Clinical practice guidelines for the management of labour and delivery

Abstract

Patients admitted to the Central Delivery Suite in the Maltese setting often do so by self-referral believing themselves to have gone into labour. Other alternative modes of admissions include emergency admissions for complications of pregnancy or elective admissions for Caesarean sections or induction of labour. The patient in the Central Delivery Suite is managed by a team of on-duty midwives and the on-duty medical obstetric team. The midwife by virtue of her professional status can assume on her own responsibility the management of women with uneventful pregnancies during labour and delivery. However, she also has the responsibility to timely detect complications in the mother and child that may arise at any time during labour and delivery; and to timely refer the case for appropriate assistance. In order that complications are identified in a timely fashion, the available management tools must be utilized effectively and in a manner that conforms to specific criteria. These management tools are all based on regular clinical assessment of the parturient woman supplemented by evidence-based norms of expected progress of labour.