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Normal Labor and Delivery(AFE) ????

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Normal Labor and Delivery(AFE) Lin Jianhua M.D., Ph.D., Professor Department Of Obstetrics & Gynecology Renji Hospital Affiliated to SJTU School of Medicine – PowerPoint PPT presentation

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Title: Normal Labor and Delivery(AFE) ????


1
Normal Labor and Delivery(AFE)????
  • Lin Jianhua M.D., Ph.D., Professor

  • Department Of Obstetrics Gynecology
  • Renji
    Hospital Affiliated to SJTU School of Medicine

2
definition
  • Term delivery(labor) 37-42weeks
  • pre-term delivery 28- lt37 weeks
  • post-term delivery? 42 weeks
  • Abortion lt28 weeks
  • 85 of women spontaneous labor and delivery
    between 37-42 weeks
  • LMP last menstrual period
  • EDC expected date of confinememt

3
The four factors for labor
  • Force (contraction)
  • birth canal (bony canal)
  • fetus (lie,position ,presentation,weight)
  • psychical-factors

4
The contractions
  • 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
  • the pain of labor is a character

5
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6
NST CST
7
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8
Bony pelvis
  • The planes of pelvis
  • inlet plane (promontory)
  • mid plane of pelvis(ischial spines)
  • outlet plane(two intersecting triangles)

9
Mechanism of labor
  • Engagement
  • Flexion
  • Decent
  • Internal rotation
  • Extension
  • External rotation

10
Symptoms and signs of the onset of the labor
  • Painful uterine contraction
  • a show
  • effacement and dilation of the cervix
  • rupture of membranes

11
  • 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

12
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
  • The fourth stage
  • 2 hours after delivery of the placenta

13
Management of normal labor
  • The first stage
  • education, eating, voiding,
  • position(sitting, reclining, recumbent)
  • monitoring of the fetal heart rate ,
  • dilation of cervix and frequency
  • severity of uterus contractions(auscultation or
    electronic monitoring)

14
The second stage
  • --- lt 2 hour
  • fetal heart rate
  • maternal conditions
  • pulse, blood pressure, respiratory rate ,
  • temperature, urine output, fluid intake
  • evaluation of progress of labor
  • cervical dilation, station,position of the
  • presenting part, status of membranes,
  • meconium, blood

15
  • 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.

16
  • Head visible on vulval gapping
  • Crowning of head
  • Laceration or Episiotomy
  • Delivery of fetus
  • Deal with umbilical cord

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19
the third stage
  • waiting for up to 30 min
  • the uterus decreases in size
  • delivery of placenta(spontaneously, manually
  • inspection of the birth canal
  • evaluated for lacerations

20
The fourth stage
  • postpartum uterine hemorrhage ,1
  • uterus palpation through the abdominal wall is
    repeats
  • the amount of blood on pads are monitored
  • pulse and BP are monitored
  • use of drug oxytocin

21
THANKS FOR YOUR ATTENTION
Lin Jianhua M.D., Ph.D., Professor Dep. of
Obstet. Gynecol. Renji Hospital Affiliated to
SJTU School of Medicine
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