A. Intrapartum fetal assessment

a. Intermittent auscultation
b. Electronic monitoring

(1) External
(2) Internal

c. Fetal scalp stimulation
d. Vibroacoustic stimulation
e. Fetal scalp blood sampling
f. Fetal pulse oximetry

2. Interpret the results of Doppler velocimetry.
3. Describe the possible causes for, and clinical significance of, abnormal fetal heart rate patterns:

a. Bradycardia
b. Tachycardia
c. Increased variability
d. Decreased/absent variability
e. Early decelerations
f. Variable decelerations
g. Late decelerations
h. Sinusoidal waveform

4. Implement appropriate interventions, such as operative vaginal delivery and cesarean delivery (see the list of procedures at the end of this unit), for fetal heart rate abnormalities.

B. Labor and delivery

a. Status of membranes
b. Presence of vaginal bleeding
c. Fetal presentation
d. Fetal position
e. Fetal weight
f. Cervical effacement
g. Cervical dilatation
h. Station of the presenting part
i. Clinical pelvimetry
j. Uterine contractility

4. Recognize appropriate indications for, and complications of, cervical ripening agents:

a. Osmotic dilators
b. Prostaglandin preparations

5. Recognize appropriate indications for, and complications of, labor-inducing agents:

a. Oxytocin
b. Prostaglandin preparations

6. Describe the normal course of labor.
7. Assess the progress of labor.
8. Describe the risk factors for abnormal labor.
9. Recognize abnormalities of labor:

a. Failed induction
b. Prolonged latent phase
c. Protracted active phase
d. Arrest of dilatation
e. Protracted descent
f. Arrest of descent

10. Recognize the appropriate role and complications of the following interventions for abnormal labor:

a. Analgesia/anesthesia
b. Amniotomy
c. Augmentation of labor
d. Uterine contraction monitoring
e. Episiotomy

(1) Midline
(2) Mediolateral
(3) Episioproctotomy

f. Operative vaginal delivery

(1) Mid, low, and outlet forceps extraction
(2) Mid, low, and outlet vacuum extraction

g. Cesarean delivery

11. Recognize and appropriately evaluate abnormal presentations and positions, such as:

a. Breech
b. Transverse lie
c. Face
d. Brow
e. Compound
f. Occiput posterior
g. Occiput transverse

12. Select and perform the most appropriate procedure for delivery (see the list of procedures at the end of this unit).
13. Counsel patients regarding the prognosis for abdominal versus vaginal delivery in a subsequent pregnancy.