Page 48 - 2023 Elctronic Book (3) Normal Labor_Neat

1-Taking the history of labor:
• Ask the woman why she has come to the hospital and review the history from

her Maternal Health Card.
Determine whether the woman is in labor or not through the presence of the
following signs:

• Uterine contractions: Ask the woman when true contractions began, how
often they are coming and how long they last.

• Show: Ask the woman if she had a blood stained mucous discharge and examine
her underclothes.
• Membranes: Ask the woman if she had a gush of fluid ? If she is not sure, use
litmus papers and smell it to exclude urine. If membranes are ruptured, record

the time of rupture.
• Sleep, rest and food: Ask the woman if she has had enough rest and sleep, and if

she has had food within 6 hours? If yes, it should be recorded and taken into
consideration.
• Ask the woman ·about her previous labor history and her present pregnancy.

• Bladder and bowel: Ask the woman if she has passed urine or stool?
Examination of woman in labor: Explain all the procedures to the woman and inform

her of the results.
2-General examination:
• The woman's general manner will indicate how she is coping with labor.

• Observe the woman's general condition such as build and stature, limb,
deformity and appearance. Pallor indicates infection and dehydration.
• Temperature, pulse, respiration and blood pressure should be taken between

contractions and recorded. If temperature is high, isolate the woman.
• . Inspect any edema

• Test urine for protein and sugar after trimming of hair, and before enema.
3-Local examination:
 Examination of the abdomen:

 Inspect the contour of the abdomen.
 Palpate the abdomen gently, and with warm hands, for the height of the fundus,
lie, presentation, position, attitude and station, and record them.
 Observe and record the frequency, duration, and intensity of contractions.

 Auscultate and record the fetal heart sound for one minute using Pinard's
stethoscope, or Sonicaid. A cardiograph machine gives information about fetal

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