How to Monitor Maternal Well-being in Labour?

Maternal Wellbeing Monitoring Method During Labor

Definition of Normal Labour:

Normal labour is the physiological process of spontaneous uncomplicated and not delayed expulsion per vaginal of mature fetus with vertex presenting following by after births of umbilical cord, placenta and membranes.

Normal labour is one which fulfills the following criteria:

  • The labour is started spontaneously at term (37 – 42 completed weeks).
  • Foetus is vertex presentation.
  • Without undue prolongation.
  • Natural termination without any aid or with minimal aid (episiotomy).
  • Without any complication affecting the health of the mother and or the baby.
Maternal wellbeing monitoring method during labor
Fig: Maternal wellbeing monitoring method during labor

Maternal Wellbeing Monitoring Method in Labour:

A. Monitoring the maternal well-being in Labour by assessment of –

1. Temperature / Monitor the maternal temperature

  • On admission,
  • Intact membranes – 4 hourly,
  • Ruptured membranes – 2 hourly.

Pyrexia may be caused by infection or ketosis and can be associated with epidural analgesia (neuraxial block)

2. Monitor the maternal pulse

  • On admission,
  • During the latent phase of labour – 4 hourly,
  • During the Active phase of labour – every 3 min.

Tachycardia may indicate anxiety, pain, infection, Ketosis & hemorrhage.

3. Monitory Measure the maternal BP (Blood Presser)

  • On admission,
  • During latent phase of labor – 4 hourly,
  • During active phase of labour -2 hourly.

4. Pre-eclampsia and eclampsia is coursed by high blood pressure. Monitor the maternal respiration

5. Monitor the urine output

6. Monitor the urine test for albuminuria \ proteinuria.

7. Monitor the maternal general condition.

If the any abnormal condition is shown, inform the senior person.

B. Monitoring the fetal well-being in labour:

Monitoring the fetal well-being in labour by assessment of

1. Auscultate the Fetal Heart Rate (FHR) during normal Labour

  • On admission,
  • Laten phase of Labour -2 hourly,
  • Active phase of labour – 30 minutely.

2. There are four characteristics when listening to fatal heart

  • Rate- The normal fetal heart rate is between 120 to 160 beats per minute or 110 to 180 beat.
  • Variability-Changes in heart beat from baseline 5 to 25 beats.
  • Acceleration- An increase in the heart rate for longer Than 15 seconds.
  • Deceleration -A decrease in the fetal heart rate of 40 or more beats from the baseline.

3. Monitor the amniotic fluid: Women with ruptured membranes should have the amniotic fluid loss checked for colour, consistency and odor:

  • On admission.
  • In Early labour -2 hourly
  • In active labour – every 30 minutes.

Increased gastrointestinal motility resulting in meconium being passed into the amniotic fluid. The presence of meconium may not lead to meconium aspiration syndrome (MAS), but the tetus will require continuous heart rate monitoring during Labour. It may indicate chorio amnionitis.

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