Principles -
1. Non-interference with watchful expectancy so as to prepare the patient for natural birth.
2. To monitor carefully the progress of labour, maternal conditions and fetal behaviour so
as to detect any intrapartum complication early.
as to detect any intrapartum complication early.
Actual management -
General -
General -
- Antiseptic dressing.
- Encouragement and assurance are given to keep up the morale.
- Constant supervision is ensured.
Bowel -
An enema with soap and water or glycerine suppository is traditionally given in early stage.
This may be given if the rectum feels loaded on vaginal examination. But enema neither
shortens the duration of labour nor reduces the infection rate.
Rest and ambulation -
If the membranes are intact, the patient is allowed to walk about. Ambulation can reduce
the duration of labour.
Perineal shave -
The purpose of perineal shave is to prevent infection, preparation of perineum involving
the shaving of mons pubis, vulva and anal region provide for cleanliness and early viewing
of perineum.
Diet -
A woman in labour, even in early stage, should not eat solid food. Gastric contents are really
dangerous if aspirated following general anaesthesia. So food is withheld during active labour.
Bladder care -
Patient is encouraged to pass urine by herself as full bladder often inhibits uterine contraction
and may lead to infection. If the woman can not go to the toilet, she is given a bed pan.
Privacy must be maintained and comfort must be ensured. If the patient fails to pass urine
specially in late stage, catheterisation is to be done with strict aseptic precaution.
Relief of pain -
The common analgesic drug used is pethidine 50-100 mg intramuscularly (IM) when the pain
are well established in the active phase of labour. Pethidine is an effective analgesic as well as
a sedative. The drug should not be given if delivery is anticipated within two hours.
Assessment of progress of labour and partograph recording -
Information in the partograph include -
1. Maternal vital signs - Temperature, pulse and BP.
2. Uterine activity - Duration and frequency of contractions.
3. Fetal heart rate.
4. Vaginal examination findings -
- Cervical dilatation in cm.
- Cervical effacement.
- Descent/ station of presenting part.
- Status of membranes.
- Status of the liquor amini.
5. Fluid examination.
6. Urine analysis.
7. Drug administration.
Fetal heart rate (FHR) -
FHR along with its rhythm and intensity should be noted every half hour in the first stage
and every 15 min in second stage or following rupture of the membrane. To avoid confusion
of maternal and fetal heart rates, maternal pulse should be counted. Otherwise maternal
tachycardia may be wrongly treated as fetal heart rate. Normal fetal heart rate ranges
from 110-150 per minute.
Que. - What is partograph recording ?
Ans. - Partograph is a graphic recording of the silent feature of labour status. In the management
of woman in labour, partograph search to validated the normal progress of labour and to
facilitate early identification of deviation from normal pattern. The number of contraction
in 10 min and duration of each contaction in second are recorded in the partograph.
- Encouragement and assurance are given to keep up the morale.
- Constant supervision is ensured.
Bowel -
An enema with soap and water or glycerine suppository is traditionally given in early stage.
This may be given if the rectum feels loaded on vaginal examination. But enema neither
shortens the duration of labour nor reduces the infection rate.
Rest and ambulation -
If the membranes are intact, the patient is allowed to walk about. Ambulation can reduce
the duration of labour.
Perineal shave -
The purpose of perineal shave is to prevent infection, preparation of perineum involving
the shaving of mons pubis, vulva and anal region provide for cleanliness and early viewing
of perineum.
Diet -
A woman in labour, even in early stage, should not eat solid food. Gastric contents are really
dangerous if aspirated following general anaesthesia. So food is withheld during active labour.
Bladder care -
Patient is encouraged to pass urine by herself as full bladder often inhibits uterine contraction
and may lead to infection. If the woman can not go to the toilet, she is given a bed pan.
Privacy must be maintained and comfort must be ensured. If the patient fails to pass urine
specially in late stage, catheterisation is to be done with strict aseptic precaution.
Relief of pain -
The common analgesic drug used is pethidine 50-100 mg intramuscularly (IM) when the pain
are well established in the active phase of labour. Pethidine is an effective analgesic as well as
a sedative. The drug should not be given if delivery is anticipated within two hours.
Assessment of progress of labour and partograph recording -
Information in the partograph include -
1. Maternal vital signs - Temperature, pulse and BP.
2. Uterine activity - Duration and frequency of contractions.
3. Fetal heart rate.
4. Vaginal examination findings -
- Cervical dilatation in cm.
- Cervical effacement.
- Descent/ station of presenting part.
- Status of membranes.
- Status of the liquor amini.
5. Fluid examination.
6. Urine analysis.
7. Drug administration.
Fetal heart rate (FHR) -
FHR along with its rhythm and intensity should be noted every half hour in the first stage
and every 15 min in second stage or following rupture of the membrane. To avoid confusion
of maternal and fetal heart rates, maternal pulse should be counted. Otherwise maternal
tachycardia may be wrongly treated as fetal heart rate. Normal fetal heart rate ranges
from 110-150 per minute.
Que. - What is partograph recording ?
Ans. - Partograph is a graphic recording of the silent feature of labour status. In the management
of woman in labour, partograph search to validated the normal progress of labour and to
facilitate early identification of deviation from normal pattern. The number of contraction
in 10 min and duration of each contaction in second are recorded in the partograph.
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