6 factors to keep a close eye on during labor

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Labor is a natural physiological process of a woman during pregnancy, helping to bring the fetus and its appendages out of the uterus through the vagina. This is a fairly important process during pregnancy, so pregnant women need to be closely monitored at specialized medical facilities such as pulse monitoring, vital index monitoring, and uterine contractions. ..

1. Monitoring of normal labor

1.1 Monitoring vital indicators Pulse monitoring:
Pregnant women need to have their pulse taken every 4 hours during labor. After giving birth, pregnant women need to have their pulse counted immediately and in the first hour, the pulse should be counted every 15 minutes, the second hour, it should be every 30 minutes. For the next 4 hours, count the pulse every 4 hours. Normal pulse in the range of 70-80 beats/min, fast pulse ≥100 beats/min, slow pulse ≤60 beats/min. Blood pressure monitoring:
During labor, pregnant women need to have their blood pressure measured every 4 hours. After birth, blood pressure should be measured immediately, then every 1 hour in the first hour after birth, and blood pressure should be measured regularly if bleeding problems or rapid pulse occur later. If the systolic blood pressure is >140 mmHg or the diastolic blood pressure is >90 mmHg or both, the pregnant woman is prescribed antihypertensive drugs and then transferred to a higher-level hospital. If blood pressure is <90/60 mmHg, resuscitation should be performed and transferred to a higher level for management. Particular attention should be paid to cases of high blood pressure or shock. Monitor body temperature:
Body temperature should be measured every 4 hours. If the body temperature is ≥38°C, at the commune level, the patient should be cooled down by applying a cool compress, wiping his body and then transferred to the upper level for treatment. Make sure pregnant women drink enough water. Observe the general condition of the pregnant woman, if the pregnant woman is tired, has signs of exhaustion, struggles or has difficulty breathing, it should be treated promptly and transferred to a hospital or medical facility at a higher level to find the cause and treat it. treat.

1.2 Uterine contractions For uterine contractions during labor, the pregnant woman should be monitored for the length of a contraction and the interval between two consecutive contractions. During the latent phase of labor, it should be measured every 1 hour for 10 minutes, and in the active phase, every 30 minutes for 10 minutes. For the case at the commune health station, the uterine contractions are too short or too long or the frequency of uterine contractions is disordered, it is necessary to transfer to a higher level hospital for monitoring, finding the cause and handling. 1.3 Monitoring fetal heart rate For the latent phase, it is necessary to monitor the fetal heart rate at least every 1 hour and every 30 minutes for the active phase. It is important to listen to the fetal heart before, after the water breaks or the amniotomy is performed. It is important to listen to the fetal heart after the contractions have ended and after each push. Count the fetal heart rate for 1 minute and see if it is even. The average fetal heart rate ranges from 120-160 beats/min. If the fetal heart rate is >160 beats/min or <120 beats/min or there is an arrhythmia, it is necessary to resuscitate and transfer to a higher level to find the cause for treatment. 1.4 Amniotic fluid status During internal examination, the status of amniotic fluid should be considered at each vaginal examination every 4 hours and at the time of rupture of membranes. In the case of normal labor, the amniotic fluid is usually flattened, and the amniotic fluid is clear or cloudy. If the amniotic fluid is blue, red or black, has a bad smell, polyhydramnios or oligohydramnios, it is necessary to find the cause to treat. In case the water breaks prematurely, the water breaks before 6 hours without giving birth, it is necessary for the pregnant woman to use antibiotics and find the cause of treatment. 1.5 Monitor the degree of cervical dilation and dilation. It is necessary to examine the pregnant woman's vagina every 4 hours, when the stain breaks and when the pregnant woman pushes to give birth. If labor progressed quickly, vaginal examination to survey the cervical area, the penetration of the fetal position to have appropriate treatment. When examining the vagina, it is necessary to pay attention to the problem of infection and minimize the examination to avoid this infection. The latent phase is when the cervix is ​​dilated up to 3cm, lasting about 8 hours. The active phase of the cervix dilates from 3-10cm, lasts about 7 hours. The cervix in normal condition is soft, thin, without edema. Conversely, if there is no progression of the cervix, or edema is present, the cervical curve on the labor chart shifts from left to right the alarm line, the cervix is ​​dilated 10cm but the tip is not in cesarean section should be considered. 1.6 Monitoring the progress of the fetal position The method to assess this condition is external abdominal manipulation and manual examination. There are 4 levels:
High head High head Good head Low head, low score includes 3 small levels: high pass, medium pass and low pass. Percentage monitoring is required to detect stalled labor.
When there is no progress in the fetal position, consider surgery.

2. Abnormal labor monitoring

In cases of abnormal labor, medical staff should closely monitor the above 6 factors including vital signs, fetal heart rate monitoring, uterine contractions, amniotic fluid status, the degree of cervical dilation, the penetration of the fetal position to notify the pregnant woman and her family members and take appropriate action.

3. Monitoring of labor in pregnant women with HIV

Consider the prognostic factors of labor to determine the fertility method for the mother, limit the Forceps procedure, pull the scissors, and take blood from the baby's scalp to prevent the possibility of HIV infection. Hold the amniotic sac to the end and cut the episiotomy when the tip is low. Use antiretroviral drugs for both mother and baby according to the protocol of the Ministry of Health. Labor plays an important role for the delivery as well as the health of both the mother and the newborn, so the mother needs to be monitored for her vital signs, uterine contractions, amniotic fluid status... closely and if there are any signs such as fetal distress, prolonged labor, it should be considered and appropriate indications.
Vinmec International General Hospital offers a Package Maternity Care Program for pregnant women right from the first months of pregnancy with a full range of antenatal care visits, periodical 3D and 4D ultrasounds and routine tests to ensure that the mother is healthy and the fetus is developing comprehensively. Pregnant women will no longer be alone when entering labor because having a loved one to help them during childbirth always brings peace of mind and happiness.

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