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OBSTRUCTED LABOR- CASE STUDY

case

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david solomon
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47 views

OBSTRUCTED LABOR- CASE STUDY

case

Uploaded by

david solomon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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EXERCISE: USING THE PARTOGRAPH

STEP 1
 Mrs. C. was admitted at 10.00 on 12.5.2000
 Membranes ruptured 09.00
 Gravida 4, Para 3+0
 Hospital number 6639.
Record the information above on the partograph, together with the following details:
 the foetal head is 3/5 palpable above the symphysis pubis
 the cervix is 4cm dilated
 there are three contractions in 10 minutes, each lasting 30 seconds
 FH 140
 amniotic fluid clear
 sutures apposed
 blood pressure 120/70mm Hg
 temperature 36.8°C
 pulse 80 per minute
 urine output 200mL; negative protein and acetone.
STEP 2
Plot the following information on the partograph:
 10.30 FH 130, Contractions 3/10 each 35 sec, Pulse 80
 11.00 FH 136, Contractions 3/10 each 40 sec, Pulse 90
 11.30 FH 140, Contractions 3/10 each 40 sec, Pulse 88
 12.00 FH 140, Contractions 3/10 each 40 sec, Pulse 90, Temperature 37°C, Head 3/5 up
 12.30 FH 130, Contractions 3/10 each 40 sec, Pulse 90
 13.00 FH 130, Contractions 3/10 each 40 sec, Pulse 88
 13.30 FH 120, Contractions 3/10 each 40 sec, Pulse 88
 14.00 FH 130, Contractions 4/10 each 45 sec, Pulse 90, Temperature 37°C, Blood
pressure 100/70
o the foetal head is 3/5 palpable above the symphysis pubis
o the cervix is 6cm dilated, amniotic fluid clear
o sutures overlapped but reducible.

STEP 3
 14.30 FH 120, Contractions 4/10 each 40 sec, Pulse 90, Liquor clear
 15.00 FH 120, Contractions 4/10 each 40 sec, Pulse 88, Blood stained
 15.30 FH 100, Contractions 4/10 each 45 sec, Pulse 100
 16.00 FH 90, Contractions 4/10 each 50 sec, Pulse 100, Temperature 37°C
 16.30 FH 90, Contractions 4/10 each 50 sec, Pulse 110, Head 3/5 up, Meconium liquor
o the foetal head is 3/5 palpable above the symphysis pubis
o the cervix is 6cm dilated
o amniotic fluid meconium stained
o sutures overlapped and not reducible
o urine output 100mL; protein negative, acetone 1+.

STEP 4
Record the following information on the partograph:
 Caesarean section at 17.00, live female infant with poor respiratory effort, Weight
4,850g.
Q 1: What is the final diagnosis?
Q 2: What action was indicated at 14.00? Why?
Q 3: What action was indicated at 16.00? Why?
Q 4: At 16.30, a decision was taken to do a Caesarean section, and this was done. Was this a
correct action?
Q 5: What problems may be expected in the newborn?

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