LECTURE № 7.ppt

LECTURE № 7 STRUCTURE OF MATERNAL PASSAGES AND PHYSIOLOGY OF THE BIRTH ACTIVITY. Dr. Nagayeva S. FEMALE GENITALS For clear picture there is short description of anatomy and physiology of reproductive apparatus. Large and small lips of pudendum Vagina Uterus - consists from 3 parts - cervix of the uterus, an isthmus, body of womb. Tubes Ovaries Ligamentous apparatus of the womb and of the ovaries CRANIAL PRESENTATION At that , movements of a fetus are better felt in the field of a bottom or edges of an uterus. At the first pregnancy the head of a fetus starts to fall to a cavity of a small basin at 38 week. At secundiparas this process occurs at the beginning of the birth activity. WHAT MAY TO HINDER FROM HEAD SINKING: a short umbilical cord or repeated cord entanglement wrong position of a head (overextension) incorrect attitude of the fetus increased tone of the lower segment of the uterus Tumors of the presentation part or of the maternal passages, congenital anomalies of development the fetus the large dimension of a fetus placenta previa narrowed or deformed female basin STAGE OF DILATION Labor begins at the certain hormonal background of female organism. Exuded oxytocin causes regular uterine contractions. Normal the center of stimulation appears in the uterine bottom, from which a chain of electric impulses spreading along the whole length of the uterus. That produce contraction at all three layers of an uterine muscles. During contraction the muscle are shortening , displacing about each other, thereof the uterine capacity decreases and the intrauterine pressure increases. These pressure passing by means the aquatic environment and the fetal bladder filling and wedging in the cervical canal of uterus. That promotes tender and painless uterine cervix effacement. STAGE OF EXPULSION When uterine cervix become smooth completely and opens on 10 sm., the fetus will start the forward - turning movement. While the cervix of the ute