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NORMAL LABOUR: NORMAL ANATOMY

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NORMAL LABOUR: NORMAL ANATOMY. NORMAL LABOUR: NORMAL PHYSIOLOGY. Passenger Passage Power. NORMAL LABOUR. LATENT PHASE: 0-4cm ACTIVE PHASE: 4-10cm. FIRST STAGE SECOND STAGE THIRD STAGE. FULL DILATION TO EXPULSION OF FETUS. BIRTH TO EXPULSION OF PLACENTA

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Presentation Transcript
slide5

NORMAL LABOUR

LATENT PHASE: 0-4cm

ACTIVE PHASE: 4-10cm

FIRST STAGE

SECOND STAGE

THIRD STAGE

FULL DILATION TO EXPULSION OF FETUS

BIRTH TO EXPULSION OF PLACENTA

Expectant (physiological) vs Active (CCT +OT)

slide6

Cervical effacement

vs

cervical dilation

Cervix closed,

3 cm long

Cervix effaced,

1 cm dilated

Cervix

5 cm dilated

Cervix

fully dilated

slide8

FIRST STAGE OF LABOUR:

LATENT vs ACTIVE PHASE

slide9

MODIFIED

WHO

PARTOGRAM

slide10

TERMINOLOGY OF

VAGINAL DELIVERY

1. Engagement of the fetal head in the transverse position.

2. Descent and flexion of the fetal head.

3. Internal rotation. The fetal head rotates 90 degrees to the

occipito-anterior position

4. Delivery by extension. The fetal head passes out of the birth canal head is tilted backwards

5. Restitution. The fetal head turns through 45 degrees to restore its normal relationship with the shoulders, which are still at an angle.

6. External rotation. The shoulders repeat the corkscrew movements of the head, which can be seen in the final movements of the fetal head.

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WHAT IS NORMALITY

Term / Preterm / Post dates

Spontaneous rupture of membranes /

Prolonged rupture of membranes/

Preterm prolonged rupture of membranes

Fetal monitoring during labour:

Intermittent fetal auscultation / continous cardiotocograph

Analgesia during normal labour:

nothing/birth partner/ TENS/ 1-1 midwifery care/ drugs/ epidural

the Ferguson reflex

Bishop score

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WHAT IS NORMAL?

Term: 37 completed weeks to 42 weeks gestation

Preterm: 24-37 completed weeks

Post-dates: after 42 weeks (postmature, prolonged pregnancy, post-term)

SROM = spontaneous rupture of membranes at term

PROM = prelabor or premature rupture of membranes at term

(labour doesn\'t ensue within 24 hours of ROM)

PPROM = preterm, premature rupture of membranes

ARM = artificial rupture of membranes (used for labor induction)

slide13

Fetal monitoring during normal labour:

Intermittent fetal auscultation

Continous cardiotocograph (CTG)

slide14

Analgesia during labour

Nothing

Water

TENS

birth partner

1-1 midwifery care

Drugs

Epidural

slide15

the Ferguson reflex:

as pressure on the cervix increases, the Ferguson

reflex increases uterine contractions so that the second stage can go ahead.

Bishop score

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