Obstetrics Book




Labor and Delivery Admission

Aka: Labor and Delivery Admission
  1. Document: General Admission Orders
    1. Admission to labor and Delivery
    2. Diagnosis: Intrauterine Pregnancy at ___ weeks
    3. Vital Signs every ___(1 to 4) hours
    4. Pregnancy monitoring (continuous or intermittent)
      1. External fetal monitor
      2. Tocometry
    5. Activity:
      1. Ambulate in Latent Labor with intact membrane
      2. Bedrest in left lateral decubitus in Active Labor
    6. Nursing
      1. Intake and Urine Output Monitoring
      2. Urine catheter as needed
    7. Diet
      1. As tolerated in latent labor
      2. Ice Chips in active labor
    8. Intravenous Fluids
      1. Lactated Ringers +/- 5% Dextrose at 125 cc/hour
    9. Labs
      1. Complete Blood Count
      2. Blood Type and Antibody Screen (Indirect Coombs)
  2. Document: Latent Phase of Labor Orders (Cervix 0-3 cm)
    1. See Latent Labor Anesthesia
    2. Favorable Cervix (Bishops score >= 5)
      1. See Pitocin Induction
    3. Unfavorable Cervix (Bishops score <5) and no ROM
      1. See Cervical Ripening
  3. Document: Active Phase of Labor Orders (Cervix 4-10 cm)
    1. See Active Labor Anesthesia
    2. Active Management of Labor
      1. Pitocin Augmentation for <1 cm dilation per hour

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