Intrapartum Care Flashcards
What constitutes general care in labour?
No interventions if labour progressing normally
Communication and support
Encourage mobilisation and comfortable positions
Hygiene
Observations
Hydration
What is the management of latent phase of 1st stage of labour?
<4 cm dilatation
Triage and assess
Offer pain relief
Encourage to be at home
Observations in labour?
Hourly pulse
4 hrly temp and BP
Frequency of contractions
Vaginal Exam 4hrly
What are the different forms of foetal monitoring?
Intermittent; for `1 min after a contraction every 15 min in 1st stage and every 5 mins in 2nd stage
continuous CTG
FBS
What is a delay in 1st stage labour?
<2 cm in 4 hrs
3 Ps; power, passage, passenger
Intervene and repeat vaginal exam in 2hrs
Management for delay in labour?
Amniotomy
Syntocinon increments
C/S
What is a delay in 2nd stage of labour?
Para 0 >2hrs
Multip >1hr
Options; transfer and deliver
What are interventions to assist with delay in 2nd stage of labour?
Nothing
Episiotomy
Instrumental delivery
C/S
What is the expected care in the 3rd stage of labour?
Minimise disruption of bonding
Observations
PV loss minimised
Active management of 3rd stage of labour
Routine use of uterotonic drugs
Deferred clamping and cutting of cord
Controlled cord traction after signs of separation of placenta
What constitutes a delay in the 3rd stage of labour?
Not completed within 30 mins of birth with active management
Not completed within 60 mins of birth with physiological management
What is the management of delay in 3rd stage of labour?
Assess
MROR under GA
What is the immediate treatment of PPH?
Empty bladder Uterine massage Uterotonic drugs IV fluids Controlled cord traction if placental not yet delivered
What is the expected care postpartum?
Assess perineum Assess blood loss Observe Skin to Skin Breastfeeding Newborn assessment
