//These were given by Dr Shathisha
Things to do while in Labour ward.//
Things to do:
- Timing utering contraction
- Identifying the Stage of labour
- Pelvic examination
- ARM
- Conducting a normal delivery
- III Stage management
- Assessing normal blood loss
- Palpating well contracted uterus
- Connecting CTG
- Labour medications
- Labour Analgesia
- Episiotomy
Diagnosis of Labour:
Regular Contractions, Increasing in Frequence, Increasing Intensity
Cervical Changes
Show may be present
Formation of bag of membranes
Mx:
Preparation - Enema, Xylocaine sensitivity, Labour Gown, IV line, Blood Corssmatch.
Admission and Evaluation - When fully effaced? Lie, Presentation (Abd), Presenting part, Position, Dilatation (PV)
Partogram - 4hrly PV, Utering Contractions, Monitor fetal heart rate
Labour Analgesia
Hydration
Positioning
Emotional Support
Mx Stg II - Frequent contractions, Bearing down, Feel Pass motions, Keep delivery tray ready, Lithotomy position when hair seen, Clean and drape, Catheterise, Encourage mother to bear down, Controlled delivery of the head, Local Anesthesia, Episiotomy just before crowning, Ant shoulder delivery, IM syntometrine
Mx Stg III - Controlled Cord tracion, suprapubic pressure, Rotate placenta as it comes out, Assess blood loss
Mx Stg IV - Obv every 15 mins for an hour, Shift once pass urine.
