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Emergency Department Active Labor Presentation
Aka: Emergency Department Active Labor Presentation, Labor Phone Triage
- History
- Demographics (if phone triage)
- Patient name and age
- Distance from hospital
- Primary obstetrics provider
- Pregnancy History
- Parity
- Gestational age and estimated delivery date
- Prenatal Course and past obstetrics history
- Twin Gestation
- Prior cesarean (planned repeat cesarean or VBAC)
- Gestational Diabetes
- Breech Presentation
- Placenta Previa
- GBS Positive status (36 week culture result)
- Contraction history
- Onset
- Frequency
- Duration
- Intensity
- Associated obstetric symptoms
- Rupture of Membranes (and is there meconium staining)
- Fetal movement
- Vaginal Bleeding
- Other symptoms
- Fever or concurrent illness
- Oral intake
- Indications: Evaluation at Labor and Delivery (via phone triage)
- General
- Unable to speak during 2 contractions during triage
- Suspected Rupture of Membranes
- Nulliparous patient
- Contractions every 5 minutes
- Multiparous patient
- Contractions every 8-10 minutes
- Exam
- Fetal Heart Rate
- Fetal Heart Tracing (if available)
- Contraction frequency
- Cervix exam
- See Cervical Examination in Labor
- Cervical dilation (closed to completely dilated at 10 cm)
- Cervical effacement (Cervical Length)
- Fetal Presentation (vertex or Breech Presentation)
- Fetal Position (Occiput Anterior or Occiput Posterior)
- Management
- See Spontaneous Vaginal Delivery
- Complications
- First Stage of Labor
- Fetal Distress
- Second Stage of Labor
- Fetal Malpresentation
- Breech Presentation
- Umbilical Cord Prolapse
- Shoulder Dystocia (and Shoulder Dystocia Management)
- Uterine Rupture
- Uterine Inversion
- Third Stage of Labor
- Postpartum Hemorrhage
- Retained Placenta
- References
- Doty in Herbert (2016) EM:Rap 16(5):3-4