Definition of Intrapartum Period:
In obstetrics, the period from the onset of labor to the end of the third stage of labor.
Intrapartum Fetal Assessment:
It includes-
- Fetal movement,
- Fetal heart rate,
- Non stress test(NST),
- Ultrasound,
- Contraction stress test (CST).
Nursing Care During Intrapartum Period:
Standard for intrapartum care are recommended to use in South-East Asia during labor and delivery. These cares include:
- Care in labor,
- Safe delivery,
- Assisted delivery of the placenta and membranes using controlled cord traction,
- Monitor maternal vital signs,
- Assess fetal heart rate/amniotic fluid,
- Bladder care,
- Prevent dehydration,
- Prevent infection,
- Prevent injury,
- Provide comfort,
- Management of prolonged second stage of labor with fetal distress by performing an episiotomy.
Necessary Guidelines on Intrapartum Period:
The guideline includes recommendations on-
- Choosing place of birth,
- The latent first stage of labour,
- Initial and ongoing assessment,
- Transfer of care,
- Monitoring during labour,
- Care in the first, second and third stages of labour,
- Care of the baby and woman after the birth.
Assessment and Care of Family During Intrapartum Period:
Assessment and care of family during intrapartum period includes-
A. The nurse should assess for parental reaction in the first stage:
- Level of involvement,
- Supportive actions,
- Control,
- Anger and hostility,
- Quilt In each action or experience of the father nursing care should be implemented.
B. In the second stage and third and fourth stages parental reactions should be concerned and provide appropriate nursing care.
C. Also other family member’s reaction should be concerned and provide nursing during intrapartum period.
Complications of Intrapartum Period:
Complication may arise during intrapartum period:
- Dystocia,
- Dysfunctional labor,
- Persistent nonreassuring FHR patterns, fetal acidosis, & meconium passage ineffective contractions or ineffective maternal pushing maternal fatigue,
- Maternal inactivity,
- Fluid and electrolyte imbalance,
- Hypoglycemia,
- Excessive analgesia or anesthesia,
- Maternal catecholamines secreted in response to stress or pain,
- Disproportion between the aternal pelvis and fetal presenting part,
- Uterine overdistention such as with multiple gestation or hydramnios.
Midwife Care in the First Stage of Labor:
Care in the first stage of labor includes-
- Partnership in care,
- Emotional and psycho logical care,
- The role of the birth support,
- Advocacy.
Midwife Care in the Second Stage of Labor:
Care in the second stage of labor includes-
- Hygiene and comfort measures,
- Support during transition,
- Support during expulsive phase of labor,
- Early bearing- down efforts,
- Delayed bearing- down efforts,
- Pushing technique,
- Perineal practices,
- Assessing the need for episiotomy,
- Preparation for the birth,
- The activities of the midwife during the birth.
Midwife Care in the Third Stage of Labor:
Care in the third stage of labor includes-
- Delivery of the placenta and membranes,
- Completion of the third stage,
- Complication of the third stage,
- No use of uterotonic drugs,
- No clamping of the cord until pulsations had ceased,
- No controlled cord traction or any manual interference with the uterus at the fundus,
- Leaving the cord attached to the baby until the placenta was delivered,
- Encouraging the mother to await the next contraction or the urge to push before pushing,
- When she started to push, encourage the woman to adopt a position to incorporate gravity in the expulsive effort.
Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”