src/processed_markdown/Management-of-Normal-Labourchart/Management-of-Normal-Labourchart.md

---\n\ncitation: "Management of Normal Labourchart"\n\n---\n\nManagement of Uncomplicated labour

Painful contractions — | Not in labour ——~* | Observe in antenatal ward °Show Effacement & progressive ~ | Uncertain i Review after 2 hours dilatation of cervix — | Established labour t Transfer to the labour suite Admission CTG to be done in all three groups and interpreted before decision is made (Y) Identify risk factors by, Review antenatal records. © Detailed clinical history o Examination Urine for protein = Monitoring by Partogram Maintain Partogram*(X) — Progress of labour © Cervical dilatation o Decent of the presenting part o Uterine contractions Routine Maternal condition care in soo o Pulse, BP, Temperature & hydration. labour suit —=}> eaintrclict o Evaluation of drugs(oxytocin, antibiotics, Opioid -Pethidine Anti hypertensives, Analgesics Regional analgesia-Epidural © Undistended bladder-catheterize if Other-spinal analgesia indicated Combined spinal-epidural analgesia Inhalational analgesia-Entonox Pudendal block for episiotomy/forceps/vacuum Fetal condition © Intermittent auscultation of fetal heart o Liquor volume o Meconeum in liquor P jonin; Most comfortable Second stage position ———==> Diagnosis Supine position-avoided v Vaginal examination for full dilatation Y Perineal distention v Anal dilatation - Medio-lateral Episiotomy At the time of crowning Delivery LOxytocies Third stage 3.Controlled cord traction 1949 pvoy poq sy) UT payUauINDOp aq plnoys snoqery Jo }WawWaseurW ou) UT sdais [TY suon{puoo ondase Japun 3no passes aq pnoys snoqer] jo }uoWeseuLW oy) UT sdajs [TV Active management 4.Examine the 2.Cord clamp ‘ placenta

r u o b a l f o e g a t s d n o c e

S

Delivery

r u o b a l f o e g a t s d r i h T

placenta

5. Observation for signs of

o Haemorrhage

o Utrine fundal level

o Evidence of collapse

o Respiratory difficulty

o Unusual behaviouror

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Monitoring

Mother should be closely monitored in the labour room for at least two hours

o Abdominal pain

Sri Lanka College of Obstetrics and Gynaecology Health sector development Project Guidelines- Management of Uncomplicated labour