Partograph || Part 2

[@priscoviakamangu9854]

I'm preparing for my final exam. I can't wait to testify. These videos are really helpful. Thank you Dr MK7

[@DrMK7]

Glad they are helping

[@Nitahkalez]

Good evening doc , Diagnosis-poor progress in the active first stage of labor due to poor cervical dilatation and poor descent. At the time of admission the cervix was 4cm dilated and the descent of the head was 3/5 with 1 moderate contraction in 10minutes After 4hrs The membranes were artificially ruptured and the amniotic fluid was clear with a stable fetal heart rate , the cervix dilated to 5 cm and the descent of the head still remained at 3/5 and 5MU/min of oxytocin was administered at 15drops/min and the drug X could be pethidine . After the augmentation of labor with the drugs mentioned above the contractions seemed to improve after 4 hours with 3 moderate contractions in 10minutes. After 2hrs the cervix dilated to 7cm and the descent of the head was 2/5 with 3 moderate contractions in 10 minutes and fetal heart rate was still stable . After 2hrs the cervix dilated to 8cm with descent of the head still at 2/5 no change in the contractions . After 2 hrs the cervix dilatation was still at 8cm with descent of the fetal head still at 2/5 no change in contractions but the fetal heart rate is dropping which denotes fetal distress and there is meconium stained liquor with grade 3 mounding which indicates a case of obstructed labor. This patient has to be taken to theatre for an emergency Cesarean section.

[@DrMK7]

would you entertain Fetal distress?

[@Nitahkalez]

@@DrMK7 not at all because it could lead to birth asphyxia so that’s why at this point we have to perform a C/S to prevent HIE

[@priscoviakamangu9854]

Well let me try to answer the question though the graph is not clear. On the foetal part, there's a decrease in fetal heart rate as it dropped below 100. I can see moulding+2, On liquor the graph is not clear. On maternal part, contractions were not recorded, cervical dilation were okay until it reached 8 cm. I can't see the time clearly but it looks like between 9 to 11 hours there was no increase in dilatation after VE. There was augmentation of labour as Oxytocin was commenced. Thank you 😅

[@DrMK7]

So what diagnosis would you entertain ? And what drug do you think was given labelled “X”?

[@zinhlemahlangu1473]

Dr. do you think it would be possible to add a CTG lecture/tutorial for this series cause some of us are still seeing flames in that department

[@DrMK7]

will work on one

[@Theon_2]

Could be prolonged 2nd stage of labour, which required augmentation with oxytocin🤔, this is a primigravida, was given oxytocin i think 5IU at 15 drops which improved contractiohs

[@DrMK7]

Okay, what drug do you think was given labelled X? And what about the status of the fetus any comments?

[@happysinkonde7296]

Thank you so very much for the partograph it's really been my nightmare whenever I think about it

[@DrMK7]

glad to help

[@husseinmohamed2123]

Notes Dr need

[@DrMK7]

Pardon?

[@happysinkonde7296]

Dr what happened to short gun QnA episodes it's been while since the last episode please will really appreciate

[@DrMK7]

will try work on new content