intrapartum

Intrapartum refers to the period of labor and birth from the onset of regular uterine contractions or rupture of membranes to the delivery of the placenta. It is one phase of the broader childbirth process, with antepartum care before labor and postpartum care after delivery. The intrapartum phase aims to support safe delivery while minimizing risks to both mother and baby.

Intrapartum care typically involves monitoring the fetus and the mother, assessing labor progress, and providing interventions as needed. Fetal heart rate and uterine activity are tracked, and labor progression is evaluated through cervical dilation, effacement, and fetal descent, often using a partograph. Interventions may include induction of labor, augmentation with oxytocin, artificial rupture of membranes, and analgesia or anesthesia such as epidural or systemic medications, chosen based on clinical circumstances and patient preference.

Labor is commonly described in stages: stage I runs from the onset of true labor to full cervical dilation; stage II extends from full dilation to birth of the infant; stage III lasts from birth of the infant to delivery of the placenta. Timeframes vary among individuals, and intrapartum care also includes immediate postpartum stabilization and management of any adverse events that arise during labor.

Common intrapartum complications include fetal distress, labor dystocia (prolonged or arrested labor), malpresentation or malposition, cord prolapse, shoulder dystocia, and uterine rupture. Management may involve adjusting contractions with medications, cesarean section for nonreassuring fetal status or obstructed labor, and instrumental vaginal delivery when indicated. Prevention of hemorrhage and infection is also a focus of care.

Outcomes of intrapartum care depend on maternal health, obstetric history, and timely escalation of care. Guidelines from professional bodies emphasize evidence-based, patient-centered decision making to optimize safety for both mother and newborn.