Intrapartum Management Flashcards
How would you plan the delivery of a mother in Labour?
Ensure stability of the mother by ATLS protocol and establish whether she’s in Labour and which stage. Site a wide bore cannula.
Take a targeted history to plan the mode of delivery and anticipate complications.
Do an abdominal and vaginal examination to assess presentation, position, engagement and descent, contractions, FHR and FM, cervix and membranes.
Provide most appropriate form of analgesia.
Manage according to the stage of Labour.
1st stage latent phase (simple analgesic, mobilize, hydrate, give enema, track cervix, check FHR)
1st stage active phase (transfer to Labour room, start partogram, track progress, urinalysis, VE, FHR every 15 mins, CTG)
2nd stage passive phase for 1-2 hours to allow descent and internal rotation. FHR every 10 mins.
2nd stage active phase <2 hrs for nulliparous and <1 hrs for multiparity. (Assess progress and descent, and strength of contractions, FHR every 5 mins, amniotomy, augmentation and episiotomy if necessary) OVD or LSCS if needed.
APGAR scoring and resuscitation of the newborn.
3rd stage Active management. Syntocinon, monitor for separation of placenta, early clamping of cord, controlled cord traction.
Examine the placenta
Monitor for PPH, check for tears and repair, episiorraphy
Skin to skin contact, care of newborn, first breastfeed.
Postnatal Care
