Chapter 25 The First Stage of Labor. Changes during the last week of pregnancy Mood swing Fetal...
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Transcript of Chapter 25 The First Stage of Labor. Changes during the last week of pregnancy Mood swing Fetal...
Chapter 25The First Stage of Labor
Changes during the last week of pregnancyChanges during the last week of pregnancy
Mood swingFetal changes : fetal in the lower site 2-3 wkExpansion of lungsEasy breathingWoman feel more comfortSoften and lightningIncrease effacementDifficult walkingBack painIncrease the pressure within the pelvises and vag. secr.
First StageLatent 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.
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
Complete effacement include internal and external cervical os. This happen by the action of combination of hormonal and mechanical factors.
Action of estrogenIncrease oxytocin receptors releaseStimulate placenta for H. production (progest.)Increase softening of cervix
What is the onset of labourIs the process of establishing true labour It is difficult to determineDiagnosis of onset of labour is important in order to make correct management
Physiology of first stage of laborDuration vary and affected by: parity, birth interval, psychological status and position of fetus
Uterine Contraction1.Fundal dominance
Uterine Contraction1.Fundal dominance2.Polarity3.Contraction and retraction4.Formation of upper and lower uterine segment5.The retraction ring 6.Cervical effacement 7.Cervical dilation 8.Show
Cervical dilation process
Mechanism Factors of Labor1.Formation of forewater
1.2. General fluid pressure
Mechanism Factors of Labor
3. Rupture of membrane4. Fetal axis pressure
Recognition of First Stage of LabouroBy womanoBy midwife [How]History Physical examVaginal exam
Indication for Vaginal Exam
Assessment of true laborDetermine presentationCheck for membraneDiscover abnormality Assess cervix dilation
[how to do vaginal exam clinical section]
Vaginal exam
Record Complete record Use of partogramAccurate ComprehensiveShared