EBCOG Part-1-Managemnt of labour & delivery – DAY1(EMQ)

a.CAT II section

b.Artificial rupture of membranes

c.Continuous CTG

d.Elective caesarean section

e.Fetal blood sampling

f.Fetal scalp electrode

g.Ventouse delivery

h.Rpr FBS in 30 mins

i.CAT III caesarean section

j.Await normal delivery

k.Oxytocin augmentation

l.CAT I caesarean section

m.Internal podalic version.

n.Rpt FBS in 15 mins

1. 25 year old primi,has fetal bradycardia in 2nd stage of labour.She has no pain relief & is pushing for 30 mins.Fetal head is in occipitoposterior position & station is +2.

2.A 27 year old primi at 38 weeks gestation is induced for FGR & oligohydramnios.She is a heavy smoker.On vaginal exam the cervix is 5 cm dilated .CTG shows baseline of 140 bpm,reduced variability & decels lasting for >15 secs for 30 mins & nadir occurs after the contraction.

3.32 year old primi in spontaneous labour at 40+4 weeks with SROM.The cervix is 7 cm dilated & liquor is meconium stained.CTG reviewd after 20 mins of admission is uninterpretable due to areas of loss of contact.

4.28 year old in 2nd pregnancy is admitted for induction of labour for postmaturity & oxytocin hasbeen started.Partogram shows satisfactory progress.Review of CTG prompted a FBS 30 mins ago ,which showed a pH of 7.25.The cervix was 9 cm dilated & CTG remained similar.

5.32 year old with normal antenatal period is in spontaneous labour at term & is progressing well.She is on continuous CTG monitoring due to audible fetal heart decels heard on intermittent auscultation in 2nd stage of labour.CTG shows a baseline of 140 bpm,variability of 7- 10,no accelerations & decels with spontaneous recovery.She has been pushing for 10 mins with fetal head at +1 station in the right occipitoposterior position.