GuidelinesOther guideline
Routine Monitoring of the First Stage of Labour
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
Latent phase (cervix ≤3 cm dilated):
- BP & heart rate 4 hourly
- Temperature 4 hourly
- Uterine contractions 2 hourly
- Fetal heart rate 2 hourly
- Vaginal examination 4 hourly
Active phase (cervix ≥4cm dilated, fully effaced):
Maternal condition
- BP 4 hourly
- Heart rate ½ hourly
- Temperature 4 hourly
- Urine test when urine is passed
Fetal condition
- Fetal heart rate ½ hourly – between, during & after contractions
- Colour of the liquor 2 hourly if the membranes have ruptured
- CTG in high risk women
Progress of labour
- Frequency & strength of uterine contractions ½ hourly
- Level of the presenting part (in fifths above the brim) 4 hourly, then 2 hourly with cervix ≥6 cm dilated
- Cervical dilatation 4 hourly, then 2 hourly with cervix ≥6 cm dilated
- Caput & moulding 4 hourly, then 2 hourly with cervix ≥6 cm dilated
Treatment given
- All medications
- All fluids administered, by whatever route