A nurse midwife is examining a patient who is at 42 weeks of gestation and believes she is in labor.
Which of the following findings would confirm to the nurse that the patient is in labor?
A.
Amniotic fluid present in the vaginal vault.
B.
Cervical dilation observed.
C.
Brownish vaginal discharge noted.
D.
Patient reports pain above the umbilicus.
The correct answer and Explanation is :
The correct answer is B. Cervical dilation observed.
Explanation:
To confirm that a patient is in labor, the primary finding to look for is cervical dilation. Cervical dilation refers to the opening of the cervix, which is a key indicator that labor is progressing. The cervix must dilate to 10 centimeters for the baby to pass through the birth canal during delivery. This dilation is measured during a vaginal examination by a healthcare provider.
Here’s a breakdown of why the other options are not definitive indicators of labor:
- A. Amniotic fluid present in the vaginal vault: While the presence of amniotic fluid might indicate that the membranes have ruptured (also known as “water breaking”), it does not alone confirm labor. Membrane rupture can occur before labor begins (prelabor rupture of membranes), and not all women will go into labor immediately after their water breaks.
- C. Brownish vaginal discharge noted: Brownish discharge can be a sign of “bloody show,” which occurs when the mucus plug that blocks the cervical canal is expelled. While this can be a sign that labor is approaching, it is not a definitive indicator that labor has started.
- D. Patient reports pain above the umbilicus: Pain above the umbilicus is not a typical sign of labor. Labor pain typically begins in the lower abdomen or lower back and can radiate to other areas as contractions become more intense. Pain above the umbilicus might be related to other issues or discomforts not necessarily associated with labor.
In summary, cervical dilation is the most direct and reliable sign of labor because it indicates that the cervix is opening in preparation for childbirth. Observing cervical dilation during an examination provides concrete evidence that the patient is indeed in labor.