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Normal Labor and Delivery

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Normal Labor and Delivery Asja osi Mentor: A. mega Horvat Labor labor series of rhythmic, progressive contractions of the uterus gradually move the fetus ... – PowerPoint PPT presentation

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Title: Normal Labor and Delivery


1
Normal Labor and Delivery
  • Asja Cosic
  • Mentor A. Žmegac Horvat

2
Labor
  • labor
  • series of rhythmic, progressive contractions of
    the uterus
  • gradually move the fetus through the cervix and
    birth canal
  • main stages of labor
  • first stage labor proper contractions cause
    the cervix to dilate and to thin and pull back
    (efface)
  • cervix merges with the rest of the uterus
  • second stage delivery of the fetus
  • third stage delivery of the placenta

3
Labor
  • within 2 weeks before or after the estimated date
    of delivery
  • after 36 weeks a cervical examination is
    performed to estimate when labor will start
  • labor lasts - 12 to 18 hours in a woman's first
    pregnancy
  • - 6 to 8 hours in
    subsequent pregnancies
  • main signs of the start of labor are
  • back pain
  • contractions in the lower abdomen at regular
    intervals
  • at first contractions may be weak, irregular, and
    far apart
  • with time, they become longer, stronger, and
    closer together
  • bloody show a small discharge of blood mixed
    with mucus from the vagina about 72 hours before
    contractions start
  • rupture of membranes the amniotic fluid flows
    out through the vagina

4
FIRST STAGE
  • from the beginning of labor to the full dilation
    of the cervix to about 4 inches (10 cm)
  • initial (latent) phase
  • active phase

5
FIRST STAGE - Initial (Latent) Phase
  • contractions become progressively stronger and
    more rhythmic
  • discomfort is minimal
  • the cervix thins and opens to approx. 4 cm
  • lasts an average of 8½ hours (up to 20 hours) in
    a first pregnancy and 5 hours (up to 12 hours) in
    subsequent pregnancies

6
FIRST STAGE - Active Phase
  • cervix opens to the full 10 centimeters
  • fetal presenting part begins to descend into the
    mother's pelvis
  • mother feels urge to push as the baby descends,
    but she should resist it
  • 5 to 7 hours in a first pregnancy and 2 to 4
    hours in subsequent pregnancies

7
SECOND STAGE
  • from the complete opening of the cervix to
    delivery of the fetus
  • 45 to 60 minutes in first pregnancy
  • 15 to 30 minutes in subsequent pregnancies
  • during this stage, the woman pushes

8
CARDINAL MOVEMENTS IN LABOR
  • Engagement
  • Descent
  • Flexion
  • Internal Rotation
  • Extension
  • External Rotation
  • Expulsion

9
THIRD STAGE
  • from delivery of the fetus to delivery of the
    placenta
  • usually lasts only a few minutes but may last up
    to 30 minutes
  • maternal blood loss is limited by contraction of
    the uterus
  • can be managed either expectantly or actively

10
Fourth stage
  • can refer to the immediate puerperium, or the
    hours immediately after delivery of the placenta

11
Admission to a Hospital or Birthing Center
  • strength, duration, and frequency of contractions
    are noted
  • weight, blood pressure, heart and breathing
    rates, and temperature are measured
  • urine and blood samples are taken for analysis
  • abdomen is examined to estimate the size,
    position and presentation of the fetus
  • vaginal examination is done to determine whether
    the membranes have ruptured and how dilated and
    effaced the cervix is
  • intravenous line to prevent dehydration and for
    therapy, if needed
  • oxytocin or prostaglandin are used to induce
    labor
  • fetal monitoring electronic monitoring is used
    to continuously monitor fetal heartbeats and
    uterine contractions (CTG)

12
References
http//www.merck.com/ http//en.wikipedia.org/wiki
/Childbirth
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