Page 218 - كتاب تمريض نسا الاكتروني

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• Labor is a crucial time for the mother, family member and the fetus. This

is the most perilous journey under taken by the fetus in utero. For the
clinician it is equally important to know and identify any deviation from

the normal pathway.

• Despite immense development in imaging techniques to assist in making
the right decision for the patient nonetheless in labor management the

clinical assessment still has a key role.

 Recommendation

• Precise assessment of onset of labor is crucial to identify any deviation from
normal course.

• Latent phase of labor is when there is painful uterine contraction and some
cervical effacement; dilatation up to 4 cm. The duration may vary days to

weeks.
• The progress of first stage labor: progressive cervical dilatation 2 cm/4 h,

frequency of uterine contraction, progressive descent and rotation of the
head.

• There is no substantial evidence to support the imaging: CT/MRI for routine
pelvic assessment. Clinical trial (labor) is still accepted for pelvic

assessment. Imaging may assist in decision making for labor in woman to

evaluate the pelvis with history of pelvic fracture.
• Monitoring of fetal heart rate should be a routine practice to ensure fetal well

being during the process of labor.

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