Normal Labor and Delivery ???? - PowerPoint PPT Presentation

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Normal Labor and Delivery ????

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Normal Labor and Delivery Labor : the process by which contractions of uterus expel the fetus. Delivery : receive the neonate 1. definition ... – PowerPoint PPT presentation

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Title: Normal Labor and Delivery ????


1
Normal Labor and Delivery????
  • ???

2
  • Labor
  • the process by which contractions of uterus
    expel the fetus.
  • Delivery
  • receive the neonate

3
1. definition
  • Term pregnancy 37-42weeks from LMP
  • pre-term delivery (labor) 28- lt37 weeks of
    gestational age
  • post-term delivery? 42 weeks
  • Abortion lt28 week
  • 85 of women spontaneous labor and delivery
    between 37-42 weeks

4
2. The four factors for labor
  • Force ( uterine contraction)
  • birth canal (bony canal)
  • fetus (lie,position ,presentation,weight)
  • psychical-factors

5
Contractions
  • onset, frequency, duration, intensity
  • increase in frequency and duration
  • uterus can be felt to harden during contraction
  • lasting about 30-45 seconds
  • interval between contractions to be 5 min
  • Intensity (slight, middle, heavy)
  • the pain of labor is a character

6
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7
???? ????
8
  • Birth canal
  • Bony canal
  • Soft tissue canal (lower part of uterus, cervix,
    vagina

9
Bony pelvis
  • The planes of pelvis
  • inlet plane (promontory)
  • mid plane of pelvis (ischia spines)
  • outlet plane(two intersecting triangles)

10
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11
  • fetus (lie, position ,presentation, weight)
  • Long axis of mother
  • LOA
  • Head down
  • Estimation of fetal weight 2500g - lt4000g

12
3. Mechanism of labor
  • The process of labor and delivery is marked by
    change in fetal position in relation to the
    maternal pelvis
  • Engagement
  • (BPD decent to a level below the pelvic inlet
  • An occiput below the ischial spines is engaged)
  • Flexion
  • Decent
  • Internal rotation
  • Extension
  • External rotation

13
4. Symptoms and signs of the onset of the labor
  • Painful uterine contraction
  • a show
  • effacement and dilation of the cervix
  • rupture of membranes

14
  • The show
  • The mucus plug is expelled from the cervix
  • mixing with a little blood
  • the rupture of the membranes
  • at any time during labor
  • effacement and dilation of the cervix
  • to be short,taken up,dilated

15
The differentiation of labor
  • in labor
  • spontaneous uterine contraction
  • with progressive dilation of
    the cervix
  • interval lt 5
  • lasting gt30
  • intensity is middle or heavy
  • False labor

16
5. Three Stages of labor
  • The first stage
  • onset of labor to full cervical dilation(10cm)
  • the latent phase ( onest to lt3cm, lt16h)
  • the active phase(gt3cm to 10cm, lt8h)
  • The second stage
  • 10 cm to the delivery of the infant, lt2h
  • The third stage
  • delivery of the infant to delivery of the
    placenta, lt30m

17
6. Management of normal labor
  • The first stage
  • education, eating, walking,
  • position(sitting, reclining, recumbent)
  • monitoring of the fetal heart rate ,
  • Palpation of cervix ( effacement ,dilation)
  • uterus contractions (palpation or electronic
    monitoring)
  • Analgesia and anesthesia

18
The second stage
  • fetal heart rate
  • maternal conditions
  • pulse, blood pressure, respiratory rate ,
  • temperature, urine output, fluid intake
  • evaluation of progress of labor
  • station, position of the presenting part,
    status of membranes, meconium, blood

19
  • Pushing
  • with the onset of each contraction, the mother is
    encouraged to inhale,hold her breath, and push
  • increase in intra-abdominal pressure
  • aiding in fetal descent through the birth cacal.

20
  • Head visible on vulval gapping
  • Crowning of head
  • Laceration or Episiotomy
  • Delivery of fetus
  • Deal with umbilical cord

21
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22
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23
the third stage
  • waiting for up to 30 min
  • Separation indication of placentathe fundus
    changes to a globular shape and firm consistency
  • A gush of blood appears vaginally
  • The umbilical cord appears to lengthen
  • delivery of placenta (spontaneously, manually
  • inspection of the birth canal
  • Repair of lacerations or episiotomy

24
Key word and questions
  • Labor
  • Delivery
  • Engagement
  • Effacement
  • What are the four factors in labor and delivery?
  • What is the mechanisms of labor ?
  • Explain the separation indications of placenta.
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