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Labor, Emergency Medicine

Jonathan B. Walker and James S. Walker Reviewed 06/2017
 


Basics

Labor denotes the sequence of physiologic occurrences that result in a fetus being transported from the uterus through the birth canal. 

Description

  • Labor brings about changes in the cervix to al...

Diagnosis

Signs and Symptoms

  • Symptoms of labor:

    • Intermittent low abdominal pain with or without low back pain

    • Occurring regularly at least every 5 min

    • Lasting 30–60 sec

  • Preterm labor is of sufficient frequ...

Treatment

Pre-Hospital

  • Emergency medical services personnel should place patients in labor on oxygen and in left lateral recumbent position to maximize delivery of oxygen to uterus

  • Maternal transport of...

Follow-Up

Disposition

Admission Criteria

  • All patients in labor who are not at risk for imminent delivery should be admitted to L&D

  • Preterm patients in labor demand immediate obstetric consultation an...

Pearls and Pitfalls

  • If vaginal bleeding is present, must rule out placental abruption or previa

  • Do not perform a digital exam if bleeding is present

  • Pelvic exam must be sterile in a patient in labor

  • Fals...

Additional Reading

  • Berghella  V, Baxter  JK, Chauhan  SP. Evidence-based labor and delivery management. Am J Obstet Gynecol.  2008;199:445–454.

  • DeCherney  A, Nathan  L, Goodwin  TM, et al., eds. C...

Codes

ICD9

  • V22.0 Supervision of normal first pregnancy

  • V22.1 Supervision of other normal pregnancy

  • V23.9 Supervision of unspecified high-risk pregnancy

  • 644.20 Early onset of delivery, unspecified as to ep...

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