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Records m3

This document is a sample labour record form used to monitor mothers during labour, delivery, and postpartum. The form collects key information such as the mother's name, age, parity, admission date and time, fetal presentation and lie, cervical dilation, fetal heart rate, maternal vitals, and any problems or treatments during labour. It also records information about the delivery such as birth time, use of oxytocin, estimated blood loss, newborn information like weight, resuscitation, and planned newborn treatment. The form allows clinicians to track the progress of labour and delivery and document any complications.

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Kobe pacquiao
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188 views1 page

Records m3

This document is a sample labour record form used to monitor mothers during labour, delivery, and postpartum. The form collects key information such as the mother's name, age, parity, admission date and time, fetal presentation and lie, cervical dilation, fetal heart rate, maternal vitals, and any problems or treatments during labour. It also records information about the delivery such as birth time, use of oxytocin, estimated blood loss, newborn information like weight, resuscitation, and planned newborn treatment. The form allows clinicians to track the progress of labour and delivery and document any complications.

Uploaded by

Kobe pacquiao
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Labour record N4

RECORDS AND FORMS

LABOUR RECORD
USE THIS RECORD FOR MONITORING DURING LABOUR, DELIVERY AND POSTPARTUM RECORD NUMBER
NAME AGE PARITY
ADDRESS
DURING LABOUR AT OR AFTER BIRTH – MOTHER AT OR AFTER BIRTH – NEWBORN PLANNED NEWBORN TREATMENT
ADMISSION DATE BIRTH TIME LIVEBIRTH  STILLBIRTH: FRESH  MACERATED 
ADMISSION TIME OXYTOCIN – TIME GIVEN RESUSCITATION NO  YES 
TIME ACTIVE LABOUR STARTED PLACENTA COMPLETE NO  YES  BIRTH WEIGHT
TIME MEMBRANES RUPTURED TIME DELIVERED GEST. AGE WEEKS OR PRETERM
TIME SECOND STAGE STARTS ESTIMATED BLOOD LOSS SECOND BABY
ENTRY EXAMINATION MORE THAN ONE FETUS  - SPECIFY FETAL LIE: LONGITUDINAL  TRANSVERSE  FETAL PRESENTATION: HEAD  BREECH  OTHER @ - SPECIFY
STAGE OF LABOUR NOT IN ACTIVE LABOUR  ACTIVE LABOUR 
NOT IN ACTIVE LABOUR PLANNED MATERNAL TREATMENT
HOURS SINCE ARRIVAL 1 2 3 4 5 6 7 8 9 10 11 12
HOURS SINCE RUPTURED MEMBRANES
VAGINAL BLEEDING (0 + ++)
STRONG CONTRACTIONS IN 10 MINUTES
FETAL HEART RATE (BEATS PER MINUTE)
TEMPERATURE (AXILLARY)
PULSE (BEATS/MINUTE)
BLOOD PRESSURE (SYSTOLIC/DIASTOLIC)
URINE VOIDED
CERVICAL DILATATION (CM)
PROBLEM TIME ONSET TREATMENTS OTHER THAN NORMAL SUPPORTIVE CARE

IF MOTHER REFERRED DURING LABOUR OR DELIVERY, RECORD TIME AND EXPLAIN

Sample form to be adapted. Revised on 13 June 2003.

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