According to NICE ( Intrapartum care for healthy
women and babies )

• Check blood pressure every 5 minutes for 15 minutes during
  establishment or after further boluses
• Check sensory block hourly
•  Continuous electronic fetal monitoring for 30 minutes during
  establishment or after boluses of 10 ml or more
• Intravenous access should be established prior to commencing regional analgesia.
• Do not administer routine preloading and maintenance fluid

In one study, he most common abnormalities were

• T wave inversion (21%)
• S1Q3T3 pattern (15%) - If you know what S1Q3T3 Pattern is - please let us know HERE
• right bundle branch block (18% during pregnancy and 4.2% in the puerperium.

Active management of Third stage of Labor includes -

1. Administer 10 IU of oxytocin by intramuscular injection with the birth of the anterior shoulder or immediately after the birth of the baby and before the cord is clamped and cut.

2. After administering oxytocin, clamp and cut the cord- Do not clamp the cord earlier than 1 minute from the birth of the baby unless there is concern about integrity of the cord, or well being of the baby ( e.g heart rate below 60 bpm AND not getting faster) .
Clamp the cord before 5 minutes.

3. After cutting the cord, use controlled cord traction- only after administration of oxytocin and signs of separation of the placenta.

• Measure post-void residual volume by bladder scan or catheterisation in women with symptoms suggestive of voiding dysfunction or recurrent UTI.
• Use a bladder scan in preference to catheterisation on the grounds ofacceptability and lower incidence of adverse events.
• Undertake a urine dipstick test in all women presenting with urinary incontinence.
• Undertake routine digital assessment to confirm pelvic floor muscle contraction before the use of supervised pelvic floor muscle training for the treatment of urinary incontinence.

Do not use the Q-tip, Bonney, Marshall and Fluid-Bridge tests in the assessment of women with urinary incontinence.

If non-surgical management for stress urinary incontinence has failed, and the woman wishes to think about a surgical procedure, offer her the choice of:
- colposuspension (open or laparoscopic) or
- an autologous rectus fascial sling.