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Chapter 25 The First Stage of Labor

Chapter 25 The First Stage of Labor. Changes during the last week of pregnancy. Mood swing Fetal changes : fetal in the lower site 2-3 wk Expansion of lungs Easy breathing Woman feel more comfort Soften and lightning Increase effacement Difficult walking Back pain

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Chapter 25 The First Stage of Labor

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  1. Chapter 25 The First Stage of Labor

  2. Changes during the last week of pregnancy Mood swing Fetal changes : fetal in the lower site 2-3 wk Expansion of lungs Easy breathing Woman feel more comfort Soften and lightning Increase effacement Difficult walking Back pain Increase the pressure within the pelvises and vag. secr.

  3. First Stage Latent phase: cervix dilated about 3-4cm this phase stay 6-8 hr this phase started before the active phase Active phase: cervix is more dilated. Started when cervix about 4cm with regular uterine cont. Transitional Phase: cervix dilated around 8cm -10cm. The onset of spontaneous labour Women have to be informed and feel comfort good labor preparation, explain and provide privacy, good management.

  4. Spurious ( false) Labour Contraction before onset of labour Contraction may be regular No cervical dilation No effacement No true labour Medical and Midwifery Management: Support Increase a awareness Reassurance Discussion for future management

  5. Complete effacement include internal and external cervical os. This happen by the action of combination of hormonal and mechanical factors. Action of estrogen Increase oxytocin receptors release Stimulate placenta for H. production (progest.) Increase softening of cervix

  6. What is the onset of labour • Is the process of establishing true labour • It is difficult to determine • Diagnosis of onset of labour is important in order to make correct management • Physiology of first stage of labor • Duration vary and affected by: parity, birth interval, psychological status and position of fetus • Uterine Contraction • Fundal dominance

  7. Uterine Contraction • Fundal dominance • Polarity • Contraction and retraction • Formation of upper and lower uterine segment • The retraction ring • Cervical effacement • Cervical dilation • Show

  8. Cervical dilation process

  9. Mechanism Factors of Labor • Formation of forewater • 2. General fluid pressure

  10. Mechanism Factors of Labor • 3. Rupture of membrane • 4. Fetal axis pressure • Recognition of First Stage of Labour • By woman • By midwife [How] • History • Physical exam • Vaginal exam

  11. Indication for Vaginal Exam • Assessment of true labor • Determine presentation • Check for membrane • Discover abnormality • Assess cervix dilation • [how to do vaginal exam clinical section]

  12. Vaginal exam

  13. Record Complete record Use of partogram Accurate Comprehensive Shared

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