Specialties Ob/Gyn
Published Oct 15, 2008
What is your hospital's policy on admission for a labor patient? Minimum dilation when no ROM? Automatic admission with SROM?
OzMW
172 Posts
We generally send them home if they aren't dilated; if they present again we tend to more often admit them for analgesia. SROM are offered options i.e immediate IOL/home/admission. The ones who go home then come back at 18 hrs for iv and abs; and IOL usually the next day. Most opt not to be induced immediately.
I would think it would be the other way around. A primip at 4 might still have hours and hours to go. A multip at 4 could be complete in half an hour. A grand multip, I wouldn't turn my back on her.
A multip at 4cm also could be just a multi OS. If shes contracting I'd keep her and reassess in two hours;if theres no change in dilation (and often a decrease in contractions) I'd send her home if she were happy. A primip at 4 I wouldn't necessarily keep - if she is having irregular contrcations I'd send out for a walk!
cvssc
40 Posts
As others say, it's case by case. Rom= admission either to L&D or antepartum. We monitor patients and make decisions. No dilation and bad tracing=admission. You can't just judge by dilation and status of membranes only.