ppt课件-the mechanismof labour（发病的劳动力）.pptVIP

Claire Allan Mechanism of labour Descent The fetus begins to descend into the pelvis due to the force of gravity and downward pressure of the contractions Relation to practice Primip-may occur before the onset of labour Multip-not until onset of labour due to laxity of uterine/abdo muscles Educate re optimal fetal positioning Adequate abdominal palpation Upright and mobile once in Labour, continual support * Claire Allan Mechanism of labour Flexion As the fetus descends the chin touches the chest (arms begin to cross) and the attitude of flexion is adopted. This is increased further when the head meets the resistance of the birth canal Relation to practice Upright position to assist with gravity When resting, adopt the left lateral position (OFP) Observation of the contractions-are they regular, do they appear to be increasing in strength and becoming expulsive? * Claire Allan Mechanism of labour Internal rotation As the occiput reaches the resistance of the pelvic floor, it rotates forward 45 degrees. The slope of the pelvic floor aids this rotation forward and allows the head to emerge in the longest diameter of the pelvis (anterposteior) Relation to practice Fully dilated, station of the head Vertex may or may not be visible Upright position-kneeling, squatting May be spontaneously pushing Would you encourage mechanical pushing or allow for natural descent? * Claire Allan Mechanism of labour Crowning The head has crowned when it escapes under the pubic arch and no longer recedes between contractions because the widest transverse diameter of the head is born Extension With slight extension the bregma, forehead, face and chin will pass over the perineum and the head is born Relation to practice May be spontaneously/mechanically pushing or still breathing through contractions, how long can the second stage last? Introverted in her behaviour and may adopt alternative Position, bending towards the floor with knees apart * Claire Allan Mechanism of labour Resti