Tools to Optimize Outcomes of Labor Safely | BirthTools
UMMC Pre-cesarean Checklist Labor Dystocia Huddle
• Team members: Primary provider, OB consult, primary RN, charge RN, resident
• Process: Review Dystocia Checklist or algorithm
• Documentation: OB consult document using dot phrase “Labor Dystocia Huddle”
• Choose one diagnosis below
|Diagnosis of Dystocia/ Arrest (all three must be present) |
|( Cervix is ( 6cm |
|( Membranes are ruptured (if possible), then |
|( No cervical change after at least 4 hours of adequate uterine activity (strong by palpation or MVUs |
|greater than 200), OR at least 6 hours of oxytocin administration with inadequate uterine activity |
|( Criteria not met, proceeded with cesarean for the following reason: |
|Diagnosis of Second Stage Arrest (only one of four needed) |
|No descent or rotation for: |
|( Nullipara, without epidural, active pushing for at least 3 hours |
|( Nullipara, with epidural, active pushing for at least 4 hours (does not include time for passive descent) |
|( Multipara, without epidural, active pushing for at least 2 hours |
|( Multipara, with epidural, active pushing for at least 3 hours (does not include time for passive descent) |
|( Criteria not met, proceeded with cesarean for the following reason: |
|Diagnosis of Failed Induction (two must be present) |
|( Bishop score ( 6 for multipara or ( 8 for nullipara before the start of the induction (must have adequate Bishop score prior to induction for non-medically |
|indicated/elective induction of labor) AND |
|Oxytocin administered for at least 12 to 18 hours after membrane rupture, without achieving cervical change and regular contractions (moderate to strong palpation|
|or ( 200 MVU). At least 24 hours of oxytocin administration after membrane rupture is preferable if maternal and fetal statuses permit. |
|OR |
|( Bishop score ( 6 for multipara or ( 8 for nullipara unfavorable and cervical ripening used when as part of the induction (for medically indicated induction of |
|labor) AND |
|Oxytocin administered for at least 12 to 18 hours after membrane rupture, without achieving cervical change and regular contractions (moderate to strong palpation|
|or ( 200 MVU). At least 24 hours of oxytocin administration after membrane rupture is preferable if maternal and fetal statuses permit. |
|OR |
|( Criteria not met, proceeded with cesarean for the following reason: |
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