Normal Labour
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The document discusses several topics related to labour and delivery: - The physiological mechanisms that initiate labour, including hormonal and anatomical changes in the mother and fetus. - How uterine contractions progress cervical dilation and effacement in the first stage of labour. - The second stage where contractions expel the fetus through the birth canal. - The third stage where the placenta is delivered. - Methods for assessing and monitoring labour including physical exams, cardiotocography to monitor the fetal heart rate, and use of the partogram to track labour progress.
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Normal Labour
- 1. Group A 16th Batch Faculty Of Medicine USJP. Group A,16th Batch,FMS,USJP.
- 11. Deeper view Group A,16th Batch,FMS,USJP.
- 14. Anatomy of the fetal skull Vault mainly consists of 2 parietal bones, parts of occipital, frontal and temporal bones. Bones are joined to each other by soft unossified membranes, known as sutures. Group A,16th Batch,FMS,USJP. skull vault face base
- 18. Lateral and posterior view of moulding of the foetal skull Group A,16th Batch,FMS,USJP.
- 20. Exact physiological mechanism of initiation of parturition is still unknown. But there are some processes that are of particular importance. Group A,16th Batch,FMS,USJP.
- 42. Cardiotocography is a method of monitoring fetal heart rate (indirect method) by using ultrasound technique. Group A,16th Batch,FMS,USJP.
- 57. THE PARTOGRAM Group A,16th Batch,FMS,USJP.
- 59. THE PARTOGRAM Group A,16th Batch,FMS,USJP. Foetal Conditions Progress of Labour Maternal Conditions
- 64. PARTOGRAM Group A,16th Batch,FMS,USJP. ALERT LINE ACTION LINE LSCS
- 67. Group A,16th Batch,FMS,USJP. Observation of the colour of the liqour Mainly - fresh meconium staining If Meconium is present – watch more closely for signs of fetal distress Thin meconium - not much of a risk Thick meconium - more dangerous Fetal heart rate -checked every 15 minutes If suspicious / eg- fetal bradicardia Apply CTG and monitor Maternal information write here; Date EDD POA BP Blood Gp Blood taken for DT
- 72. Secondary Arrest of Active Phase • Definition – No change in cervical dilatation over a period of 2hrs. Cervix becomes oedematous. Can occur at 4-7 cm dilatation or as a protracted Deceleration phase • Aetiology – CephaloPelvic Disproportion [often absolute] – Foetal head malposition or malpresentation [breech] – Insufficient uterine action – Excessive sedation • Outcome – Will require LSCS. If protracted deceleration beware of shoulder impaction Group A,16th Batch,FMS,USJP.
- 87. Foley catheter insertion
- 106. 1 st stage of labour Latent phase Active phase Group A,16th Batch,FMS,USJP.
- 114. Group A,16th Batch,FMS,USJP. 2nd stage Phase 1( Passive Phase): a) No maternal urge to push b) Fetal head is high c) Sagittal suture is in the transverse position Phase 2( Active Phase): a) Maternal urge to push is present b) Fetal head is low c) Sagittal suture is in the anterior-posterior position d) bearing down sensation
- 124. Episiotomy Group A,16th Batch,FMS,USJP.
- 125. What is an Episiotomy ? Group A,16th Batch,FMS,USJP. Definition An episiotomy is a surgical incision made in the perineum, the area between the vagina and anus. Episiotomies are done during the second stage of labor to expand the opening of the vagina to prevent tearing of the area during the delivery of the baby.
- 130. Infiltration of perineal tissue with local anaesthetic Group A,16th Batch,FMS,USJP.
- 133. Repair of episiotomy Group A,16th Batch,FMS,USJP.
- 138. Controlled cord traction Clamp the cord close to the perineum using sponge forceps. Hold the clamped cord and the end of forceps with one hand. Place the other hand just above the woman’s pubic bone and stabilize the uterus by applying counter traction during controlled cord traction. This helps prevent inversion of the uterus. Keep slight tension on the cord and await a strong uterine contraction (2–3 minutes). Group A,16th Batch,FMS,USJP.
- 139. When the uterus becomes rounded or the cord lengthens, very gently pull downward on the cord to deliver the placenta. Do not wait for a gush of blood before applying traction on the cord. Continue to apply counter traction to the uterus with the other hand. If the placenta does not descend during 30–40 seconds of controlled cord traction (i.e. there are no signs of placental separation), do not continue to pull on the cord: Gently hold the cord and wait until the uterus is well contracted again. If necessary, use a sponge forceps to clamp the cord closer to the perineum as it lengthens; With the next contraction, repeat controlled cord traction with counter traction. Never apply cord traction (pull) without applying counter traction (push) above the pubic bone with the other hand. Group A,16th Batch,FMS,USJP.
- 140. 1 2 3 4 5 6 Group A,16th Batch,FMS,USJP.
- 141. 7 8 Group A,16th Batch,FMS,USJP.
- 147. Group A,16th Batch,FMS,USJP. Most widely used type Use for outlet&low cavity deliveries Used in outlet & low cavity deliveries There is a sliing lock No pelvic curve so it allows fetal head to rotate inside the pelvis Uses for mid cavity deliveries Types of obstetric forceps Wrigley’s forceps Simpson’s forceps kieeland’s forceps
- 157. PAIN RELIEF IN LABOUR
- 158. PAIN IN LABOUR IS NOT BENEFICIAL EITHER TO MOTHER OR FETUS PAIN DYSFUNCTIONAL LABOUR UTERINE VASOCONSTRICTION FETAL ACIDOSIS HYPERVENTILATION Pco 2 MATERNAL CATECHOLAMINES PLACENTA PERFUSION
- 170. Causes of maternal deaths worldwide. Group A,16th Batch,FMS,USJP.
- 172. Uterine atony & PPH with fundal massage. Group A,16th Batch,FMS,USJP.
- 179. Bakri balloon catheter. Group A,16th Batch,FMS,USJP.
- 180. Condom attached to a catheter which can be inflated with saline after introducing in to the uterine cavity. Group A,16th Batch,FMS,USJP.
- 183. B-Lynch suture. Group A,16th Batch,FMS,USJP.
- 187. Controlled cord traction. Group A,16th Batch,FMS,USJP.
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