Labor and Delivery (L&D)



Labor and Delivery room
Maternity ward

أعده : نور المسعود

  Important Skills:
- Antenatal examination
- CardioTacoGraphy " CTG"  how to attach and read strip deepened on 
DR C BRAVADO
·                Define Risk
·                Contractions per 10 mins
·                Baseline heart Rate 110 – 160 beat \ min
·                Variability
·                Accelerations
·                Decelerations
·                Overall assessment






- Breast feeding 
" as patient education specially for primigravida "
1.     Care and importance
2.     Breast feeding positions : "cross cradle , cradle, football  and side lying "

- Importance of skin to skin contact after birth
- Identification of newborn and mother
- CODE PINK " infant abduction in hospital "
- Skin care and hygiene for newborn
- Circumcision
- Emergency birth " Caesarean Section "
- Post partum assessment
- Perineal care
Newborn care and measurement
- Apgar score
- Collection of specimens
- Blood transfusion 



Common medication in L & D :
1.     Syntocinon 5 units \ ml  , methergin 0.2 \ ml , prostin gel * 2 or 1 mg*  pabal 100 mcg\ml
2.     Narcotic " pethidine 50 - 100 mg and  valium 10 mg "
3.     Antibiotics " Augmaentin 1.2 mg , epicocillin 1 g , zinoxime 1.5 g "
4.     Primperan 10 mg\2ml
5.     Scopinal 20 mg\ml
6.     Voltaren 100 mg suppository
7.     Lidocaine
8.     Dexomethazone 8mg/2ml
9.     Other
epidural , antonox gas , Vitamin K




Common test preformed in L & D and meternity 
( value , aim causes of increase or decrease )
- CBC (complete blood count) for  " Hemoglobin and hematocrit , platelet count "
- Urine Screen for UTI urinary tract infections
- Blood Type and Rh Status and Antibody Screen
- GBS Group B streptococcus
- Hepatitis B
    - Gestational Diabetes
there are another laboratory request depened on the case demands 


Common Cases 
1. Preeclampsia
2. Eclampsia 
3. placenta previa
4. Abruptio placenta
5. umbilical cord prolapse 
6. Gestational diabetes mellitus GDM
7.  Abortion
8. Distocia
9. Intrauterine Fetal Death IUFD
10.Ante \ post partum  heamorrhage 


Equipments :
Labor and Delivery set
Labor and Delivery prep set
Aminohook

Amincator



Textbooks and References :
- Materal neonatal fact incredibly quick