help w/ cervical effacement

[newrn2010]

Hi All I am a new grad in L&D and 1 month on my own after 6 wk of classes and 6 wks my preceptor. I am getting more accurate w/ dilation (off usually around 5-9 by 1 cm) but the effacement is a big huh? any tips? Please start from scratch maybe it is a liitle thing I missed earier. Everyone says it will come but if my pt is on pitocin my SVE must be accurate to determine cervical change q 2hrs.Thanks for helping us newbies

[klone, MSN, RN]

If you have a pt on Pit, effacement is probably not going to be a HUGE piece of the puzzle, IMO. If you can determine that change has been made, based on previous exams, then the exact number is not extremely important.

One thing that is helpful is knowing how thick an uneffaced cervix is. You can assume that it would be around 3-4 cm but you can probably get your pt's unripe cervical length from early U/S reports. So measure your index finger to figure out what 3-4 cm is, and that will help you to gauge effacement. If the cervix is the thickness of your first knuckle, then she's probably around 50%.

Keep in mind that effacement is extremely subjective. Like I said uppost, knowing the specific number is less important than just being able to tell that the pt is making progress and getting thinner.

It's also okay to chart a range. I've been known to chart 50-75%. I generally don't chart anything more specific than ranges of 25. For me, effacement is either thick, 25, 50, 75, 90 (okay, I will throw that in there if it's very thin but not TOTALLY effaced) and 100. When I see a nurse chart "60% effaced" I alway chuckle a bit.

[L&DRNJenn]

I agree with klone, it is very, very subjective. I usually err on the the conservative side and reserve 100% to paper-thin. As long as you tell if there has been change or no change is what is really important!

[LDRNMOMMY, BSN, RN]

I agree with what the pp's have said. It is incredibly subjective.