Clinical Protocols in Labour

Introduction. The Approach to Care. Domino and GPO and home deliveries. Normal labour. The unbooked woman presenting to the labour ward. Pain relief in labour. Use of the birth pool for labour and delivery. Care of the baby. Hypoglycaemia in the newborn. Breastfeeding on labour ward and skin-to-skin contact. The prevention of thromboembolism. Induction. Stimulation and augmentation of labour. Caesarean section. Vaginal instrumental deliveries. Cardiotocograph interpretation and fetal blood sampling. Preterm labour. Prevention and treatment of neonatal group B streptococcal infection. Eclampsia and pre-eclampsia. Management of maternal diabetes. Infection control precautions with particular reference to women with blood borne pathogens (Hep B or HIV). Management of shoulder dystocia. Breech delivery. Twin delivery. Prolapse of the umbilical cord. Uterine rupture. Massive obstetric haemorrhage. Rescue cerclage. Female genital mutilation. Overwhelming sepsis. Failed intubation drill. Refusal to receive blood products. Refusal to undergo medical intervention. Sickle cell disease. Peripartum collapse. Rhesus disease. Termination of pregnancy following diagnosis of fetal abnormality or intrauterine death in the second trimester. Appendices.