A client presents: 37+3: G2 P1: Group strep B positive for IV antibiotics in labour..... history of Spontaneous rupture of membranes (SROM)at 0200hrs.... presented to hospital at 12noon, fetal movements felt and clear liquor noted...team decision for IOL...dept busy so client to walk around until staff available to commence IOL, the woman may go into labour on her own...still no contractions... now 1300 hrs staff available.. CTG for 20mins reactive no contractions, clear liquor noted..... IV syntoncion commenced as per regime.....Would you do a baseline vaginal examination at this point or would you wait until the woman commenced contracting? is there a need to do this vaginal examination at this point? What do you think?
hmm, some would, I don't see the need though until there have been some contractions to cause cervical change. The less poking around in a GBS pos vagina the better....
ReplyDeleteWell, it's my view that in artificial labour, cervical effacement and dilation should really progress at a particular rate, and given that this woman is G2, I would like to know where she's starting from, yes.
ReplyDeleteWhether she should be induced with synto only 13 hours post-PROM of course is a different matter altogether.
yes Laura Jane, that was my decision, but after discussion...thankfully the woman birthed soon after..
ReplyDeletethanks in two minds for dropping by... yes the woman was GBS pos... not sure why the decision to induce was made...however not sure why it is necessary to know the baseline when no contractions have occured and it really does not change the outcome... a vaginal examination will be done 2hrs once contractions have started.
ReplyDeleteIt is interesting to see two clinicns with two different responses.