Parturient R., 30 years old has been brought to the Maternity House in 2 h after
the onset of contractions. Three hours ago at home clear amniotic fluid has poured out.
Menstrual function is not disturbed. This is her 5th pregnancy. Previous 4 have ended up
with term labours.
Objective examination: common condition is satisfactory, BP – 120/80 mm Hg,
HR is rhythmical 76 per min. No internal organs pathology found. Abdominal girth is 110
cm, UFH – 33 cm. External pelvic diameters are as followings: 26-29-31-21 cm. Fetal lie
is longitudinal, presenting head is engaged into the pelvic inlet with greater segment.
Fetal HR is clear, rhythmical 136 per min to the right below umbilicus. Contractions are
for 40 sec every 3 min.
Vaginal examination: parous vagina, cervix is effaced, dilated by 10 cm.
Membranes are absent. Head is engaged into the pelvic inlet with greater segment,
sagittal suture is in the left oblique diameter, posterior fontanelle anteriorly to the right,
anterior one closer to sacrum to the left
Diagnosis? Labour management plan? Possible complication during labour and
their prophylaxis?
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