Spontaneous rupture of membranes, oligohydramnios
Room 5GA 38+3G1P031 yRuptured 09:00, scant clear liquor
6 cm, deep variable decelerations with every contraction. Needs assessment.
38+3wksG1P0 · 31 y
- Triage
- Latent
- Active
- Second stage
- Delivery
- Postpartum
12:00: 6 cm, 100% effaced, station -1
Maternal
- BP
- 112/70
- HR
- 96
- Temp
- 37
- Labs
- no flags
- Running
- None
Fetal
- Monitor
- Deep variables
- Presentation
- Cephalic, occiput posterior, station minus 1
- Membranes
- Ruptured 09:00, scant clear liquor
- Next
- Examine for cord
Summary
31-year-old G1P0 at 38+3, spontaneous rupture of membranes, oligohydramnios. 6 cm, deep variable decelerations with every contraction.
- Membranes
- Ruptured 09:00, scant clear liquor
- Fetal presentation
- Cephalic, occiput posterior, station minus 1
- Board status
- Needs assessment
Notes
- A scan last week showed a deepest pocket of 1.8 cm (oligohydramnios) with normal growth and Doppler; induction had been booked for 39 weeks.
- Since 11:40 the monitor shows deep variable decelerations with every contraction, slower to recover, and the baseline has risen from 145 to 155.
- Occiput posterior on the last examination.
Plan
- Vaginal examination now: cord, progress, position
- Reposition; discuss amnioinfusion with the senior
- Prepare for delivery if the pattern progresses
Medications
- None: Requesting an epidural
Maternal vitals
| Time | HR | BP | Temp |
|---|---|---|---|
| 09:30 | 88 | 116/74 | 36.9 |
| 12:00 | 96 | 112/70 | 37 |
Labs
- Haemoglobin115 g/L
- GBSNegative
What to watch
- Cord at the examination
- Baseline and variability trend over the next 30 minutes
- Response to amnioinfusion if used
- Progress: 6 cm at 12:00 with an occiput posterior position
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