Maternal and Newborn Nursing
Core concepts
Maternal-newborn questions cluster around antenatal risk, labour progression, postpartum haemorrhage, hypertensive disorders, and newborn transition. Know the stages of labour, fetal monitoring categories, APGAR scoring, and the normal ranges for newborn vital signs and glucose. Understand pre-eclampsia and eclampsia, placenta praevia versus abruption, and the difference between early and late decelerations.
Traps to expect
- Deceleration patterns: early decelerations are head compression and benign; variable decelerations suggest cord compression (reposition); late decelerations suggest uteroplacental insufficiency and demand immediate action.
- Magnesium sulphate toxicity: loss of deep tendon reflexes and respiratory depression precede arrest; keep calcium gluconate available.
- Postpartum haemorrhage: a boggy uterus with heavy bleeding calls for fundal massage and uterotonics, not observation.
- Placenta praevia: painless bleeding; never perform a digital vaginal examination.
- Newborn thermoregulation: cold stress leads to hypoglycaemia and respiratory distress; dry and warm the baby first.
Worked rule of thumb
For any fetal heart tracing, ask: does the pattern recover with maternal repositioning and oxygen? If not, or if late decelerations persist, escalate urgently. For the newborn, follow dry, warm, stimulate, assess in that order.
Study approach
Learn each emergency as a three-step chain: recognise the pattern, perform the immediate bedside action, then escalate.