Obstetrics and Gynecology – Intrapartum Care: By Melanie Ornstein M.D.

Obstetrics and Gynecology – Intrapartum Care: By Melanie Ornstein M.D.


Intrapartum Care involves the care of both
the mother and fetus during labour and delivery including the first one hour following birth. The goal of care is a healthy mother and baby. When a woman presents in labour, it is essential
to review her obstetrical, medical and surgical history, confirm the gestational age, and
GBS status and determine that she is in active labour. Examination must ensure a normal fetal heart
rate, determine cervical dilatation and effacement and membrane status and note the contraction
pattern. The clinician must be aware of any contraindications
to vaginal birth such as placenta previa, malpresentation, and previous classical caesarian
section. It is important to understand the 4 stages
of labour: Stage 1 – latent and active phase
Stage 2 – full dilatation to delivery Stage 3 – delivery of the placenta
Stage 4 – the 1st hour postpartum During labour and delivery clinicians must
be able to diagnose and treat problems such as labour dystocia and any obstetrical emergencies
such as preeclampsia, chorioamnionitis, cord prolapse… shoulder dystocia, uterine rupture, and decide
on the need for caesarian section. Once the baby is delivered, cord blood for
gas analysis and blood group are collected. Next, any lacerations can be repaired. Bleeding and vital signs of the mother and
the baby can be evaluated. Parent infant bonding can be promoted, including
having the baby skin to skin and initiating breastfeeding.

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