Approach to Precipitous Delivery in the Emergency Department: Best Practices for Managing Emergent Vaginal Deliveries and Associated Complications

Precipitous deliveries in the emergency department are one of the highest-acuity events that emergency providers manage. These deliveries can range from uncomplicated to wrought with difficulty. They require emergency care providers to manage intrapartum complications, such as nuchal cords, shoulder dystocia, and breech presentation, and maternal complications such as uterine atony, birth canal trauma, and postpartum hemorrhage. Delivery may additionally necessitate resuscitative hysterotomy or neonatal resuscitation. Our narrative review discusses preparatory practices, normal labor and delivery progression, and brief guidelines for managing complications of precipitous deliveries for emergency medicine providers.