Objectives:
lDiagnose true labor
Describe factors influence vaginal birth
Assess maternal and fetal condition
Assess progress of labor
Manage first stage of labor
Describe mechanism of normal vaginal delivery
Describe steps for conduction vaginal delivery
Labor – Uterine contractions that result in effacement and dilatation of the cervix.
Braxton-Hicks – Uterine contractions NOT associated with cervical change.
Shorter in duration
Less intense
Over lower abdomen and groin
Resolve with ambulation
Lightening – Descent of the fetal head into the pelvis
Spontaneous expulsion, through the natural passages (birth canal) of a single, mature (37-42 completed weeks of pregnancy) Alive fetus, presenting by vertex, within a reasonable time, without fetal or maternal complications.
Clinical course of labour
Onset of labour: not definitely known – however there are several theories, but none of them is completely proven.
Mechanical theories: - uterine distension
Hormonal theories:
1.Maternal :
progesterone withdrawal
oxytocin stimulation
prostaglandins
oserotonin
2.fetal:
fetal cortisol
fetal membranes
3.Neuronal factors:
sympathetic- alpha receptor stimulation
First Stage-- stage of cervical effacement and dilation
Begins when uterine contractions of sufficient frequency, intensity, and duration are attained to bring about effacement and progressive dilation of the cervix
Ends when the cervix s fully dilated (10 cm) to allow passage of the fetal head
Second stage of labor-- stage of expulsion of the fetus ,begins when dilatation of the cervix is complete
and ends with delivery of the fetus
Stage 3- Birth of the Placenta
