Managing Complications in Pregnancy and Childbirth: - IAWG

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C-70 Normal labour and childbirthFigure C-11, page C-69 is a sample partograph for normal labour:• A primigravida was admitted in the latent phase of labour at 5 AM:- fetal head 4/5 palpable;- cervix dilated 2 cm;- 3 contractions in 10 minutes, each lasting 20 seconds;- normal maternal and fetal condition.Note: This information is not plotted on the partograph.• At 9 AM:- fetal head is 3/5 palpable;- cervix dilated 5 cm;Note: The woman was in the active phase of labour and thisinformation is plotted on the partograph. Cervical dilatation isplotted on the alert line.- 4 contractions in 10 minutes, each lasting 40 seconds;- cervical dilatation progressed at the rate of 1 cm per hour.• At 2 PM:- fetal head is 0/5 palpable;- cervix is fully dilated;- 5 contractions in 10 minutes each lasting 40 seconds;- spontaneous vaginal delivery occurred at 2:20 PM.
Normal labour and childbirthC-71FIGURE C-11Sample partograph for normal labourName Mrs. SGravida 3 Para 2+0 Hospital number 7886Date of admission 12.5.2000 Time of admission 5:00 A.M. Ruptured membranes 1 hours200190180170160Fetal 150heart 140rate 1301201101009080Amniotic fluidMouldingCervix (cm)[Plot X]HoursDescentof head[Plot O]10987654321XOC C C C C C C C C CAlertXActionSVD at 14:20Live femaleinfantWt. 2,850 g0HoursOTime9 10 11 12 13Contractionsper 10 minsOxytocin U/Ldrops/minDrugs givenand IV fluidsPulseandBP18017016015014013012011010090807060Temp oC36.8 37 37Urineproteinacetonevolume200 150
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WHO/RHR/00.7Distr: GeneralIntegrate
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©World Health Organization, 2000Th
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iiTable of contentsLoss of fetal mo
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ivPreface
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viIntroduction
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viiiHow to use the manualprocedure,
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xAbbreviations
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xiiList of diagnoses
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RAPID INITIAL ASSESSMENT C-1When a
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Rapid initial assessmentC-3Abdomina
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TALKING WITH WOMEN AND THEIR FAMILI
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EMOTIONAL AND PSYCHOLOGICAL SUPPORT
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Emotional and psychological support
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C-16 Emotional and psychological su
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C-16 Emergencies• If the woman is
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C-18 General care principles- after
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C-20 General care principlesaGloves
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C-22 General care principles- weari
Page 43 and 44: C-24 General care principles• Nev
Page 45 and 46: C-24 Clinical use of blood, blood p
Page 57 and 58: ANTIBIOTIC THERAPY C-35Infection du
Page 59 and 60: ANAESTHESIA AND ANALGESIA C-37Pain
Page 61 and 62: Anaesthesia and analgesiaC-39• Gi
Page 63 and 64: Anaesthesia and analgesiaC-41TABLE
Page 65 and 66: Anaesthesia and analgesiaC-43MANAGE
Page 67 and 68: Anaesthesia and analgesiaC-45- Give
Page 69 and 70: Anaesthesia and analgesiaC-47Proced
Page 71 and 72: OPERATIVE CARE PRINCIPLES C-47The w
Page 73 and 74: Operative care principlesC-49• Ho
Page 75 and 76: Operative care principlesC-51HAEMOS
Page 77 and 78: Operative care principlesC-53- Plac
Page 79 and 80: Operative care principlesC-55A urin
Page 81 and 82: NORMAL LABOUR AND CHILDBIRTH C-57NO
Page 83 and 84: Normal labour and childbirthC-59- E
Page 85 and 86: Normal labour and childbirthC-61•
Page 93: Normal labour and childbirthC-69FIG
Page 99 and 100: Normal labour and childbirthC-75Not
Page 101 and 102: Normal labour and childbirthC-77Nev
Page 103 and 104: NEWBORN CARE PRINCIPLES C-77When a
Page 105 and 106: PROVIDER AND COMMUNITY LINKAGES C-7
Page 107 and 108: Provider and community linkagesC-81
Page 109 and 110: SHOCK S-1Shock is characterized by
Page 111 and 112: ShockS-3BEDSIDE CLOTTING TEST• As
Page 113 and 114: ShockS-5• If trauma is suspected
Page 115 and 116: VAGINAL BLEEDING IN EARLY PREGNANCY
Page 117 and 118: Vaginal bleeding in early pregnancy
Page 127 and 128: S-18 Vaginal bleeding in later preg
Page 135 and 136: S-26 Vaginal bleeding after childbi
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HEADACHE, BLURRED VISION, CONVULSIO
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Headache, blurred vision, convulsio
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UNSATISFACTORY PROGRESS OF LABOUR S
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Unsatisfactory progress of labourS-
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MALPOSITIONS AND MALPRESENTATIONS S
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Malpositions and malpresentationsS-
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S-84 Shoulder dystociaFIGURE S-26As
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S-86 Shoulder dystocia
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S-88 Labour with an overdistended u
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S-94 Labour with a scarred uterus-
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S-96 Fetal distress in labour- If t
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S-98 Prolapsed cord- If breech pres
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S-100 Fever during pregnancy and la
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FEVER AFTER CHILDBIRTH S-107PROBLEM
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Fever after childbirthS-109Presenti
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Fever after childbirthS-111aGive he
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Fever after childbirthS-113• If t
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Fever after childbirthS-115- apply
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Fever after childbirthS-117• Remo
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ABDOMINAL PAIN IN EARLY PREGNANCY S
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Abdominal pain in early pregnancyS-
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Abdominal pain in early pregnancyS-
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S-120 Abdominal pain in later pregn
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S-126 Difficulty in breathingDIAGNO
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S-128 Difficulty in breathing- Give
