Page 235 - Critical Maternity & Newborn Health Nursing

d. Head descend(station).

2. Fetal:

a. FHS: Every 1-1/2hr by sonicaid

b. CTG: If FHS abnormalities arise.

B) Second stage of labor: Wait for long anterior rotation

(60minutes):

- Careful fetomaternal observation

- Oxytocin: for inertia to help internal rotation of the head.

1) Normal Mechanism (long anterior rotation)

- Head engaged given the chance to rotate

- Prolonged second stage of labor more than 1hr or if there is fetal

or maternal distress intervention is indicated.

2) Direct occipto- posterior:

- 50%Episiotomy spontaneous vaginal delivery.

- 50%Episiotomy + Low forceps or ventous

3)Obstructed labor: in persistent occipto-posterior and deep

transverse arrest.

- Head not engaged Cesarean section

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