新 疆医科大学第一临床医学院妇产科学课件 正常分娩.pptVIP

正常分娩 The normal labor and delivery 分娩: 妊娠满28周后,胎儿及附属物由母体娩出的过程称为分娩。根据分娩时间的不同又划分为： 早产 足月产 过期产 早产（premature delivery）: A delivery that occurs 28 weeks or more than 28 weeks, less than 37 weeks (196~258 days ) is called premature delivery. 即:孕满28周~不足37周 足月产term delivery : A delivery that occurs from 37 weeks to less than 42 weeks (259~293 days) is called term delivery. 即：孕满37周~不足42周妊娠 过期产 postterm delivery: A delivery that occurs 42 weeks or more than 42 weeks is called post term delivery (294 or more than 294 days) 即：妊娠满42 周及其以后。 第一节:分娩动因：Mechanism of initiation of Labor many theories have been proposed over the years to explain the sequence of events that culminate in labor and delivery, but the exact metabolic and endocrine pathway are not yet known. A consideration of several the more plausible theories suggests that the mother, the fetus, and the placenta all contribute to the maintenance of pregnancy, and that the removal of certain restraints finally triggers progressively more rhythmic and forceful uterine contractions. 分娩发动的原因目前尚不清楚，分娩是一个复杂的生理活动，分娩发动必备的条件是胎儿的成熟和母体的准备，可能与下列学说有关。 一、宫颈成熟及宫颈下段形成学说。 二、内分泌控制学说：前列腺素（PGS） 三、机械性学说：机械扩张。 四、神经介质学说：儿茶酚胺及乙酰胆 碱。 第二节：决定分娩的四大因素 The progress and final outcome of labor are influenced by 4 factors: .the passage (the bony and soft tissues of the maternal pelvis) .the powers (the contractions or forces of the uterus) .the passenger(the fetus) .the psyche Abnormalities of any these components, singly or in combination, may result in dystocia. The first is not subject to change by therapeutic manipulation during delivery; the second and third can be influenced by medication or by manual or forceps intervention. The psyche is profoundly influenced by preparation for labor, familiar support, trust in care providers, previous life experiences and by behavior of those in her environment during labor. In turn the psyche can materially influence the powers and the passenger. 决定分娩的四大因素是产力、产道、胎儿和精神因素。若各