EDAPT INTRAPARTUM COMPLICATIONS NURSING CARE
Some of the complications that can arise during the intrapartum period of labor and childbirth. These
complications may be related to pre-existing conditions or abnormal situations that occur during labor, which
put the woman and the fetus at risk for poor outcomes. The nurse plays a key role in preventing, detecting,
and managing these complications.
A woman in labor is experiencing complications that require augmentation of labor. Which of the following
represents how the nurse would characterize her labor?
Labor dystocia is most often used for labor that is not progressing or failure to progress. Labor dystocia can put
both mother and child at risk and may result in medical interventions such as augmentation, cesarean delivery,
or forceps- or vacuum-assisted delivery. Each of these interventions carries its own risks and benefits.
A woman who has been in labor for an extended time is getting very tired. Which of the following
intrapartum complications is concerning the nurse, that may result from maternal fatigue?
When the labor has been particularly stressful or physically demanding, or the woman has not slept, she may
not have the physical or mental strength to carry on the labor. The labor can slow or stop, or the pushing may
become ineffective. The nurse needs to monitor for signs that the woman is becoming fatigued, both verbal (“I
can’t do this anymore!”) and non-verbal (ineffective coping, irregular breathing pattern), and objective findings
(changes in vital signs and contraction pattern). The nurse can also take steps to preserve the woman’s
energy, help her relax, breathe effectively, and provide a calming environment.
A pregnant woman comes to the emergency department in precipitous labor that started 30 minutes ago.
She says that she feels like she needs to have a bowel movement. The nurse observes on the electronic fetal
monitor that the fetal heart rate decreases gradually when a contraction starts and returns to baseline when
the contraction ends. What does the nurse suspect is causing this?
A pregnant woman comes to the emergency department in precipitous labor that started 30 minutes ago.
She says that she feels like she needs to have a bowel movement. The nurse observes on the electronic fetal
monitor that the fetal heart rate decreases gradually when a contraction starts and returns to baseline when
the contraction ends. What does the nurse suspect is causing this?
Fetal head compression
Precipitous labor is defined as a childbirth that occurs within 3 hours after the labor onset and can result in
rapid descent of the fetal presenting part. The fetal heart rate decreases gradually when a contraction starts
and returns to baseline when the contraction ends. This pattern indicates an early deceleration, reflecting fetal
head compression. With contractions, the fetus’s head is pressed into the pelvis and compressed, causing the
fetal heart rate to decrease with each contraction and then return to baseline.
Early decelerations can be a good sign, however, the pressure of the fetal head on the cervix can advance
labor if the fetus is tolerating it. This may indicate that delivery is close. Late decelerations, which start after
the contractions start and end after the contraction ends, indicate uteroplacental insufficiency. Umbilical cord
compression causes decelerations with a more rapid decline during contractions. The described fetal heart
rate pattern does not indicate fetal distress.