Page 75 - 2023 Elctronic Book (3) Normal Labor_Neat

Management:
- Turn patient to left side.

- Administer o2 by tight face mask.
- Correct hypotension.
- If oxytocin used, turn off.

- Infuse rapidly intravenous fluid

. - Expect expeditious delivery if not corrected in 30 min.

5. Variable deceleration:
variable decelerations are irregular, often jagged dips in the fetal heart rate that look more

dramatic than late decelerations.
Causes:
- Intermittent compression of umbilical cord by fetal head.
- Oligo hydrominos.

- Cord between fetus and mother's uterus or pelvic without obvious prolapse.
Management:
- Change maternal position to decrease cord compressive (turn sides to side or knee chest

position).
- Give O2 at 8 – 10 L/min by tight face mask.
- Improve circulating volume.

- Amnion per fusions.
- Monitor for change fetal heart pattern dis continue oxytocin if it being administered.
- Perform vaginal examination to assess for prolapsed cord

6. Prolonged deceleration:
there are isolated deceleration which last longer than 60 – 90 seconds.
Causes:

- Tetanic uterine contractions.
- Placental abruption.

- Umbilical cord prolapse.
- Maternal hypoxia.
Management: - Notify physician or mid wife of first occurrence.
- Check for cord prolapse.

- Examine the cervix.
- Check progress of dilation and descent.
- Correct maternal hypotension increase intravenous fluids.

- Continuous observation until delivery be prepared for emergency delivery.

74