ToCervical Assesment Emergency Birth Pt.2

Instructions for Using the Cervix Assessment of Labor Guide

1. You need sterile gloves, the CxAL-Guide, and lubricant.
2. Tell the laboring woman what you will do.
3. Open the gloves and lubricant. Place the CxAL Guide next to the open glove package.
4. Put on the sterile gloves. Lubricate the first two fingers of the dominant hand. With the non-dominant hand, place two fingers on the labia minora and spread them.
5. Inspect the perineal area for lesions (herpetic).
6. Place the first two fingers of your dominant hand in the vagina and locate the cervix. Note if the cervix is anterior (pointing up), mid position, or posterior (pointing towards the mother’s back).
7. Palpate the presenting part, making certain it is the fetal head (hard). Note if the bag of water is ruptured or if you feel the membranes.
8. Place your fingers inside the os and spread your two fingers until you feel how far apart the inner walls of the cervix are. Remember how far apart your fingers are.
9. Note how thick or thin the cervical tissue is between the external and internal os. Remember where the cervical wall hits your finger and its thickness.
10. Palpate the fetal scalp. Feel for the sagital suture. Follow the sagital suture until you feel a fontanel. See if the sutures divide in a “Y” making a triangular fontanel (posterior fontanel) or if they end in a diamond suture (anterior fontanel). Remember where the sagital suture and the fontanels were in the maternal pelvis.
11. Withdraw your fingers from the cervix, palpate the lateral vaginal walls, and feel the ischial spine. Place one finger on the spine and the other finger even with the presenting part or bone of the fetal scalp. (Swelling of the fetal scalp is not the point at which station is measured.) Note how far apart your fingers are when they feel the presenting part, and if the presenting part is above or below the ischial spine.
12. Withdraw your fingers from the vagina. Place your fingers on the dilation area of the CxAL-Guide and determine the dilation of the cervix. Place your forefinger in the effacement portion of the CxAL-Guide and estimate how effaced or thin the cervix is. . Place your finger on the ischial spine portion of the CxAL-Guide at 0 station and determine how far above or below the ischial spine your finger was when it felt the fetal skull.
13. Notice the fetal position area of the guide, and select the fetal position corresponding with your assessment. Record your findings.