ARM in Active Phase of Labour

Abd Halim: Dr Saiful, in malaysia ARM is indicated for patients who are in Active Phase of Labour ke?

 Dr Shaiful Ehsan: Assalamualaikum halim
ARM is indicated for augmentation in patient come with favourable bishop score or those already established in active phase of labor..
It is STATED in most labor room protocol....
Kenapa ya?

Atiqah ZB: So dr, it is not considered as induction of labour right?

 Dr Shaiful Ehsan: It is considered as augmentation....which means bishops score more than 7.....
Induction is indicated for unvavourable bishops score....

However...some books do mentioned amniotomy, pitocin & ect as part of induction modalities...tq

Mb Abd Halim: Something just crossed my mind, is it done with the intent of making labour quicker in view of not enough labour rooms to accomodate patients

Or

For reasons of morbidity.

Dr Shaiful Ehsan: The reasons you augment the labor is to reduce the morbidity.....
Lets say u just let the labor progress without doing ARM....patient might end up with prolonged active phase of labor  in which it is PAINFUL experience....
Late ARM....late in detection of meconium stained liquor....in which child may end up with HIE and lifelong palsy....

No IT IS TOTALLY not becoz not enough labor rooms bed...

Mb Abd Halim: Owh. Makes more sense.

Mb Abd Halim: Kalau doula tanye:

"Izinkanlah labour berlaku sepertimana semula jadi"

Kita ade hujjah based on clinical evidence.

Dr Shaiful Ehsan: Yupp....doula is not clinical practitioners....they are just normal public personnel....
However they demand high amount of fee for their so call "labor advice"...
But if anything bad happen to patients, they not gonna be sued, becoz they are not medical personnel and no licensed....they are just giving opinions (BUT GETTING FEE FOR THAT)...

Therefore dear my future doctors....please EDUCATE your patients well....who are this doula is....
And EDUCATE your patient how important they follow the DOCTOR advice...not doula...tq

 Adlina: 👍🏼👍🏼👍🏼