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NORMAL LABOUR: NORMAL ANATOMY

NORMAL LABOUR: NORMAL ANATOMY. NORMAL LABOUR: NORMAL PHYSIOLOGY. Passenger Passage Power. NORMAL LABOUR. LATENT PHASE: 0-4cm ACTIVE PHASE: 4-10cm. FIRST STAGE SECOND STAGE THIRD STAGE. FULL DILATION TO EXPULSION OF FETUS. BIRTH TO EXPULSION OF PLACENTA

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NORMAL LABOUR: NORMAL ANATOMY

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  1. NORMAL LABOUR: NORMAL ANATOMY

  2. NORMAL LABOUR: NORMAL PHYSIOLOGY Passenger Passage Power

  3. NORMAL LABOUR LATENT PHASE: 0-4cm ACTIVE PHASE: 4-10cm FIRST STAGE SECOND STAGE THIRD STAGE FULL DILATION TO EXPULSION OF FETUS BIRTH TO EXPULSION OF PLACENTA Expectant (physiological) vs Active (CCT +OT)

  4. Cervical effacement vs cervical dilation Cervix closed, 3 cm long Cervix effaced, 1 cm dilated Cervix 5 cm dilated Cervix fully dilated

  5. FIRST STAGE OF LABOUR: LATENT vs ACTIVE PHASE

  6. MODIFIED WHO PARTOGRAM

  7. TERMINOLOGY OF VAGINAL DELIVERY 1. Engagement of the fetal head in the transverse position. 2. Descent and flexion of the fetal head. 3. Internal rotation. The fetal head rotates 90 degrees to the occipito-anterior position 4. Delivery by extension. The fetal head passes out of the birth canal head is tilted backwards 5. Restitution. The fetal head turns through 45 degrees to restore its normal relationship with the shoulders, which are still at an angle. 6. External rotation. The shoulders repeat the corkscrew movements of the head, which can be seen in the final movements of the fetal head.

  8. WHAT IS NORMALITY Term / Preterm / Post dates Spontaneous rupture of membranes / Prolonged rupture of membranes/ Preterm prolonged rupture of membranes Fetal monitoring during labour: Intermittent fetal auscultation / continous cardiotocograph Analgesia during normal labour: nothing/birth partner/ TENS/ 1-1 midwifery care/ drugs/ epidural the Ferguson reflex Bishop score

  9. WHAT IS NORMAL? Term: 37 completed weeks to 42 weeks gestation Preterm: 24-37 completed weeks Post-dates: after 42 weeks (postmature, prolonged pregnancy, post-term) SROM = spontaneous rupture of membranes at term PROM = prelabor or premature rupture of membranes at term (labour doesn't ensue within 24 hours of ROM) PPROM = preterm, premature rupture of membranes ARM = artificial rupture of membranes (used for labor induction)

  10. Fetal monitoring during normal labour: Intermittent fetal auscultation Continous cardiotocograph (CTG)

  11. Analgesia during labour Nothing Water TENS birth partner 1-1 midwifery care Drugs Epidural

  12. the Ferguson reflex: as pressure on the cervix increases, the Ferguson reflex increases uterine contractions so that the second stage can go ahead. Bishop score

  13. Thank You

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