Labour Progression | Western Sydney University

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

152

Pages:

4
Author:

Mariam A. A.

Labour Progression History, Examination and Management History How long has she been in labour? Is this labour induced? If no ->, has she been in hospital before or after the labour begun? If yes -> what has been used, how much is given and when was it given? What stage of labour is she in? Is she on any pain relief? If yes ->, what is she on and how much and when was it given? Is she in pain? Did the waters break? When did they? What colour is it? Is there blood or meconium? Is there a smell? Is there any associated bleed? Are there any changes to fetal movements? Are there any contractions? When did they begin? How long have they been going on for? Have any complications in labour occurred so far? Did any complications occur in this pregnancy? Was it natural or spontaneous? Did she attend all antenatal appointments and scans? Any abnormalities found? Rh status -> was she given anti-D Medical history Surgical history STI screen, CST screen or other screening Medications Allergies CTG Review DR C BRAVDO Confirm patient details Define risk Contractions In labour should be 4 to 5 in 10 minutes for it to be considered reassuring If more -> hypercontractility If less hypo contractility Frequency and duration Baseline heart rate -> should be 110 to 160 for it to be considered reassuring If more than range -> anaemia, hypoxia, hyperthyroidism or chorioamnionitis If less than range -> cord compression, head compression and placental insufficiency or fetal distress Acceleration -> more than 15 beats per minute for at least 15 seconds This must be present for a reassuring CTG Variability For it to be normal -> 5 to 25 Deceleration Variable -> cord compression -> change maternal position Early -> head compression -> assess labour progression Late -> placental insufficiency -> consider C section or augmentation of labour Outcome Assuring vs abnormal Progress Assessment and Management Timing and palpating of contractions Assess for the four Ps of labour: Powers Psych Pelvis Passenger VE exam C section