Page 85 - 2023 Elctronic Book (3) Normal Labor_Neat

 Suspected infection, including:
 Maternal fever during labor.

 Rupture of membranes > 18 hours.
 Other findings identified by the obstetrician.
o Personnel:
 Pediatric resident.

 Intensive care nursery nurse.
 Assistant specialist or specialist (only if the obstetrician or the pediatric
resident feels necessary).

o Equipment:
 Infant care equipment as indicated above.
 Emergency cart or the NICU should be ready for immediate use:

 The Emergency cart: contains several drawers that have all the required
emergency medications (such as: epinephrine, NaHC03, calcium gluconate,
saline, etc.) and tools (such as: IV catheters, endotracheal tubes, chest tubes,

etc.). This cart is physically located on each floor or unit and can be moved
to the bedside
o High risk delivery
o Identification:

Premature delivery less than 32 weeks gestation.
 Severe Rh disease.
 Several antepartum or intrapartum hemorrhage.

 Suspected asphyxia (such as: cord prolapsed or loss of fetal heart rate).
o Personnel:
 The most senior resident or assistant specialist in house.

 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.

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