Emergency delivery: prehospital care, emergency department delivery, perimortem salvage

The incidence of high-risk conditions complicating pregnancy is greater than one would suspect. Many times a pregnancy does not become high risk until labor starts. Prehospital and Emergency Department protocol should be directed at getting the mother to the labor and delivery suite as soon as possible. Most complications resulting in maternal-fetal morbidity and mortality are handled best in that setting. Prehospital and Emergency Department personnel should, however, be prepared to handle imminent delivery because it cannot be avoided when it occurs. Emergency Department personnel also should be familiar with the technique of perimortem cesarean delivery and use this technique when indicated for fetal-maternal salvage.