By sumanOn

By the end of this exercise, the participant will be able to correlate between assessment of cervical dilation, effacement & station of head with Partograph and likelihood of normal labour.

  • Wash your hands and wear sterilized gloves on both hands to ensure complete aseptic technique
  • Take an antiseptic solution swab in a sponge holder and clean both labia from above to downwards. Antiseptic Solution will be Betadine.
  • Repeat the step again by using another antiseptic cotton swab.
  • Discard the used swabs in the yellow bucket.
  • Now Separate the labia, clean with antiseptic swab from above to downwards.
  • Insert index and middle finger to perform the Per vaginal examination.
  • Rotate the hand 90 degrees so that palm faces upwards and gently stretch the fingers till the rim of cervix is felt (usually at 3–9 o’clock position).
  • Assess cervical dilatation and inform/record in cm (For ex. 7cm, dilated).
  • It can be reordered as: not effaced, partly effaced, fully effaced or according to the %.
  • Now Check for the Membranes: Present/Absent. If absent colour of liquor should be mention.
  • I-Intact:
  • If ruptured colour of liquor would be-
  • C=Clear,
  • B=Blood
  • M=Meconium
  • Now Check/confirm the Presentation of the fetus Vertex/breech/empty pelvis.
  • If Vertex – check- caput (boggy feeling) or moulding*
  • Now check for the Station – It will be at spines/above/below (If the presenting part felt at Ischial spine, it considers as 0 station If below Ischial spine it comes under plus and if the above consider as a minus.)
  • Assess Pelvis Adequacy
  • The sacral promontory should not be reached by examine finger
  • The sacrum should well curved
  • The ischial spines are not prominented and both ischial spines can not be felt by the 2 fingers at the same time
  • Space between two Ischial tuberosities admit 4 Knuckles.
  • Remove the glove in red bin.
  • Record the finding and inform to the mother.

*It could be obstructed labour/ fetal malpresentation so refer the mother to higher centre for the further management.

Key points to remember:

  • Need to Ensure high level aseptic precaution and gentleness throughout the procedure.
  • If she in active stage of labour (when cervical dilatation is 4 cm and regular contractions present), start filling the partograph
  • Ensure disposal of swabs and used material as per the Guideline.
  • If a woman comes with a complain of preterm labour – differentiate between true and false labour pains by history and per abdomen examination. True Labour pains increase in frequency, intensity and duration of contractions and the pain does not subside even after rest. They are associated with show, dilatation and effacement of cervix and formation of bag of membranes.
  • If period of gestation is more than 28 weeks and woman is complaining of labour pains then give Injection Dexamethasone 6 mg, intra-muscularly, 4 doses, 12 hourly to enhance fetal lung maturity and transfer the women to higher centre with facility of SNCU.

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