👤 By the CinnaEMS Content Team🕐 Updated 2026-09-27🏷️ Medical, Obstetrics & Gynecology🔖 Free to read, print, and share
Also known as: shoulder dystocia · breech · postpartum hemorrhage · eclampsia · maternal cardiac arrest · left uterine displacement · McRoberts
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Use this quick-reference guide to recognise, treat and hand over Obstetric Emergencies on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Shoulders
Turtle sign
McRoberts + suprapubic pressure
📌 Breech
Hands off to the umbilicus
Stuck head → two-finger airway
📌 Bleeding / Seizure
Heavy bleeding → fundal massage
Seizure + high BP → eclampsia
🚩 Arrest
Manual left uterine displacement
Notify early
📚 Obstetric Emergencies — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
Advanced obstetrics covers the rare births and maternal conditions that kill quickly. The exam tests recognizing them early and the maneuver or positioning each needs, remembering that the fetus survives only if the mother perfuses.
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Key points
Understand these first
Shoulder dystocia: McRoberts position (thighs sharply flexed toward the abdomen) plus suprapubic pressure — no forceful traction on the head.
Breech: hands off until the body delivers to the umbilicus; if the head is stuck, make an airway with two fingers.
Eclampsia: seizures with hypertension in late pregnancy or postpartum; magnesium sulfate is the treatment.
Maternal cardiac arrest: high-quality CPR with continuous manual left uterine displacement.
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Treatment priorities
What to do, in order
Treat the mother — maternal perfusion is fetal perfusion.
Seizure in pregnancy is eclampsia until proven otherwise.
Pregnant trauma: displace the uterus and transport even with minor findings.
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Red flags — report now
Escalate immediately
Turtle sign — the head retracts against the perineum
Blood loss over 500 mL after birth, or any bleeding with signs of shock
Tearing abdominal pain with loss of contractions (uterine rupture)
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Patient teaching
What patients must know
Arrest in late pregnancy: notify early — delivery within minutes of arrest can save the mother.
❓ Obstetric Emergencies: NREMT FAQs
What are the priority actions for Obstetric Emergencies in the field?
Treat the mother — maternal perfusion is fetal perfusion. Seizure in pregnancy is eclampsia until proven otherwise. Pregnant trauma: displace the uterus and transport even with minor findings.
What findings in Obstetric Emergencies change your plan or your transport decision?
Turtle sign — the head retracts against the perineum. Blood loss over 500 mL after birth, or any bleeding with signs of shock. Tearing abdominal pain with loss of contractions (uterine rupture).
What do I need to know about Obstetric Emergencies for the NREMT?
Shoulder dystocia: McRoberts position (thighs sharply flexed toward the abdomen) plus suprapubic pressure — no forceful traction on the head. Breech: hands off until the body delivers to the umbilicus; if the head is stuck, make an airway with two fingers. Postpartum hemorrhage: fundal massage, breastfeeding if possible, treat shock, rapid transport. Eclampsia: seizures with hypertension in late pregnancy or postpartum; magnesium sulfate is the treatment.
What should the crew communicate or document for Obstetric Emergencies?
Arrest in late pregnancy: notify early — delivery within minutes of arrest can save the mother.
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Quick Tip
Shoulder dystocia: McRoberts position (thighs sharply flexed toward the abdomen) plus suprapubic pressure — no forceful traction on the head.