamination on the perineal area helps elevate the presenting part and decrease the pressure the fetal chin exerts on the perineal skin. Immediately following delivery of the head, palpate the fetal neck to inspect for umbilical cord encircling the neck. This cord needs to be reduced over the fetal head before delivery can continue.


Gentle digital stretching with a lubricated finger may prevent tears and lacerations.

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