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Telemedicine in Prenatal Care: Obstetric Emergencies During Pregnancy

May 2, 2022

The advent of telemedicine, or better still, telehealth was not aimed at replacing in-person health care. Instead, it serves as a supplementary means of providing healthcare, especially to nonemergent cases.

However, this does not rule out the use of telemedicine in emergency cases. Your virtual physician could help link you with a facility nearby while giving directives on what could be done to alleviate some symptoms or buy time. 

Generally, health emergencies are health problems that require immediate medical in-person attention. In pregnant women, they are referred to as obstetric emergencies. 

Obstetric emergencies are health problems arising at any time during pregnancy, labor, and childbirth that threaten the life of a pregnant mother and that of her baby or babies. In most cases, these health problems require specialist care, hospital admission, and extended stay.

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Obstetric Emergencies During Pregnancy

Obstetric emergencies may occur during pregnancy, labor, and childbirth. The following are obstetric emergencies that arise during pregnancy:

Miscarriage

This is the loss of a baby before the 20th week of pregnancy.  It usually manifests with bleeding, abdominal cramping, and pain. If a miscarriage occurs, the mother may need to be treated to prevent infection or to remove retained tissue in the uterus.  

Ectopic pregnancy 

This is a serious condition where the fertilized egg implants anywhere other than the uterus or womb. The most common site of ectopic pregnancy is in one of the fallopian tubes leading to the damage and loss of the tube. A woman with an ectopic pregnancy will experience bleeding accompanied by severe abdominal or pelvic pain, feeling faint, and shoulder pain.  Ectopic pregnancy reduces a woman's chances of getting pregnant in the future due to damage and loss of a fallopian tube.

Placental abruption

This condition occurs when the placenta separates from the uterus before birth. Manifestations include bleeding, pain, and contractions. There is a higher risk of infection as blood could be trapped behind the placenta and in the uterus. Bleeding could also result in weakness, anemia, shock in the mother, and the death of the baby.

Placenta praevia 

This is when the placenta attaches to the lower segment of the uterus and partly or completely lies over the internal of the cervix, also called the neck of the uterus. This results in vaginal bleeding during pregnancy. 

Pre-eclampsia and eclampsia

Pre-eclampsia, also known as pregnancy-induced high blood pressure is an obstetric emergency. Pregnancies in women with preeclampsia are regarded as high-risk pregnancies. Symptoms include high blood pressure, edema (severe swelling) from water retention, and protein in the mother's urine. It can cause kidney and liver failure in the mother and cause preterm labor. It also affects the growth and development of the child and causes premature birth and stillbirth. If it progresses to eclampsia (convulsions), it can be life-threatening for the mother and her baby.

Premature rupture of membranes (PROM) 

This is when a woman's water breaks before contractions or labor begins. This is an emergency if the waters break before 37 weeks of pregnancy and lead to a major leak of amniotic fluid or infection of the amniotic sac.

Management of Obstetric Emergencies

These conditions cannot be managed at home or virtually. They mostly require hands-on treatment by specialists or a team of healthcare professionals.

Generally, medical history will be collected and pelvic and general physical examinations carried out. Series of tests may also be carried out including blood and urine tests, blood pressure monitoring, and abdominal ultrasound, amongst others. Your baby's heartbeat will also be checked and monitored.

Depending on your condition, you may require one or more of the following:

  • Bed rest
  • Medications such as analgesics, antibiotics, antihypertensives, anticonvulsants, antenatal corticosteroids, etc.
  • Manual vacuum aspiration
  • Blood transfusion
  • Induced labor 
  • Cesarean section (in placenta previa, preeclampsia, and eclampsia)
  • Surgery such as laparoscopy, etc.

At My Virtual Physician...

As a supplementary health care service, our team at My Virtual Physician is available to help guide you through your pregnancy and answer any questions that may arise. We also help with electronically sending orders for tests and examinations while you wait for an appointment with a local OB doctor.

We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare and Blue Cross. 

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