Active Management of Labor

Chapter 195 Active Management of Labor



THE CHALLENGE


Active management of labor is a system of labor management designed to promote effective labor and reduce the need for cesarean delivery.


Scope of the Problem: Cesarean birth rate for nulliparous patients approximates 30% in many areas. Active management has been associated with cesarean delivery rates of less than 5% for its developers (Ireland).

Objectives of Management: To reduce cesarean delivery rates through a system of management that includes education, strict criteria for labor and abnormal progress, one-on-one care, and the use of high-dose oxytocin (when needed).


TACTICS



Relevant Pathophysiology: As developed in Ireland, active management of labor is based on the following:
• Patient education

• Strict criteria for the diagnosis of labor, the determination of abnormal progress, and the diagnosis of fetal compromise

• One-on-one nursing care during labor

• Use of high-dose oxytocin infusion (when needed)

• Peer review of all operative deliveries

Strategies:

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Active Management of Labor

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