La. Admin. Code tit. 46 § XLV-5353

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

Section XLV-5353 - Required Physician Consultation, Postpartum Period [Formerly Section 5363.C-D]

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

1. has a third or fourth degree laceration;

2. has uterine atony;

3. bleeds in an amount greater than normal lochial flow;

4. does not void within 2 hours of birth;

5. develops a fever greater than 100.4nF or 38nC on any two of the first 10 days postpartum excluding the first 24 hours;

6. develops foul smelling lochia;

7. develops blood pressure below 100/50 if pulse exceeds 100, pallor, cold clammy skin, and/or weak pulse.

B. The midwife shall obtain medical consultation or refer for medical care any infant who:

1. has an Apgar score of 7 or less at 5 minutes;

2. has any obvious anomaly;

3. develops grunting respirations, retractions, or cyanosis;

4. has cardiac irregularities;

5. has a pale, cyanotic, or grey color;

6. develops jaundice within 48 hours of birth;

7. has an abnormal cry;

8. weighs less than 5 pounds or weighs more than 10 pounds;

9. shows signs of prematurity, dysmaturity, or postmaturity;

10. has meconium staining of the placenta, cord, and/or infant with signs or symptoms of aspiration pneumonia;

11. does not urinate or pass meconium in the first 24 hours after birth;

12. is lethargic or does not feed well;

13. has edema;

14. appears weak or flaccid, has abnormal feces, or appears not to be normal in any other respect;

15. has persistent temperature below 97°F;

16. has jitteriness not resolved after feeding; or

17. has a blood glucose level of less than 30mg/dL.

La. Admin. Code tit. 46, § XLV-5353

Promulgated by the Department of Health and Human Resources, Board of Medical Examiners, LR 12:520 (August 1986), amended by the Department of Health and Hospitals, Board of Medical Examiners, LR 17:779 (August 1991), Amended by the Department of Health, Board of Medical Examiners, LR 421295 (8/1/2016).

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