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Spontaneous labour, active phase

Room 1GA 39+2G1P029 yIntact

6 cm, epidural, contractions every 3 minutes. Active labour.

39+2wksG1P0 · 29 y
  1. Triage
  2. Latent
  3. Active
  4. Second stage
  5. Delivery
  6. Postpartum

12:00: 6 cm, 100% effaced, station 0

Maternal

BP
108/66
HR
90
Temp
37.1
Labs
no flags
Running
Epidural

Fetal

Monitor
Reassuring
Presentation
Cephalic, occiput anterior, station 0
Membranes
Intact
Next
Reassess 16:00

Summary

29-year-old G1P0 at 39+2, spontaneous labour, active phase. 6 cm, epidural, contractions every 3 minutes.

Membranes
Intact
Fetal presentation
Cephalic, occiput anterior, station 0
Board status
Active labour

Notes

  • Uncomplicated pregnancy, all screening normal, anatomy scan normal, placenta fundal.
  • Progressing from 4 to 6 cm over 5.5 hours with an epidural in place, now entering the active phase by contemporary definition.
  • Category I tracing on continuous monitoring since the epidural.

Plan

  1. Reassess at 16:00 or sooner if the membranes rupture
  2. Continue continuous monitoring while the epidural runs
  3. Encourage position changes; empty the bladder (catheter with the epidural)

Medications

  • Epidural: Bupivacaine and fentanyl, continuous, sited 09:15

Maternal vitals

TimeHRBPTemp
08:0084118/7236.9
10:0088112/6837
12:0090108/6637.1

Labs

  • Haemoglobin118 g/L(110 to 150)
  • Platelets210(150 to 400)
  • Blood groupO positive, antibody screen negative
  • GBSNegative (36+4)

What to watch

  • Progress at 16:00 (expect 8 cm or more)
  • Maternal temperature with the epidural
  • The tracing if membranes rupture

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