5-1 NORMAL LABOR.ppt

NORMAL LABORwang jingyin Ⅰ . Definition Delivery is the process by which the mature or nearly mature (fetus and placenta) are expelled from the maternal body. The term delivery refers to the labor occurring between the beginning of the 37w to 42w. The premature delivery refers to the labor occurring between the 28w to the 37w. The postdelivery refers to the labor occurring over 42w. Ⅱ . Agents of labor 1. Mechanical theory 机械性理论 2. Endocrine regulating theory 内分泌控制理论 3. Neurohumor theory 神经介质理论 Ⅲ .Factors affecting labor. There are four factors affecting labor: expulsive force, the fetus (line position and presentation of fetus), passage (the bony pelvis and soft tissue), and psychological factors. If the four factors accommodate each other, the fetus may be easily delivery, otherwise difficult delivery may occur. 1. The powers 产力 1) uterine contraction rhythm 节律性 symmetry 对称性 polarity 极性 retraction 缩复作用 2) abdominal muscles and diaphragm 腹肌、膈肌 3) levator 肛提肌 2. Birth canal 产道 1) bony pelvis 骨产道 pelvic inlet plane 骨盆入口平面 mid plane of pelvis 中骨盆平面 pelvic outlet plane 骨盆出口平面 2) the soft part of the birth canal 软产道 formation of lower segment changes in the cervix changes in the floor of pelvis, vagina and perineum 3. The fetus 胎儿 1) size of the fetus 2) position of the fetus 胎位 3) abnormality of the fetus 胎儿畸形 4. Psychological factors 精神心理因素 Ⅳ. The mechanism of normal labor in vertex presentation 1. Engagement 衔接 2. Descent 下降 3. Flexion 俯屈 4. Internal rotation 内旋转 5. Extension 仰伸 6. Restitution and external rotation 复位、外旋转 7. Expulsion of fetus 胎儿娩出 Ⅴ. Threatened labor and in labor 1. Threatened labor 先兆临产 1) false labor 假临产 2) lightening 胎儿下降感 3) show 见红 2. In labor 临产 Ⅵ. Total stage of labor 总产程 1. The first stage or dilatation of the cervica