Important Factors in the Evaluation of the Patient with Abnormal Labour
1 . Review the labour record
2 . Assess maternal status
• Vitals
• Pain management
• Contraction pattern
• Membranes: intact vs ruptured
• Cervical dilatation and effacement
• Pelvic architecture
3 . Assess fetal status
• Fetal heart
• Fetal station
• Fetal presentation and position
4 . Determine best course of action
• If membranes are not ruptured then do Artificial Rupture of Membranes (AROM)
• Offer pain relief: endogenous catecholamines can inhibit uterine contractility. Ensure adequate hydration
• Oxytocin infusion to improve uterine contractility
• If all the above tried consider operative delivery (i.e. CS or assisted vaginal birth if fully dilated)