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Second stage, pushing

Room 3GA 39+0G3P235 yRuptured 06:00, clear

Fully dilated 40 minutes, head at plus 1, variable decelerations. Second stage.

39+0wksG3P2 · 35 y
  1. Triage
  2. Latent
  3. Active
  4. Second stage
  5. Delivery
  6. Postpartum

10:40: 10 cm, 100% effaced, station 1

Maternal

BP
128/82
HR
100
Temp
37.2
Labs
no flags
Running
Penicillin G, Nitrous oxide

Fetal

Monitor
Variables, recovering
Presentation
Cephalic, occiput anterior, station plus 1 to plus 2
Membranes
Ruptured 06:00, clear
Next
Reassess 15 min

Summary

35-year-old G3P2 at 39+0, second stage, pushing. Fully dilated 40 minutes, head at plus 1, variable decelerations.

Membranes
Ruptured 06:00, clear
Fetal presentation
Cephalic, occiput anterior, station plus 1 to plus 2
Board status
Second stage

Notes

  • Two prior uncomplicated vaginal births.
  • Pushing well; the head is visible with contractions.
  • Intermittent variable decelerations with shoulders and moderate variability between contractions.

Plan

  1. Continue pushing with maternal position changes
  2. Reassess the strip every 15 minutes in the second stage
  3. Prepare for delivery; paediatrics not required at this point

Medications

  • Penicillin G: Intravenous, 4-hourly, for GBS
  • Nitrous oxide: As needed

Maternal vitals

TimeHRBPTemp
09:0092124/8037
11:20100128/8237.2

Labs

  • Haemoglobin121 g/L
  • GBSPositive; penicillin given 06:30 and 10:30

What to watch

  • Baseline rising or variability falling
  • Decelerations deepening or slower to recover
  • Descent with each contraction

OBGynSpace Tutor

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