Intrapartum management (during 1st stage of labour)- updated

🌟VenOMMS formula🌟

1. Plot partogram & T/O LR

[Ventilation]

[Oral intake]

2. Allow CF (clear fluids)
3. 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]

4. V/S monitoring hourly
✔️If PIH in crisis, every 15-30 mins
✔️add on GM monitoring in GDM patients

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

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

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

8. 1 to 1 care (if enough LR personnel)

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

[Medication]

10. Analgesia if strong contraction

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

12. DIK regime (for GDM patients)

[Special Order]

13. ARM (if membrane intact)

❗️local LR protocol varies