Obstetric emergencies are acute, life-threatening conditions that can occur during pregnancy, labour, delivery, or the immediate postpartum period. They require rapid recognition, prompt assessment, immediate nursing intervention, and coordinated medical management to prevent maternal and fetal morbidity and mortality. In maternal health nursing, the nurse plays a central role in early identification of danger signs, stabilization of the mother, continuous monitoring of the fetus, preparation for emergency procedures, administration of prescribed medications, and emotional support to the woman and her family. Antepartum obstetric emergencies 1. Antepartum haemorrhage: Bleeding from the genital tract after the period of viability and before delivery is an important obstetric emergency. The common causes are placenta previa and placental abruption. Placenta previa occurs when the placenta is implanted partly or completely over the internal cervical opening and commonly causes painless, bright-red vaginal bleeding. Placental abruption is premature separation of a normally situated placenta and is usually associated with painful vaginal bleeding, abdominal pain, uterine tenderness, and fetal distress. Severe blood loss can lead to hypovolemic shock, maternal anemia, disseminated intravascular coagulation, fetal hypoxia, and fetal death. Nursing care includes assessing the amount and nature of bleeding, monitoring vital signs and fetal heart rate, establishing intravenous access, maintaining fluid replacement as prescribed, preparing blood for transfusion, and avoiding unnecessary vaginal examination when placenta previa is suspected. 2. Ectopic pregnancy: An ectopic pregnancy occurs when the fertilized ovum implants outside the uterine cavity, most commonly in the fallopian tube. Ruptured ectopic pregnancy can cause massive internal haemorrhage and circulatory shock. The woman may present with lower abdominal pain, vaginal bleeding, shoulder-tip pain, dizziness, fainting, pallor, and signs of shock. Rapid assessment, intravenous fluid and blood replacement, monitoring of vital signs, and preparation for emergency surgical management are essential. 3. Abortion with severe haemorrhage: Spontaneous or induced abortion may result in excessive bleeding, retained products of conception, infection, or shock. The nurse should assess bleeding, pain, vital signs, and general condition and prepare the woman for appropriate medical or surgical treatment. Emotional support is also important because pregnancy loss can produce considerable psychological distress. 4. Severe pre-eclampsia: Pre-eclampsia is characterized by hypertension occurring after 20 weeks of pregnancy with evidence of maternal organ involvement. Severe disease may present with severe headache, visual disturbances, epigastric or right upper abdominal pain, markedly elevated blood pressure, oliguria, and abnormal laboratory findings. It can progress rapidly to eclampsia, stroke, pulmonary edema, renal failure, placental abruption, and fetal compromise. Nursing management includes frequent monitoring of blood pressure, neurological status, urine output, reflexes, fetal condition, and administration of prescribed antihypertensive and anticonvulsant therapy. 5. Eclampsia: Eclampsia is the occurrence of seizures in a woman with pre-eclampsia that cannot be attributed to another neurological cause. It is a major obstetric emergency. During a seizure, the nurse should protect the woman from injury, maintain airway and breathing, position her appropriately, provide oxygen as indicated, administer magnesium sulfate according to protocol, monitor for magnesium toxicity, and prepare for delivery after maternal stabilization. Continuous maternal and fetal observation is essential. 6. HELLP syndrome: HELLP syndrome is characterized by haemolysis, elevated liver enzymes, and low platelet count. It is a severe complication associated with pre-eclampsia and may cause right upper abdominal pain, nausea, vomiting, headache, hypertension, bleeding tendencies, liver complications, and fetal compromise. Prompt recognition, laboratory monitoring, stabilization, and preparation for delivery are necessary. 7. Severe hyperemesis gravidarum: Although vomiting is common during pregnancy, severe and persistent vomiting may cause dehydration, electrolyte imbalance, nutritional deficiency, weight loss, and metabolic abnormalities. Nursing care includes assessment of hydration and nutritional status, monitoring of intake and output, administration of prescribed fluids and antiemetics, and gradual nutritional rehabilitation. Intrapartum obstetric emergencies 8. Obstructed labour: Obstructed labour occurs when the fetus cannot descend through the birth canal despite adequate uterine contractions. Causes include cephalopelvic disproportion, malpresentation, malposition, pelvic abnormalities, and fetal abnormalities. It can result in maternal exhaustion, dehydration, uterine rupture, infection, postpartum haemorrhage, fetal hypoxia, and death. The nurse should monitor labour progress, maternal and fetal condition, identify abnormal findings early, maintain hydration and intravenous access, and prepare the