Active Management of Labour

This manual encompasses a comprehensive approach to the management of labour. Based on the simple proposition that effective uterine action is the key to normal delivery, Active Management of Labour covers all aspects of delivery for nulliparous women with vertex presentation and single foetus.

This is an accessible and practical guide for obstetricians and midwives as well as anaesthetists and the auxiliary staff of maternity units.

• Encourages an active interest in labour by all professional staff
• Emphasises the importance of constant personal attention and good communication in labour
• Discusses in detail the need to distinguish between:
  - first and subsequent births
  - single cephalic and all other pregnancies
  - induction and acceleration of labour
• Fosters the development of a team
• spirit between midwife and obstetrician
• Demonstrates how good labour ward organisation can improve care
• Proves the importance of audit in ensuring quality of care

<br>Section 1: Text<br>1. Nulliparous v parous women <br>2. Induction v acceleration <br>3. Malpresentations, malformation, twins <br>4. Duration of labour <br>5. Diagnosis of labour <br>6. Progress: first stage <br>7. Progress: second stage <br>8. Acceleration of slow labour <br>9. Oxytocin in labour <br>10. Normal and abnormal labour (dystocia) <br>11. Inefficient uterine action <br>12. Cephalopelvic disproportion <br>13. Occipitoposterior position <br>14. Trauma <br>15. Pain <br>16. Antenatal preparation <br>17. Analgesic drugs <br>18. Epidural anaesthesia <br>19. Personal attention <br>20. Role of the doctor <br>21. Role of the nurse/midwife<br>22. Role of the mother <br>23. Care of the fetus <br>24. Induction <br>25. Organization<br>26. Cervix in labour <br>27. Caesarean section rates <br>28. Cerebral palsy <br><br><br>Section II: Visual Records <br>1. Nulliparous labour <br>2. Duration of labour <br>3. Diagnosis of labour <br>4. Progress in labour <br>5. Care of the fetus <br>6. Oxytocin <br>7. Analgesia <br>8. Method of delivery and additional items <br>9. Normal labour (1) <br>10. Normal labour (2) <br>11. Normal labour (3) <br>12. Abnormal labour: slow progress (1) <br>13. Abnormal labour: slow progress (2) <br>14. Abnormal labour: slow progress (3) <br>15. Abnormal labour: secondary arrest (1) <br>16. Abnormal labour: secondary arrest (2) <br>17. Method of treatment: artificial rupture of membranes <br>18. Method of treatment: oxytocin infusion (1) <br>19. Method of treatment: oxytocin infusion (2) <br>20. Failure to respond to treatment: error in diagnosis <br>21. Failure to respond to treatment: membranes intact <br>22. Failure to respond to treatment: hesitant use of oxytocin <br>23. Failure to respond to treatment: cephalopelvic disproportion <br>24. Induction: success <br>25. Induction: failure (1) <br>26. Induction: failure (2) <br>27. Fetal distress: placental insufficiency/accident of labour <br>28. Parous labour<br> <br><br>Section III: Clinical Data <br>1. Comparative figures for 35 years <br>2. Analysis of hospital population <br>3. Clinical circumstances of perinatal deaths <br>4. Rupture of uterus <br>5. Traumatic intracranial haemorrhage in firstborn infants <br>6. Cerebral dysfunction in mature infants <br>7. Diagnosis of labour <br>8. Duration of labour in nulliparous women <br>9. Spontaneously labouring nulliparous women with a single cephalic pregnancy at term <br>10. Obstetrical norms in nulliparous women