Abstract
Precipitous or emergency department (ED) delivery is a stressful event that requires preparation to comfortably approach and safely manage—often including development of ED delivery checklists or kits and appropriate expedited consultant notification (i.e., paging lists). Complications are rare but include shoulder dystocia, prolapsed umbilical cord, and breech presentation. If a shoulder dystocia is encountered, an algorithm of maneuvers can be employed and should start with McRoberts maneuver and application of suprapubic pressure and proceed to include rotational or internal maneuvers. Management of a prolapsed umbilical cord should start with elevation of the presenting fetal part to alleviate pressure on the umbilical cord and expedited obstetric assistance for emergent cesarean section. Breech delivery is best managed by allowing the mother to deliver the fetus with no assistance in delivery until the umbilicus is visualized.
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