🤰Intrapartum management
(during 1st stage of labour)

🌟according to VenOMMS 🌟


1️⃣ Plot #partogram & T/O LR

[Ventilation]


[Oral intake] 🔽🔽🔽

2️⃣ Allow sips of CF (clear fluids)

3️⃣ Insert large bore branula & start IVD NS/HM/Dextrose Saline; 125cc/hour

❗️In PIH patient; only 1cc/kg/hr (risk for APO) & use only NS ‼️

❗️In Diabetic patients; if DXT less than 7mmol/litre, use D5% solution instead of NS ‼️


[Monitoring] 🔽🔽🔽

4️⃣ V/S monitoring hourly

✔️If PIH in crisis, every 15-30 mins
✔️add on GM monitoring in GDM patients


5️⃣ CTG #monitoring (tracing on admission & post ARM), then to repeat accordingly based on risk factor

6️⃣ Time #contraction; aim good contraction (4:10 in primid, 3:10 in multipara)

7️⃣ NRVE in ? hour (according to current V/E findings)

8️⃣ 1 to 1 care (if enough LR personnel)

9️⃣ Husband/#companion to accompany during labour (not available during pandemic 😷 )


[Medication] 🔽🔽🔽

🔟 #Analgesia if strong contraction

1️⃣1️⃣ For Pitocin #augmentation 1 or 2 hour post ARM if contraction inadequate ( <4:10 in primid, <3:10 in multipara)

1️⃣2️⃣ DIK regime (for GDM patients)


[Special Order] 🔽🔽🔽

1️⃣3️⃣ Amniotomy ie #ARM (if membrane intact)

Source;  ❤️ Medicorp’s O&G #online course❗️local LR protocol varies