Note when monitoring, take care of a regular labor

When the maternity is normal, if there is enough gestational time, the labor of childbirth is a natural thing. However, during labor there are some problems that may arise affecting the mother and baby. For the necessary understanding, women and relatives should be equipped with full knowledge of labor to coordinate with health workers to help deliver safely.

• Abdominal pain is caused by an increase in the contraction of the uterus, the frequency of contraction of the uterus usually reaches 3 bouts in a period of 10 minutes, each lasting more than 20 seconds.
• Maternity sees bloody mucus in the vagina
• Amnioticrupture : See clear or colored fluid flowing out through the vagina.
• Examination: the cervical is erased or almost all and has opened 2cm or more; Form the amniotic head.

As soon as the signs of labor are seen, the maternity should go to the facilities for adequate monitoring and care during labor until after the birth of the baby.

When labor appears, atthe maternity medical facility is closely monitored for the following signs:

2.1 Full-state tracking

• barley
• During labor, the pulse begins every 4 hours.
• Normally, the pulse 70-80 times / minute, fast circuit 100 times / minute or 60 times slow / minute is an abnormal sign, if you are on the commune line, you have to resuppose and transfer the nearest route.
• blood pressure
• Blood pressure measurement: During labor every 4 hours; must measure blood pressure regularly when there is bleeding or rapid pulse
• At the commune health station, glands must be switched when: Sysysy blood pressure above 140 mmHg or minimum blood pressure above 90 mmHg or both, hypotension should be given before transfer; Blood pressure drops below 90/60 mmHg to resmoly and transfer, if the drop is too low to resmoly and call the upline to support
• The upline should take measures to bring blood pressure to normal levels or handle bad situations caused by abnormal blood pressure.
• Body temperature
• Temperature test every 4 hours, when the amniotic fluid breaks, monitor every 2 hours.
• Normal 37oC. When the temperature is 38oC, if in the commune, the temperature is reduced by simple means (e.g. warm compresses, for women to drink enough water …), transfer when handling is not fruitless.
• Observe the state of the condition: If the mother is tired, exhausted, struggling, short of breath, appropriate treatment is required.

2.2 Monitoring of uterus contractions

• Monitor the length of a contraction and the uterus the distance between 2 contractions. Monitor your uterus contraction manually or by monitor
• In the potential phase measured every 1 hour for 10 minutes, positive phase every 30 minutes for 10 minutes
• Muscle disorders contract when: The uterus contraction is too short < 20 giây), quá dài (> (60 seconds) or disorder (frequency < 2 hoặc > 4).

2.3 Monitoring of gestational heart rate

• Listen to your heart at least once an hour at a potential phase, every 30 minutes at a positive phase. Listen to the pregnancy before and after the amniotic rupture or when the amniotic fluid is pressed.
• The time of hearing the pregnancy heart is after the end of the uterus contraction. By the stage of calving listen to the pregnancy heart after each push.
• Count the gestational heart rate for 1 minute, comment on the pregnancy heart rate evenly or not.
• The average gestational heart rate is 120-160 times per minute. If the gestational heart rate is more than 160 times per minute or less than 120 times per minute or irregularly, treatment should be taken. This is a manifestation of pregnancy failure.

2.4 Monitoring of amniotic fluid

• Reviews of amniotic fluid per vaginal visit (every 4 hours) and when the amniotic fluid breaks.
• Normally the amniotic head is flattened, the amniotic fluid can be clean or opaque white.
• If the amniotic fluid is blue, red or black brown, foul, multi-amniotic, at least the amniotic fluid in the commune must be transferred. On the upline find the cause for proper handling.
• The amniotic fluid breaks at the right time when the ≥ opens 5cm, the amniotic fluid breaks prematurely when there is real labor but breaks at the wrong time, the amniotic fluid breaks young without real labor.
• If the amniotic fluid breaks prematurely, the amniotic fluid ruptures early over 6 hours without calving, in the commune gives antibiotics and then transfers. In the upline need to find the cause to handle.

