![]() Other hand on abdomen supporting the uterine fundus. Sudden gush of blood.ġ9 Labor – Third Stage Placenta is delivered using one hand on umbilical cord with gentle downward traction. The umbilical cord descends three (3) inches or more further out of the vagina. The uterus becomes globular in shape and firmer. The time from fetal delivery to delivery of the placenta Signs of placental separation: a. PrimiG – h mulitG 0-30minĬut between the clamps Clamp the umbilical cordġ8 Labor – Third Stage Placental separation and delivery. Examining the fetal head during the second stage may become difficult due to molding Caput is the localized edematous area on the fetal scalp caused by pressure on the scalp by the cervix. Indications of second stage: Increased maternal show Pelvic/rectal pressure Mother has active role of pushing to aid in fetal descent.ġ6 Labor – Second Stage Molding is the alteration of the fetal cranial bones to each other as a result of compressive forces of the maternal bony pelvis. Characterized by descent of the presenting part through the maternal pelvis and expulsion of the fetus. The active phase comprises the interval from the onset of the acceleration phase to the beginning of the second stage.ġ5 Labor – Second Stage Interval between full cervical dilation to delivery of the infant. The distinctive phases of the first stage are shown. The normal patterns of cervical dilation (solid line) and descent (broken line) as they are traced against elapsed time in labor. Labor NulliG MultiG 1st Stage Active phase Duration 6-18 h 2-10 h Dilation ~1 cm/h ~1.5 cm/h Arrested >2 h >2h 2nd Stage 0.5-3 h 5-30 min 3rd Stage 0-30 minįig 1: An idealized labor pattern. Interval between the onset of labor and full cervical dilation Two phases: Latent phase – onset o f labor with slow cervical dilation to ~4 cm and variable duration Active phase – faster rate of cervical change, cm /hour, regular uterine contractionsġ2 The Labor Curve First stage - A: latent phase B + C + D: active phase B: acceleration C: maximum slope of dilation D: deceleration E: second stage.ġ3 Labor Freidman’s curve is a good guideline for expected progression in labor and therefore helpful to note abnormal labor patterns. 5 is a floating baby, 0 station is said to be engaged in the pelvis, and +5 is crowning.ĩ Passage Passage = Pelvis Consists of the bony pelvis and soft tissues of the birth canal (cervix, pelvic floor musculature) Small pelvic outlet can result in cephalopelvic disproportion Bony pelvis can be measured by pelvimetry but it not accurate and thus has been replaced by a clinical trial of labor Station – degree of descent of the presenting part of the fetus, measured in centimeters from the ischial spines in negative and positive numbers. Attitude – degree of flexion or extension of the fetal head Position Number of fetuses Presence of fetal anomalies – hydrocephalus, sacrococcygeal teratoma Generally 3-5 contractions in a 10 minute period is considered adequate laborĦ Passenger Passenger =fetus Fetal variables that can affect labor:įetal size Fetal Lie – longitudinal, transverse or oblique Fetal presentation – vertex, breech, shoulder, compound (vertex and hand), and funic (umbilical cord). Contraction force can also be measured by direct measurement of intrauterine pressure using internal manometry or pressure transducers.ĥ Power There is no specific criteria for adequate uterine activity Labor - Mechanics Uterine contractions have two major goals: To dilate cervix To push the fetus through the birth canal Success will depend on the three P’s: Powers Passenger PassageĤ Power Uterine contractions Power refers to the force generated by the contraction of the uterine myometrium Activity can be assessed by the simple observation by the mother, palpation of the fundus, or external tocodynamometry. Your cervix starts out being two inches long, and 50% effaced would be a 1 inch cervix.ģ To push the fetus through the birth canal Changes in the uterine cervix tend to precede uterine contractions Dilatation: the enlarging of the cervix to 10 centimeters. It involves the sequential integrated changes in the uterine decidua, and myometrium. Analgesia in labor.Ģ Labor Labor is the physiologic process by which a fetus is expelled form the uterus to the outside world. Analgesia in labor."- Presentation transcript:ġ Physiology of delivery. ![]() Presentation on theme: "Physiology of delivery. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |