A few questions related to labour and delivery practice

[Cica]

Hey

I had a couple of questions relating to labour and delivery practice in other countries:
- Is fundal/uterine pressure used for deliveries where the 2. stage is prolonged (max. 50 mins. with oxytocin drip) but at the same time there is no fetal or maternal distress? In other words is it used at all in this day and age and if so what the are contraindications for its use?

- if the patient is fully dilated and the head is crowned but again there is prolonged 2. stage of labour can one decide to a c-section? what are the contraindications and indications of emergency c section in 2. stage of labour?

Thanks in advance.

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[anonperson]

Hey

I had a couple of questions relating to labour and delivery practice in other countries:
- Is fundal/uterine pressure used for deliveries where the 2. stage is prolonged (max. 50 mins. with oxytocin drip) but at the same time there is no fetal or maternal distress? In other words is it used at all in this day and age and if so what the are contraindications for its use?

- if the patient is fully dilated and the head is crowned but again there is prolonged 2. stage of labour can one decide to a c-section? what are the contraindications and indications of emergency c section in 2. stage of labour?

Thanks in advance.

Do you mean physically pushing on the uterine fundus during the second stage? I haven't seen it to be honest. During a shoulder dystocia, it is considered a move that will lead to greater fetal injury.

There is a bit of a paradigm shift with the second stage. Some place's call it 'laboring down' or whatever, but basically as long as the tracing is cat 1/reassuring, there really isn't a hard and fast limit to the second stage. If the patient is exhausted and needs time to rest in order to push, we wait. If it's the second stage and there's already significant molding and it's only been 30 minutes or an hour and the fetal station is pretty highs sometimes I will counsel the patient on the likelihood of a C/D and we'll just go ahead, even if it hasn't been the traditional amount of time.