meconium stained liqour

Question 1

task

Answer 1

Your patient is a 25-year-old primigravida who is in early labour at 41 weeks of gestation She is in
the local district hospital where you are attending as a general practitioner. The hospital has good
facilities but a consultant obstetrician is not available. Pelvic examination 30 minutes ago showed
the cervix was 3 cm dilated, well effaced, and well applied to the presenting part. The cephalic
presentation was position left occipitotransverse (LOT), at zero station, with no caput or moulding
evident. The membranes were still intact and allowed to remain so. Spontaneous rupture of the
membranes then occurred and revealed profuse, thick meconium-stained liquor. The pregnancy
had been uneventful to date, and blood pressure and urine testing have been normal in labour.
The fetal heart rate, as defined using auscultation, has been between 130 and 140/min.
YOUR TASKS ARE TO:
* Take any further relevant history you require.
* Ask the examiner about relevant findings likely to be evident on general and obstetric
examination.
* Advise the patient of the diagnosis and subsequent management during and after delivery.

Question 2

questions

Answer 2

-how was the preganancy so far?
-when was the baby due?
-CTG was done 3 days ago >normal
-fetal movements?
-vaginal bleeding?
-contractions, interval, how long(3-4 min for 45 sec)

Question 3

examination findings

Answer 3

-colour of meconium
-cervix : dilation, effaced,
-position : LOT, zero station
-caput moulding, cord prolapse
-BP, pr
-CTG

Question 4

explanation

Answer 4

-meconium stained liqour common during post term, sometimes it may mean the baby is having some problem>therefore CTG needs to be done
-if CTG abnormal>further action required
-pelvic examination should be done to exclude cord prolapse

Question 5

explanation

Answer 5

-meconium stained liqour common during post term, sometimes it may mean the baby is having some problem>therefore CTG needs to be done
-if CTG abnormal>further action required
-pelvic examination should be done to exclude cord prolapse
-absence of abnormal PV and CTG>labour allowed to progress
-if progress normal and ctg>labour allowed to progress till normal delivery
-minor CTG abnormality > check fetal scalp PH and lactate to check the significance of CTG>if abnormal C section or manipulative vaginal delivery
2.AT TIME OF DELIVER V IMP
-adequate suction of mouth, pharynx nose
-if aspiartion may need visualise vocal cord and aspirate
-paediatrician should be available