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Labour Record: Time Active Labour Stared Time Membranes Ruptured Time Record Stage Starts

This document is a sample labour record form used to monitor a patient during labour, delivery, and postpartum. It collects information such as the patient's name, age, parity, address, admission date and time, time active labour started, time membranes ruptured, fetal heart rate, maternal vital signs, cervical dilation, any problems and their treatments, birth details for both mother and newborn, and planned post-delivery care. The form is adapted as needed for each patient and collects essential medical information over the course of labour and delivery.

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mayflor navarro
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35 views

Labour Record: Time Active Labour Stared Time Membranes Ruptured Time Record Stage Starts

This document is a sample labour record form used to monitor a patient during labour, delivery, and postpartum. It collects information such as the patient's name, age, parity, address, admission date and time, time active labour started, time membranes ruptured, fetal heart rate, maternal vital signs, cervical dilation, any problems and their treatments, birth details for both mother and newborn, and planned post-delivery care. The form is adapted as needed for each patient and collects essential medical information over the course of labour and delivery.

Uploaded by

mayflor navarro
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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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 OXY – TIME GIVEN RESCITATION NO YES
TIME ACTIVE LABOUR STARED PLACENTA COMPLETE NO YES BIRTH WEIGHT
TIME MEMBRANES RUPTURED TIME DELIVERED GEST. AGE OR PRETERM NO YES
TIME RECORD STAGE STARTS ESTIMATED BLOOD LOSS SECOND BABY

ENTRY EXAMINATION
STAGE OF LABOUR NOT IN ACTIVE LABOUR YES
NOT IN ACTIVE LABOUR PLANNED MATERNAL TREATMENT

HOUR SINCE ARRIVAL 1 2 3 4 5 6 7 8 9 10 11 12


HOUR SINCE RUPTURED MEMBRANES
VAGINAL BLEEDING (0+ ++)
STRONG CONTRACTIONS IN 10 MINUTES
FETAL HEART RATE (BEATS PER MINUTES
T (AUXILLARY)
PULSE (BEATS/MINUTES)
BLOOD PREASURE (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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