影响分娩的四大因素2FourfactorsforlaborFetusNormalLaborand.PPT

Normal Labor and Delivery正 常 分 娩 ObsGyn Department of 1st Clinical Hospital Wuhan University Associate Professor Ming lei （明蕾） Outline Delivery is the process by which the mature or nearly mature fetus and placenta are expelled from the maternal body after 28 weeks 分娩是指妊娠满28周及以后的胎儿及其附属物从母体排出的过程 Outline Outline 1. Engagement 衔接 Passage of widest diameter of presenting part to level below the plane of the pelvic inlet 胎儿先露部的最大径线进入骨盆入口平面，先露部最低点接近或达到坐骨棘连线水平 2、3. Descent Flexion下降和俯曲 4. Internal rotation 胎儿内旋转 As the head descends, the presenting part, usually in the transverse position, is rotated about 45°to anteroposterior (AP) position under the symphysis. Internal rotation brings the AP diameter of the head in line with the AP diameter of the pelvic outlet 5. Extension 仰伸 1) With further descent and full flexion of the head, the base of the occiput comes in contact with the inferior margin of the pubic symphysis 2) Upward resistance from the pelvic floor and the downward forces from the uterine contractions cause the occiput to extend and rotate around the symphysis 6. External Rotation 外旋转 When the fetus head is free of resistance, it untwists about 45°left or right, returning to its original anatomic position in relation to the body 7. Expulsion 胎儿娩出 分娩方式的进展Prospective for delivery method Benefits 优点 increasing chances of giving birth naturally and normally with the minimum of interference or medical intervention. Reduce womens perceptions of pain Reduce episiotomy rates 减少会阴侧切率 Limitation 局限性 Not all women can try water birth Need professional equipment More expensive Mechanism of labor (枕先露的分娩机转) Occiput presentation 3 Mechanism of labor (枕先露的分娩机转) Occiput presentation 3 Mechanism of labor (枕先露的分娩机转) Occiput presentation 3 Mechanism of labor (枕先露的分娩机转) Occiput presentation 3 Mechanism of labor for left occiput anterior position * * Definition 1 2 3 Mechanism of labor Four factors for labor 2 3 （定义） Definition 1 （定义） Definition 1 Term delivery: