Labor room
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ประเมิน Labor Room คุณภาพ PowerPoint PPT Presentation


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ประเมิน Labor Room คุณภาพ. นายแพทย์สุธิต คุณประดิษฐ์  พบ. วว. สูติศาสตร์-นรีเวชวิทยา นายแพทย์ทรงคุณวุฒิ(ด้านเวชกรรม สาขาสูติ-นรีเวชกรรม) กลุ่มงานสูติ-นรีเวชกรรม โรงพยาบาลลำพูน สำนักงานสาธารณสุขจังหวัดลำพูน. แนะนำตัว ฐานะที่มา กัลยาณมิตร

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ประเมิน Labor Room คุณภาพ

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Labor Room

. . -( -)

-


-

-


  • :

  • :

  • : re-check

  • : safety delivery of mother and newborn


Labor room

  • : Competency Teamwork

  • :

  • :

  • Process :


Process of labor room

  • Labor care

  • Prevention birth asphyxia and PMR

  • Prevention and treatment PPH

  • Initiate breast feeding

  • Other : Operating room

  • : Blood bank

  • : NICU


LAB

Rehab


COMPOSITION

  • LABOUR ROOM

  • DELIVERY ROOM

  • OPERATING ROOM

  • RECOVERY ROOM


LABOR ROOM

  • Assessment unit

    • Monitoring the Fetal condition

    • Monitoring the Maternal condition

    • Monitoring the Progress of Labor

  • Induction of labor

    • Designed to artificially initiate uterine contractions leading to progressive dilatation and effacement of cervix that leads to delivery of baby


DELIVERY ROOM

PURPOSE : To have safe delivery for both mother and baby

  • Use for normal cephalic delivery

    • NSD (normal spontaneous delivery)

    • Instrumental Delivery

      • Forceps delivery

      • Ventous delivery


OPERATING ROOM

  • Delivery thru caesarean section


Quality of Labour room

Quality

LR


Quality of Labour room

Quality

LR


Quality of Labour room

Quality

LR


1.


1.

  • 1.1 18

  • 1.2

  • 1.3

  • ( CPG )


Labor room 1


Weak point

  • Labor room : admit plan of management


2.


2.

  • 2.1 /

  • 2.2

  • 2.3

  • 2.4

  • ()


Labor room 2


Weak point

  • Plot partograph : plot

  • progression of labor


3.


3.

  • 3.1 laryngoscope blade 3

  • 3.2 endotracheal ( 6-7.5 2)

  • 3.3ambu bag resevior/

  • 3.4 mask /

  • 3.5

  • 3.6 finger-tip y suction

  • 3.7 suction 120 .

  • 3.8 (adrenaline, sodium bicarbonate, calcium, NSS)

  • 3.9 Stethoscope

  • 3.10 Oxygen sat


3.

  • ( )


4.


4.

  • 4.1 /

  • 4.2 cardiac arrest birth asphyxia


Weak point

  • CPR Team


5.


5.

  • 5.1 30

  • 5.2 30 ()


6.



6.

  • 6.1 Oxytocin 10 ( 1 )

  • 6.2 1-3 ()

  • 6.3 controlled cord Traction() Modified crede'maneuver

  • 6.4 15 2 ( CPG )

  • 6.5 (CPG)


Active management of the third stage of labor

WHO Recommendation

WHO 2007

.

. Clamp

. controlled cord traction


Procedure for Active Management

Palpate abdomen to rule out presence of another baby

Within 1 minute of birth, give oxytocin 10 IU IM

Await strong uterine contraction (2-3 minutes)

Apply controlled cord traction while applying counter traction above pubic bone

If placenta does not descend, stop traction and await next contraction

After placental delivery, rub uterine fundus gently every 15 minutes for 2 hours to ascertain it is contracted

Harshad Sanghvi, Maternal & Neonatal Health Program JHPIEGO

Source: MCPC, WHO 2002


  • CPG


Weak point

  • Active management of the third stage of labor

  • PPH


7.


7.

  • 7. / hemacell( 10 Unit/blood group 5 Unit/blood group 30 )


8. 1 : 3


8. 1 : 3

  • 8. + : (......... .......... .........) 1:3


9. 30 1


9. 30 1

  • 9. ( 4 ()


Weak point

  • 4 () skin-to-skin contact


10.


10.

  • 10. / / Flow chart


Weak point


11. /


11. /

  • 11. rate of C/S and indication, , Low birth weight, Birth asphyxia, Hypothermia, PPH, PIH, perinatal mortality, maternal death


Weak point


12


12

  • 12. 11 (CQI) MCH Board (CPG) MCH Board


Weak point

  • Continuous quality improvement (CQI)


Data analysis

Birth asphyxia

Postpartum hemorrhage , Breast feeding !!!


13.


13.

  • 13. 80%


Labor Room


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