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m High or low fetal heart rate

as a rule, an FHR of more than 160

bpm(fetal tachycardia) or less than 110
bpm(fetal bradycardia) is a sign of fetal
distress. An equally important sign is a
late or variable decelaration pattern on
the fetal monitor.
m ¢econium staining, a green color in the
amniotic fluid, is not always a sign of fetal
distress but is highly correlated with its
occurrence and it reveals that the fetus has
had an episode of loss of sphincter control,
allowing meconium to pass into the
amniotic fluid. It may indicate that the fetus
has or is experiencing hypoxia, which
stimulates the vagal reflex and leads to
increased bowel motility.
m þrdinarily, a fetus is quiet and barely
moves during labor. Fetal hyperactivity
may be a sign that hypoxia is occurring,
because frantic motion is a common
reaction to the need for oxygen.
m If blood analyses are made on a fetus
during labor by use of a scalp capillary
technique, the finding of acidosis(blood
pH lower than 7.2) is a certain sign that
fetal well-being is becoming
compromised.
m Rising or falling Blood pressure

Normally, a woman·s blood pressure rises

slightly in the 2nd stage of labor because
of her pushing effort. A systolic pressure
greater than 140 mmHg, or an increase
in the systolic pressure of more than 30
mmHg or in diastolic pressure of more
than 15 mmHg(the basic criteria for
pregnancy-induced hypertension),
should be reported.
m ¢ost pregnant women have a pulse rate
of 70-80bmp. This rate normally increases
slightly during the second stage of labor
because of the exertion involved. A
maternal pulse rate greater than
100bmp during the normal course of
labor is unusual and should be reported.
It may be another indication of
hemorrage.
m vterine contractions normally become
more frequent, intense, and longer as
labor progresses. If the become less
frequent, less intense, or shorter in
duration, this may indicate uterine
exhaustion(Inertia). If this problem
cannot be corrected, a cesarean birth
may be necessary.
m An indentation across a woman·s
abdomen, where the upper and lower
segments of the uterus join, may be a
sign of extreme uterine stress and
possible impending uterine rupture.
m If a woman has a full bladder during
labor, around bulge on her lower
anterior abdomen may appear. This is
dangerous signal for 2 reasons: first, the
bladder may be injured by the pressure
of a fetal head; 2nd, the pressure of the
full bladder may not allow the fetal head
to descend.
m —arnings of psychological danger during
labor are as important to consider in
assessing maternal well-being as are
physical signs. Increasing apprehension
also needs to be investigated for
physical reasons, because it can be a
sign of oxygen deprivation or internal
hemorrhage.