Louisiana Administrative Code
Title 46 - PROFESSIONAL AND OCCUPATIONAL STANDARDS
Part XLV - Medical Professions
Subpart 3 - Practice
Chapter 53 - Licensed Midwives
Subchapter A - Standards of Practice
Section XLV-5339 - Required Physician Consultation, Antepartum and Intrapartum Periods [Formerly Section 5363.A - B]

Universal Citation: LA Admin Code XLV-5339

Current through Register Vol. 50, No. 9, September 20, 2024

A. The midwife shall obtain medical consultation or refer for medical care any woman who during the antepartum period:

1. develops edema of the face and hands;

2. develops severe, persistent headaches, epigastric pain, or visual disturbances;

3. develops a blood pressure of 140/90 or greater;

4. does not gain 14 pounds by 30 weeks gestation or at least 4 pounds a month in the last trimester or gains more than 6 pounds in two weeks in any trimester;

5. develops greater than trace glucosuria or greater than trace proteinuria on two consecutive separate visits;

6. has abnormal vaginal discharge with no signs of improvement with medication;

7. has symptoms of urinary tract infection;

8. has vaginal bleeding before onset of labor;

9. has rupture of membranes prior to 37 weeks gestation;

10. has marked decrease in or cessation of fetal movement;

11. has inappropriate gestational size;

12. has demonstrated anemia by blood test (hematocrit less than 30 percent);

13. has a fever of equal or greater than 100.4°F or 38°C for 24 hours;

14. has polyhydramnios or oligohydramnios;

15. has excessive vomiting or continued vomiting after 24 weeks gestation;

16. has severe, protruding varicose veins of extremities or vulva;

17. has known structural abnormalities of the reproductive tract;

18. has a history of stillbirth from any cause;

19. has an abnormal Pap smear;

20. reaches a gestation of 41 weeks, 3 days by dates and examination.

B. The midwife shall obtain medical consultation or refer for medical care any woman who during the intrapartum period:

1. develops a blood pressure of 140/90 or greater;

2. develops severe headache, epigastric pain, or visual disturbance;

3. develops proteinuria;

4. develops a fever over 100.4°F or 38°C;

5. develops respiratory distress;

6. has persistent or recurrent fetal heart tones below 100 or above 160 beats per minute between or during contractions, or a fetal heart rate that is irregular;

7. has ruptured membranes without onset of labor after 12 hours;

8. has bleeding prior to delivery (other than bloody show);

9. has meconium or blood stained amniotic fluid with abnormal fetal heart tones;

10. has an abnormal presentation other than vertex;

11. does not progress in effacement, dilation, or station in accordance with practice standards;

12. does not show continued progress to deliver in second stage labor in accordance with practice standards;

13. does not deliver the placenta within one hour if there is no bleeding and the fundus is firm;

14. has a partially separated placenta during the third stage of labor with bleeding;

15. has a blood pressure below 100 systolic if the pulse rate exceeds 100 beats per minute or who is weak and dizzy;

16. bleeds more than 500 cc with or after the delivery of the placenta;

17. has retained placental fragment or membranes; or

18. desires medical consultation or transfer.

AUTHORITY NOTE: Promulgated in accordance with R.S.37:1270 and 37:3241-3259.

Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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