Case 1
Case 1
Case 1
► Caridad is a 22-year old G2P1 (1001) who arrives at your birthing center with an 8 cm dilated cervix at 2 pm.
Vital signs: BP- 100/70 mm Hg, PR-80/min; T-36.7°C.
► The BOW ruptures after 60 minutes of observation revealing meconium-stained amniotic fluid.
► On IE , the cervix is still 8 cm dilated even if the contractions are coming at 2-3 every 10 mins.
Vital signs: BP- 120/70, PR-90/ min, T- 37 °C.
► You are deciding whether to continue monitoring her or to refer her immediately to the district hospital which
is 4 hours away. How will you decide?
CASE 2
► Alma is a 29-year old G4P3 (3003) who arrives at your birthing facility at 6 am. She lives in the island barangay 5
hours away so she decided to come even if the labor pains are still bearable. IE - cervix is 3 cm dilated, cephalic
presentation, intact bag of waters. BP- 100/60, PR- 85/min, T- 37°C.
► At 2 pm, the BOW ruptures showing clear amniotic fluid. IE shows a fully dilated cervix. Vital signs remain the
same.
► At 3 pm, the patient has not delivered even if the cervix is fully dilated on repeat IE.