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S-130 Difficulty in breathing
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LOSS OF FETAL MOVEMENTS S-131PROBLE
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Loss of fetal movementsS-133• Alt
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PRELABOUR RUPTURE OF MEMBRANES S-13
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Prelabour rupture of membranesS-137
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Prelabour rupture of membranesS-139
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IMMEDIATE NEWBORN CONDITIONS OR S-1
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Immediate newborn conditions or pro
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SECTION 3PROCEDURES
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P-2 Paracervical blocktry again. Ne
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P-4 Pudendal blockFIGURE P-2Perinea
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P-6 Pudendal block• Inject 10 mL
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P-8 Local anaesthesia for caesarean
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P-10 Local anaesthesia for caesarea
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P-12 Spinal anaesthesia• If the n
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KETAMINE P-13TABLE P-5Indications a
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EXTERNAL VERSION P-15• Review for
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INDUCTION AND AUGMENTATION OF LABOU
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Induction and augmentation of labou
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VACUUM EXTRACTION P-27Figure P-6 sh
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Vacuum extractionP-29• With the p
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Vacuum extractionP-31FAILURE• Vac
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FORCEPS DELIVERY P-33• Review for
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Forceps deliveryP-35- fetal heart r
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BREECH DELIVERY P-37• Review for
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Breech deliveryP-39• Hold the bab
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Breech deliveryP-41Note: Ask an ass
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Breech deliveryP-43extended at hip
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CAESAREAN SECTION P-43• Review fo
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Caesarean sectionP-45• Use two fi
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Caesarean sectionP-47• Hand the b
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Caesarean sectionP-49CLOSING THE AB
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Caesarean sectionP-51• Women with
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Caesarean sectionP-53• Grasp the
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P-54 SymphysiotomyAbduction of the
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P-56 Symphysiotomy• After separat
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P-58 Craniotomy and craniocentesis
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P-60 Craniotomy and craniocentesisA
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P-62 Dilatation and curettage- Take
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P-64 Dilatation and curettage- feve
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P-66 Manual vacuum aspiration• Di
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P-68 Manual vacuum aspiration• Qu
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CULDOCENTESIS AND COLPOTOMY P-69CUL
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Culdocentesis and colpotomyP-71•
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P-72 EpisiotomyFIGURE P-39Infiltrat
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P-74 Episiotomy- At the opening of
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P-76 Episiotomy
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P-78 Manual removal of placenta•
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P-80 Manual removal of placenta•
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P-2 Repair of cervical tears
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REPAIR OF VAGINAL AND PERINEAL TEAR
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P-84 Repair of vaginal and perineal
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CORRECTING UTERINE INVERSION P-91
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P-92 Correcting uterine inversionHY
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P-94 Correcting uterine inversion-
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P-96 Repair of ruptured uterus• S
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P-98 Repair of ruptured uterus• I
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UTERINE AND UTERO-OVARIAN ARTERY P-
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Uterine and utero-ovarian artery li
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POSTPARTUM HYSTERECTOMY P-103Postpa
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Postpartum hysterectomyP-105FIGURE
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Postpartum hysterectomyP-107• Clo
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Postpartum hysterectomyP-109POSTOPE
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P-110 Salpingectomy for ectopic pre
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P-112 Salpingectomy for ectopic pre
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INDEX A-3Abdominal distensiondiagno
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IndexA-5Atonic uterusdiagnosis, S-2
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IndexS-97transverse lie and, P-49tu
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IndexDescentassessment of, C-61Dext
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IndexFetal skull landmarks, C-62Fev
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Indexpostoperative care, P-108subto
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IndexA-15Maintenance fluid therapy,
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IndexA-17syphilis, management, S-15
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Indexgeneral management, S-25Pre-ec
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IndexA-21Stillbirthemotional consid
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IndexA-23anaesthesia options, C-45b
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Managing Complications in Pregnancy and Childbirth: - IAWG

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