正常分娩妇科七年制教学.pptxVIP

Normal Labor and Delivery(AFE)正常分娩definitionTerm delivery(labor): 37-42weekspre-term delivery: 28- 37 weekspost-term delivery:? 42 weeksAbortion: 28 weeks85% of women spontaneous labor and delivery between 37-42 weeks LMP :last menstrual periodEDC: expected date of confinememtThe four factors for laborForce (contraction)birth canal (bony canal)fetus (lie,position ,presentation,weight)psychical-factorsThe contractions increase in frequency and durationuterus can be felt to harden during contraction lasting about 30-45 secondsinterval between contractions to be 5 min’the pain of labor is a characterNST CSTBony pelvisThe planes of pelvis inlet plane (promontory) mid plane of pelvis(ischial spines) outlet plane(two intersecting triangles) Mechanism of laborEngagement*FlexionDecentInternal rotationExtensionExternal rotationSymptoms and signs of the onset of the laborPainful uterine contractiona showeffacement and dilation of the cervixrupture of membranes The showThe mucus plug is expelled from the cervixmixing with a little blood the rupture of the membranesat any time during laboreffacement and dilation of the cervixto be short,taken up,dilatedStages of laborThe first stage: onset of labor to full cervical dilation(10cm) the latent phase ( onest to 3cm, 16h) the active phase(3cm to 10cm, 8h)The second stage: 10 cm to the delivery of the infant, 2hThe third stage: delivery of the infant to delivery of the placenta, 30m’The fourth stage: 2 hours after delivery of the placentaManagement of normal labor The first stage:education, eating, voiding, position(sitting, reclining, recumbent)monitoring of the fetal heart rate ,dilation of cervix and frequency severity of uterus contractions(auscultation or electronic monitoring)The second stage:--- 2 hourfetal heart ratematernal conditions: pulse, blood pressure, respiratory rate , temperature, urine output, fluid intake… evaluation of progress of labor cervical dilation, station,position of the present