Mrs. Amanda returned three weeks later to the MCH clinic, complainingthat she has been having regular contractions for 8 hours. She knows thebaby is sill moving, no water broke.
: within normal limits
Uterine fundus 30 cm above symphisis.Leopold 1 : a globular round hard mass is occupying the uterine fundus.Leopold 2 : small fetal part detected on the left abdominal wall, on therigh side a long flat area of mass with higher resistence is detected on theright sideLeopold 3 : some soft mass is palpable above the symphisis, and havesomehow entered the pelvic inlet.Estimated fetal weight 2700 grmContraction: once every 3 minutes, lasting 50 second, strong.Fetal heart rate: 152-160 beat per minute
Vulva/vagina : no abnormalitiesPortio: axial position, soft, effacement 80%Cervical dilatation: 9-10 cmAmniotic membrane : intactPresenting part: breect, sacrum on the right, station +2 no feet palpable
Admission test result with cardiotocography : fetal in concition.
An hour later full dilatation is reached and as the baby’s buttocckis bulgingin the perineum. She was lead to bear down. There was some difficultywhile delivering the shoulder, and an assisted breech delivery had to bedone.
A baby boy is born, emerging limph, pale, cyanotic and takes onegasping breath on the way to the open warmer.
His heart rate is noted to be 80 beath min.