Dx of labour
#obgyn
Dx of Labour:
• Expect irregular, not excessively painful contractions which become more frequent, regular and uncomfortable
• Often start in low back and come around to front/lower abdomen
• Character may be similar to menstrual cramps
• Ultimately generally require moderate to strong contractions every 2-3 minutes (start to start) lasting 45 to 60 seconds to result in expected cervical changes
• Often associated with small amount of vaginal loss of blood stained mucous, also called “bloody show”
• 30% of women rupture their membranes before the pain starts (prelabour rupture of membranes or PROM)
• Ruptured membranes is identified by a gush of fluid and/or ongoing leakage
• Amniotic fluid loss is confirmed by Nitrazine test and ferning
• Nitrazine paper will turn dark blue when wet with amniotic fluid
• Nitrazine test is confirmed by placing a sample of the fluid on a glass slide, allowing it to air dry well and then examining this under the microscope for the presence of a “fern-like” pattern
• Nitrazine paper can turn blue in the presence of semen, blood and vaginitis so it is not diagnostic of amniotic fluid presence
• A positive fern test is diagnostic for the presence of amniotic fluid
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Details