Landmark to measure how far down the baby is: ischial spine

Beginning of one contraction to the next: measured in minutes: frequency

ROM: 3 hours ago, gotten more intense

How far along patient is: 39 weeks Dec 11

Questions to ask:

Age? 29

G/P?: 2/1

Last delivery: 4 years ago

LMP: EDD:

GA: 39 weeks

PNC: 15 weeks

What assessment?

• vital signs

• confirmed how ruptured

  • Sterile speculum exam to assess ROM

  • With fluid

  • COAT

• Monitor mom’s temperature

Noelle:

• SROM 3 hours ago, clear fluid, small amount and no odor

• SVE?

  • Yes: 3cm dilated 50% effaced -3 station

  • Stage 1: early

  • Frequency/duration: every 5-20 min/ 30-60 sec

• Should be taking frequent vital signs, put monitor on contractions, fetal monitoring, reposition and activity

• Call midwife/provider

• Head to toe assessment

Patient says there is more pressure:

• SVE

  • 7cm dilated/ 100% effaced/ 1+ station

  • 2-4min/45-60 seconds

Patient thinks she needs to push, what now?

• SVE check to see that dilation is 10 cm

  • 9 cm/ 100% effaced/ 2+ station

• Responsibility: call midwife

• Continue FH monitoring

• emotional support

• baby warmer/crib

• prepare room for delivery

Golden Hour: the adrenaline in the baby when they are awake