MANAGEMENT OF LABOUR

 Ist Stage Management

(1) General:- 

Emotional & mental support is given to mother

Provide privacy to the Pt.

Antiseptic dressing

Aseptic technique should be used

Constant supervision

(2) Bowel & Bladder:- 

Enema with soap & water

Empty the bladder of women is unable to empty it catheterization should be done

Maintain Privacy

Antiseptic wash of external genitals

(3) Rest & Ambulation:-

If membranes are intact tell pt. to walk

Ambulation reduces duration of labour

Need of analgesics & improve maternal comfort

(4) Diet:-

Delayed emptying of stomach in labour

Fluids should be started

With held food during active labour

(5) Pain:- In active phase of labour pethidine 50-100 mg IM

The Drug shouldn’t be given if delivery anticipated with in 24 hrs.

Progress of Labour:- It is noted by

(1) Per abdomen finding:-

Increased Uterine contraction intensity, duration, frequency

Shifting of fetal heart beat down wards

Gradual displacement of pole of head

(2) Upper Vaginal findings:-

Dilation of cervix

Noting the descent of head

Degree of molding of head

Colour of liger.

(3) Continuous Monitoring of Maternal Condition:-

Record vital signs

Regulation of fetal heart sound

IV fluids

Urine out put

Assess cervical dilation & effacement 

Assess fetal station, presentation position

Assess the colour of amniotic fluid

Monitor Uterine contraction by palpation, determine frequency duration & intensity