Activity ID
8708Expires
October 14, 2024Format Type
EnduringCME Credit
0.5Fee
75CME Provider: Louisiana Medical Mutual Insurance Company (LAMMICO)
Description of CME Course
The second stage of labor creates the greatest physiologic challenge to both mother and fetus. Oxygen delivery is reduced while oxygen consumption increases during this phase of labor. Certain interventions may help or hinder oxygenation. Using closed-glottis (Valsalva technique), coach-assisted active pushing in non-upright positions is no longer acceptable. Using this approach has a negative impact on maternal-fetal oxygenation and increases the chance of a serious reportable event. Use of open-glottis, patient-directed active pushing in upright or lateral positions is underutilized in clinical practice by all perinatal providers. This course is part II of our Second Stage Labor series that outlines important evidence-based studies, professional organization recommendations, and management that focuses on specific interventions that increase oxygen delivery to the mother and fetus. Hospitals should be consider these factors when developing or maintaining a second stage labor management policy or protocol or performing quality improvement to mitigate risk exposure.
ABMS Member Board Approvals by Type
ABMS Lifelong Learning CME Activity
Family Medicine
Commercial Support?
NoNOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.
Educational Objectives
a. a. Use interventions that maximize maternal-fetal oxygen delivery and minimize oxygen consumption when managing the second stage of labor.
b. Design or modify the hospital second stage labor management protocol/policy to guide the use of delayed and active pushing based on the clinical needs of each patient, evidence-based professional recommendations, and scientific studies.
Keywords
Laboring down, second stage of labor, closed glottis pushing
Competencies
Interpersonal & Communication Skills, Medical Knowledge, Patient Care & Procedural Skills, Practice-based Learning & Improvement, Professionalism, Systems-based Practice
CME Credit Type
AMA PRA Category 1 Credit
Practice Setting
Academic Medicine, Inpatient, Outpatient, Rural, Urban, VA/Military
