[crysobrn]

This morning after a crazy long night with patients calling left and right, literally coming in a few minutes after one another (and only two of us working mind you). I have already had my fill by this time of pretermers, r/o rom, and labor in general. I get a primip who's supposed to be coming in for an induction but now is in labor. She appears uncomfortable with her ctxn's but handling them quite well... I decide I better quick check her before the next shift comes on so I can give report without worrying that she's delivering. So, I SWEAR she was 6 with a bbow, baby at about a -2 station. I was really excited for her because she seemed so in control and was able to labor on her own without the induction.

I was told this evening that she was only 2-3 cm!!!! What gives???? I have never and I mean never in the 4 yrs I've worked in OB to my knowledge anyway been this "generous" lol... I'm not sure what's going on here. I feel like an idiot and I have to sit and listen to report on someone that they sectioned for ftp at 4cm that I swear was 6. OH MY!!

I'm just in shock cause I know what I felt. I'm thinking I won't live this down for a while!! Maybe it's my pregnant fingers lol...

[LizzyL&DRN]

Was it a nurse or doctor that checked the patient after you? I have seen doctors be unbelievable stingy with their dilation for the sake of less grief from the patient and family for a c section. I wouldn't worry about it too much and don't beat yourself up. How long did she get to labor after you left. I've seen very experienced nurses RUSH a patient from triage to labor and delivery because they said she was complete and then found them to be less that 3 cm. It was that darn 100% effacement that screwed them up.

[babyktchr]

Oh my gosh...it happens to everyone. If you do have a bulging bag, sometimes it stretches the cervix and when it breaks (or is broken) the cervix will go backwards because of the stretching. The other thing could be that the cervix was a bit more posterior and you felt folds. That happens to me on occasion. I always check back posterior, even if I think I have found the cervix.

Honey, after a long shift like you described...even fingers get tired.

[bagladyrn]

As the previous poster said, it's happened to all of us! I've had that experience of feeling what I thought was cervix at 5-6, then on subsequent exam found a ft cervix way posterior only to realize that what I felt was a "fold" of tissue all the way around. And of course, we've all known docs who just couldn't ever agree with the nurse's exam - usually if they had evening plans.

[awsmom8]

When I was in labor with my daughter, I had a 2 hr drive to the hospital thru no man's land. Well, baby's don't just fall out so I figured plenty of time. Got to the hospital and and was told by exp. OB nurse I was 4 cm. I then pushed twice a few min later and out shot my daughter. Morale of the story? Not everyone follows the book on how to have a baby! Was the nurse right that I was 4 cm or can someone deliver that quickly? I dunno but she visited me every day wondering how her fingers could have been wrong.

[Suzanna4]

I am only a nursing student at this time, so I don't have any experience of my own yet (can't wait to though!) My aunt was an OB nurse for 25 years, and swears to the fact that she has seen women "go backwards" in dialation when they felt threatened or were scared. I find this idea fascinating, and am curious to see if other OB nurses have seen this. She told me in all the years she did this it occurred many times where 2 diff nurses gave the same assessment, only to find out on subsequent exam they were wrong. She thought it was part of "white coat syndrome".

[babyktchr]

Vaginal exams are so subjective. Depending on finger size and your degree (MD vs RN). One man's 2cms is anothers 4, yada yada yada. Be confident in your exams and when there is a discrepancy, go back and feel again. You learn from it. I told a midwife once a patient was 5-6. She came in and checked the patient, then said..put on a glove. She asked me to feel way back and there was that cervix...at 1cm. I never forgot that. Now, as I said, I always go posterior when I do an exam.

I checked a patient once who was extremely posterior. She was comfortable with her contractions and I called the MD (who was on the unit and the time). I went to do something else while we monitored her, and he went in with another nurse and examined her and said she was NINE. I came back and they were rushing her into a room, putting a table together and getting ready for delivery. I was like..what is going on here? They said Dr. SO and SO said she was 9. I was horrified. The mother of the patient said....SHE WAS NINE, NOT TWO. I pulled the doctor aside and asked if her cervix was posterior still. He said no. I told him what I had done just a half hour ago, and he graciously put on another glove and examined her, to find a 2cm cervix, up to her tonsils. He then, even more graciously, told the patient he made a mistake, had her walk, and subsequently sent her home. It happens to everyone.

[crysobrn]

Well I asked the doctor what he thought of her cervix when I went back in. I told him I was really dissapointed that she ended up a c/s because I thought she was 6 and he said he thought she was 4cm so I feel a little better than the other nurse that said she was 2-3. He said she really didn't change all day so they made the call.

I still swear she felt like a 6 to me lol. Oh well. On a positive note he agreed with my assessment of the pretermer so I felt a little better about the night in general.