intrapartal care /-pär″təl/ [L, intra + partus, birth] , care of a pregnant woman from the onset of labor to the completion of the fourth stage of labor with the expulsion of the placenta. See also antepartal care, emergency childbirth, newborn intrapartal care, postpartal care. ▪ METHOD: The signs and symptoms of true labor are observed. Uterine contractions increase in frequency, duration, and strength. Pressure of the presenting part of the fetus causes dilation and effacement of the cervix and contractions of the amniotic sac, producing a bloody discharge called “bloody show.” A physical examination of the mother is performed. Urine is measured regularly through labor and may be tested for levels of ketones, protein, and glucose to determine specific gravity. A microhematocrit is often done. The position, attitude, and presentation of the fetus are ascertained by abdominal palpation. The cervical effacement and dilation and the station of the presenting part of the fetus are determined periodically by vaginal examination, using careful aseptic technique. If the amniotic sac has broken, the color, character, and quantity of the amniotic fluid are noted. The fetal heart rate is counted, and variations are noted in relation to the timing and intensity of contractions.
