Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
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Reference Manual<br />
Figure 5.1. Positions that a woman may adopt during labor. (WHO, 2003)<br />
Monitor progress of the first stage of labor using the partograph<br />
Findings which suggest satisfactory progress in the first stage of labor are:<br />
• regular contractions of progressively increasing frequency <strong>and</strong> duration.<br />
• rate of cervical dilatation at least 1 cm per hour during the active phase of labor (cervical<br />
dilatation on or to the left of alert line).<br />
• cervix well applied to the presenting part.<br />
Findings which suggest unsatisfactory progress in first stage of labor are:<br />
• irregular <strong>and</strong> infrequent contractions after the latent phase, or<br />
• rate of cervical dilatation slower than 1 cm per hour during the active phase of labor<br />
(cervical dilatation to the right of alert line), or<br />
• cervix poorly applied to the presenting part.<br />
Use the partograph card (see Figure 5.2 below) to monitor progress of the first stage of labor.<br />
Unsatisfactory progress in labor can lead to prolonged labor (the woman has been<br />
experiencing labor pains for 12 hours or more without delivery). Be sure to transfer women<br />
immediately to a facility with operative facilities as soon as unsatisfactory progress has been<br />
identified.<br />
Other signs that indicate the woman is experiencing a complication include:<br />
• There is vaginal bleeding in labor <strong>and</strong> delivery.<br />
• The diastolic blood pressure is 90 mm Hg or more.<br />
• The woman complains of severe headache or blurred vision.<br />
• The woman is found unconscious or having convulsions.<br />
• The fetal heart rate is less than 100 or more than 180 beats per<br />
minute after a contraction.<br />
• Membranes have been ruptured for more than 12 hours before<br />
childbirth.<br />
• The woman has a fever.<br />
Follow national<br />
protocols for<br />
management<br />
<strong>and</strong> referral of<br />
complications.<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course<br />
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