Laboring Morbidly Obese Women

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Hi Everyone,

Does anyone have a protocol out there on best practices regarding labor management of the morbidly obese woman who cannot be monitored externally and who is not dilated enough for internal monitoring?

Any help is appreciated!!

Thank you!!

Specializes in L&D.

Oh and I have used the Monica and it is AWESOME!

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Specializes in OB, OR.

I have found that shooting the efm at an angle very very high on the fundus (like you would for breech, or even higher) can sometimes help trace baby in an obese woman. Tends to be less adipose tissue there, and THROUGH the panniculus is basically impossible. other option, sometimes, is to get the mom to lift her belly up, find ht under there and then lower the belly back down to hold the efm in place.

Our koala rep came by recently and gave us some disposable tocos to try. They are supposed to be better for big women.

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