2.5 Monitoring the extent of cervical open deletion

• The potential phase lasts 8 hours (from the removal of the cervical to the opening of 3 cm). Monitor every 4 hours, or as the uterus contraction increases, when the maternity hurts a lot.
• The positive phase lasts up to 7 hours (from the time the cervical opening 3cm to 10cm). Monitor every 2 hours; The cervical is almost complete (7- 10 cm) every 15 minutes or as soon as the maternity wants to push.
• In case the labor progresses rapidly, it is possible to visit the vagina to assess the cervical, the degree of the throne. Vaginal visits should be restricted to avoid infection.
• Normally the cervical is soft, thin, without edema.
• If the cervical gland does not progress, edema, the cervical opening is opened without the head not reaching, the commune gland must be transferred to the upline, where surgical conditions are available.

2.6 Track pregnancy progress

• It is necessary to assess the degree of development of the head of the fetus by externally forming the abdominal wall and visiting the vagina. There are 4 levels: High liquid head, wishing head, tight end and shortlisted head. When the head has reached, there are 3 levels: high, medium and low.
• Write the degree in the labor chart. Early detection of stagnant labor.
• If the fetus does not progress, the commune gland must be transferred conditionally to surgery.

When monitoring for identifying abnormal signs for timely handling measures, if the commune line needs to be transferred to the upline, there are sufficient equipment and manpower to handle abnormalities.

• Circuit: More than 100 times/min, less than 60 times/min.
• Blood pressure: Sysysy blood pressure above 140 mmHg or dƣới 90 mmHg. Diasym blood pressure above 90 mmHg or less than 60 mmHg.
• Temperature: 38oC or more.
• Full condition: Very tired, short of breath, blue skin, pale mucous membranes.
• Signs of pregnancy failure: Amniotic fluid with mixed stools or blood, tachycardia (over 160 times/min), slow (less than 120 times/min) or irregular (at a slow pace).
• Signs of amniotic infection.
• Abnormal contractions: Too long (more than 1 minute), too short (less than 20 seconds), too fast (more than 5 bouts in 10 minutes), which is associated with slow progress of the cervical.
• Asymmetry between the pelvis and the head of the fetus: The head does not reach, there is a cranial overlap of 2nd degree or more.
• Prolonged labor: The potential phase lasts (more than 8 hours); active phase stagnation (open less than 1cm/hour).
• Severe body diseases.
• Production, pre-production.
• Bleeding during labor.
• Abnormal pregnancy, multiple pregnancies, multiple amniotic fluid, amniotic mitigation and pregnancy beyond the date of birth.

4.1 Potential phase

• Nutrition: Eat full of nutrients
• Clean personal hygiene
• It is advisable to exercise gently, unless: Infusion, premature rupture of the amniotic fluid, pathology …
• Change the dressing regularly, observe the color of the amniotic fluid (for prematurely breaking amniotic fluid)
• Notify medical staff of abnormal signs (water, vaginal blood)
• Health workers guide how to breathe, push, rest so that pregnant women control pain

4.2 Positive phase

• Nutrition: Eat porridge
• Hygiene of the biological layer, the prepares for the process of birth.
• The medical staff instructs how to breathe, push, rest so that the pregnant woman manages the pain.

The process of labor is natural but there is always a risk to the health of the mother and baby. The above are the basic knowledge that helps women to coordinate with medical staff to identify abnormal signs.

At Share99 International Health Hub, there is a full maternity service as a solution to help pregnant mothers feel secure because there is a team of doctors throughout the pregnancy. When choosing a full-service maternity, a pregnant woman can:

• The process of pregnancy is monitored by a team of specialists
• Regular examination, early detection of abnormalities
• Package maternity for the convenience of childbirth
• Infants receive comprehensive care