Cpd???

burn out · Jan 19, 2007

I am not an OB/LD nurse and I have a world of respect for them but I can tell you as a first time mother I only labored for 12 hours with pit and pushed for 4 hours when they decided cpd and did the c section. What a horrible experience for that new mom, will she ever be able to have any more children? That must be one of the hardest times in an ob/ld unit.

HappyNurse2005, RN · Jan 19, 2007

Nurse79-

how did she deliver-vag or c/sec? how big was the baby? (jsut curious)

nurse79 · Jan 20, 2007

Happy, She went for C/S after we had left..not too sure how much the infant weighed.

SmilingBluEyes · Jan 20, 2007

Would have been sectioned sooner where I am. They are very hooked on the labor curve there, for the most part.

nurse79 · Jan 20, 2007

thanks for ur input. So typically stuck at a certain cms for longer than 2 hrs isnt good..?

KellNY, RN · Jan 20, 2007

If she wasn't fully dilated, then really it seems more an issue of FTP (failure to progress) than CPD. Both issues are often bogus, to throw my opinion out there.

Here it would depend. As long as the baby was looking good, if the mother wanted to keep laboring, she would have been "allowed". If the mother had been pushing for a c/s most of our docs would have taken her back in a shorter period of time.

A quick FYI-unless this woman had an IUPC, the mmHg on the toco doesn't mean much. I've seen women get Braxton Hicks up to 90, and women deliver a full termer while only registering in the 40s on the toco. I can't tell you how many times I've answered a call bell from a family member (or the woman herself!) "OMG! Come quick! She (I) just had a huge Ctx!!" so I go in, ask the usual questions (LOF, VB, mucus plug, etc). I ask how painful it was and I get "Oh, I didn't even hardly feel it. But you shoulda seen those numbers moving up!" :rolleyes: Placement of the toco, position of the baby and uterus, body shape, body mass index, etc can all effect the readings. An external toco is really very relative.

Burn out-Not trying to sound snarky, but a primip opting for a c/s after laboring for 12 hours (am I correct that labor was 12 hours and SROM was 20?) is far from being one of the hardest times here. Far far far, especially when mama and baby are alive and healthy in the end.

CEG · Jan 20, 2007

12 hours isn't really a very long labor. Isn't that the average length for a primip? Mine were both 18+ hours so I guess I was lucky to deliver where I did.

nurse79 · Jan 20, 2007

Thats what I was thinking KEIINY,,re: the duration of her labor. and yes she had an IUPC and FSE in. She SROM at 0045. 3-4 cm -1 station and was in early labor... but started having regular UCs like at 930 am, and dilated to like 7.5cm by around 1500, still -1 station. 1900 still no change. Baby looked fine all day, no decels. I just thought it was rude for the next shift to wonder "what took so long for her to go to c/s" a PRIMIP (and only 16 years of age might i add). I didnt think my preceptor did anything wrong...did lots of hip rocking, hands and knees, etc to get baby to drop.

CMCRN · Jan 21, 2007

50 mm by IUPC is NOT adequate labor. UCs need to be 60 or greater. This sounds more lack of forces than CPD. We give moms all the time they need as long as progress is being made, and forces are adequate. An exhausted 16 year old, I might have encouraged her to get an epidural, increased the Pitocin and let her labor down.

KellNY, RN · Jan 21, 2007

I'm thinking that she just wasn't in real labor. Even if she were "term" (and there's a good chance that dates are off), I think her body or her baby just weren't ready.

Did anyone get her up to walk around for a little while?

What a shame a 16 y/o had a primary c/s.

nurse79 · Jan 21, 2007

Yes i agree regarding the intensity of her UCs. Unfortunately she would hyperstim when Pit was increased past 9mu..she also didnt want an epidural. Maybe just FTP ??