LABOR AND DELIVERY:

Data:

Type of delivery: Cesarean section   
Length and date of Labor: 0800-1756 on 10/30/07: 
Total cesarean section time: 45 minutes
Procedures in labor: Tubal ligation with fishline clips
Pain Management in Labor: Spinal Epidural
Intake during labor: 2100 ml Crystalloids/ Lactated ringers 
Output/fluid loss: 1000cc

Labor descripton:

	The patient was a high risk pregnancy due to a history of chronic hypertension and current diagnosis of preeclampsia. According to Davidson London and Ladewig (2008 p. 508) birth is the only cure for preeclampsia. This condition puts the mother at a high risk for stroke, hyperreflexia, and seizures. Also the condition puts the fetus at risk because “perinatal mortality associated with preeclampsia is approximately 10%.” (Davidson London and Ladewig 2008, p. 507) She had a previous vaccum-assisted vaginal delivery with a fourth degree laceration. The laceration extended from the vagina to the rectal lumen. Vaginal delivery would put her at a high risk of a repeat laceration with possible permanent damage to the rectum.
	  The patient began labor around 0800 in the latent phase with 4 contractions per hour lasting 50-80 seconds with and intensity upon palpation of +1 mild (nose). Labor progressed to the active phase with 10 contractions per hour lasting 60-100 seconds.  Her blood pressure during labor was recorded to be 159/94 with a pulse of 86 bpm and 20 respirations per minute. She reported contraction pain rating it at an 8 on a scale of 1-10. A spinal epidural was used for pain management during labor. She was moved to the operating room for a cesarean section around 1715. A transverse abdominal incision was made accompanied by a low transverse uterine incision. The amniotic membrane was artificially ruptured and the fluid was found to be clear and free of meconium. The baseline fetal heart rate during labor was 150 bpm. The fetus was found to be in the vertex position. She was delivered at 1756. The placenta was delivered and a tubal ligation with fishline clips was preformed. The incisions were repaired with sutures. The delivery was non-complicated. The patient and daughter were moved to the recovery room.