By David Liu, Susan R. Sloan
An intensive revision of this well-illustrated, useful handbook brings it brand new with vital carrier and perform adjustments. protecting all points of work administration, the emphasis is still on common, secure deliveries in neighborhood devices or hospitals.
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Additional resources for Labour Ward Manual
Sample text
Before removal of the speculum check for normality of the cervix, for the presence of vaginal infection and for evidence of varicosities. When indicated take cervical swabs. Learn to recognize presence of active herpes infection. Fundal height in primigravida and multigravida. Vaginal examination Detection of fetal heart rate by Doppler technique. • Use full aseptic precautions. • Warn mother of what to expect. • Insert index and, if that is tolerated, middle finger through introitus. • Palpate around the fornices and sense the proximity of the presenting part of the fetus to the examining finger.
Reassure once the correct diagnosis of labour has been established. g. g. cephalic presentation. ADMISSION TO THE LABOUR WARD Lie This defines the relationship between the longitudinal axis of the fetus and that of the mother (Fig. 1). Engagement This occurs when the biparietal (vertex) or biischial (breech) diameters descend below the pelvic brim. Descent of the fetal head into the pelvis is usually described as if the head is divided into five segments. The head would be engaged if less than three-fifths were palpable above the pelvic brim (Fig.
Approximately another minute is needed for adequate relaxation. Blood vessels must traverse the myometrium to reach the placenta. Contractions occurring more than once every 2 minutes contribute to poor myometrial relaxation and reduce blood and hence oxygen supply to the fetus. When two contractions are noted every 10 minutes for an hour consider possible onset of labour. In established labour contraction rates range between 3 and 5 per 10 minutes. In early labour the uterus is not working at maximum capacity.