NORMAL LABOUR: NORMAL ANATOMY

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NORMAL LABOUR NORMAL ANATOMY
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NORMAL LABOUR NORMAL PHYSIOLOGY
Passenger Passage Power
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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)
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Cervical effacement vs cervical dilation
Cervix closed, 3 cm long
Cervix effaced, 1 cm dilated
Cervix 5 cm dilated
Cervix fully dilated
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FIRST STAGE OF LABOUR LATENT vs ACTIVE PHASE
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MODIFIED WHO PARTOGRAM
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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.
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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
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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)
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Fetal monitoring during normal labour
Intermittent fetal auscultation Continou
s cardiotocograph (CTG)
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Analgesia during labour
Nothing Water TENS birth partner 1-1 midwifery
care Drugs Epidural
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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
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Thank You