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First Stage Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
The intrauterine pressure catheter (IUPC) can measure more objectively than external tocomonitor the intensity of uterine contractions. It necessitates rupture of membranes (ROM). Intensity is usually calculated by Montevideo units, that is, the sum of peak pressures above baseline of all contractions in 10 minutes.
Amniotic Fluid Embolism
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Although it is said that AFE is largely unpreventable, measures must still be taken to impede trauma to and excessive contractions of the uterus. Trauma to the uterus must be avoided when performing intrauterine manoeuvres such as amniotomy and placement of an intrauterine pressure catheter. Judicious use of oxytocic agents during induction and augmentation of labour is vital in preventing excessively forceful uterine contractions (discussed in Chapter 8).
Midwifery and obstetrics
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
Beverley Gordon, Gareth Thomas
No commentary on intrapartum care would be complete without specific reference to CTGs. A cardiotocograph (CTG) is a simultaneous recording of uterine activity and fetal heart rate (Figure 10.3). The uterine activity is usually detected by means of a pressure transducer, which is strapped to the maternal abdomen. Sometimes the record is obtained by means of an intrauterine pressure catheter. The fetal heart rate is derived using an ultrasound transducer, which again is strapped to the maternal abdomen. Sometimes the record will be obtained by means of an electrode attached to the fetal scalp (fetal scalp electrode). The trace paper runs at 1 cm per minute unless specifically indicated otherwise.
A case of a contained uterine rupture
Published in Journal of Obstetrics and Gynaecology, 2019
This patient was a 27-year-old gravida 2 para 1 at 40 weeks and 2 days in gestation, who presented with a leakage of fluid and occasional irregular contractions. She was found to have a rupture of membranes and was two centimetres dilated. Her past obstetric history was significant for one previous documented primary low transverse caesarean section 3 years ago due to a failed induction of labour complicated by chorioamnionitis. She opted for a trial of labour after being counselled on the risks and benefits. After three hours of expectant management, the patient requested an epidural. She had minimal cervical change and was augmented with oxytocin to induce her labour. The oxytocin was titrated using the standard hospital protocol to 22 milliunits per millilitre over the course of 23 hours. An intrauterine pressure catheter demonstrated inadequate contractions, but the patient continued to make cervical changes.