The Labour Ward Handbook

This succinct manual provides detailed clinical practice guidelines for the care of women in labour, this is designed to be a ready guide for use in the delivery suite by the busy clinician. The third edition has been updated to include new developments in clinical practice and governance and new guidelines. So far as is possible, the differences in care scenarios internationally have been addressed to provide a reliable guide to safe delivery.

Key Features

• Provides detailed clinical practice guidelines for the care of women in labour
• Offers a ready guide for use in the delivery suite by the busy obstetric clinician and all members of the team
• Focuses on the clinical relevance of the problem points arising.

Table of Contents:

Acknowledgements

About the Author

Abbreviations

Glossary

Bleep/crash calls

Part I: Approach to care

1. The biopsychosocial approach to care of the woman in labour

2. Communication between care providers

3. Documentation

4. A dmission to, and discharge home from, the delivery suite

5. Learning from clinical incidents

6. T ransfer of care between professionals

7. Reviewing what happened

Part II: Normal and Low-Risk Labour

8. Vaginal examination

9. Intravenous cannulation

10. Management of normal labour

11. Prelabour rupture of membranes at term (37–42 weeks)

12. Management of the first stage of labour

13. Fetal monitoring

14. Fetal scalp blood sampling

15. Augmentation of labour

16. Cord-blood sampling

17. Epidural analgesia in labour

18. Management of the second stage of labour

19. Criteria for paediatric attendance at delivery

20. Management of the third stage of labour

21. Immediate postpartum care

22. Care of the newborn

23. Meconium-stained amniotic fluid

24. Neonatal resuscitation

25. Babies born before arrival at hospital

26. Episiotomy

27. The woman with a history of childhood sexual abuse

28. Use of birthing pool

Part III: Abnormal and high-risk labour

SECTION 1. Powers, passenger, passage

29. Caesarean section

30. Recovery of obstetric patients

31. High-dependency care

32. Failed intubation drill

33. Instrumental delivery

34. Trial of vaginal delivery after a previous caesarean section

35. Induction of labour

36. Antenatal corticosteroid therapy

37. Preterm prelabour rupture of membranes

38. Preterm uterine contractions

39. Deliveries at the lower margin of viability

40. Multiple pregnancy

41. Abnormal lie in labour

42. Occipito-posterior position

43. Malpresentation

44. Breech presentation

45. External cephalic version

46. The woman with genital cutting

47. The obese woman in labour

48. Perineal tear

SECTION 2. Medical conditions

49. Heart disease in labour

50. Peripartum cardiomyopathy

51. Pre-eclampsia

52. Eclampsia

53. Diabetes mellitus

54. Asthma (acute exacerbation in labour)

55. Epilepsy

56. Systemic lupus erythematosus

57. Connective tissue disorders

SECTION 3. Haemorrhage and haematological disorders

58. The rhesus-negative woman

59. Thromboembolism prophylaxis

60. Acute venous thromboembolism and pulmonary embolism

61. Major haemoglobinopathy

62. Inherited coagulation disorders: Haemophilia and von Willebrand disease

63. Immune thrombocytopenic purpura

64. Thrombophilia

65. Gestational thrombocytopenia

66. Antepartum haemorrhage

67. Major placenta praevia

68. Placenta accreta spectrum

69. Retained placenta

70. Postpartum haemorrhage

71. Disseminated intravascular coagulopathy

72. Delivery of the woman at known risk of haemorrhage

73. Standards for administering blood transfusion

74. Management of the woman who declines blood transfusion

SECTION 4. Infection

75. Prophylactic antibiotics

76. Intrapartum sepsis

77. Hepatitis B and C

78. Intrapartum antibiotic prophylaxis for Group B streptococci

79. Genital herpes

80. Human immunodeficiency virus

81. The woman with COVID-19

SECTION 5. Other obstetric emergencies

82. Paravaginal haematoma and cervical tear

83. Rupture of the uterus

84. Shoulder dystocia

85. Cord prolapse

86. Anaphylaxis

87. Inverted uterus

88. Amniotic fluid embolism

89. Sudden maternal collapse

90. Latex allergy

SECTION 6. Stillbirths and congenital abnormalities

91. Checklist for fetal loss at 13–23 weeks

92. Intrauterine fetal demise

93. Mid-trimester termination of pregnancy for fetal abnormality

Appendix

Index