Page 90 - 33Elctronic Book (3) Normal Labor
P. 90

▪  NICU nurse.
                       ▪  Specialist should be available as necessary.

                               Equipment: As in mild to moderate.
                   ❖  Conclusion:

                       •  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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