Labor is a process by which the fetus, Placenta
and membranes are expelled through birth canal.
Series of events that take place in the genital
organs in an effort to expel the viable products of
conception out of the womb through the vagina in to
outer world is called labour.
STAGE OF LABOUR
FIRST STAGE:- It starts from onset of true labor
pain and ends with full dilatation of cervix. It’s
average duration 12hrs in primigravida and 6hrs in
SECOND STAGE:- It starts from the full dilatation of
cervix and ends with expulsion of fetus from the birth
THIRD STAGE:- It begins after expulsion of fetus
and ends with expulsion of the Placenta &
FOURTH STAGE:- It is the stage of observation for
at least one hour after expulsion.
MANAGEMENT OF FIRST STAGE LABOUR
Food & Fluids by mouth
Position & Ambulation
Monitoring Maternal physiological changes
Monitoring Of Fetal Wellbeing
Evaluation Of Maternal Wellbeing
Bodily Care Of Progress Of Labour
EVALUTION OF PROGRESS OF LABOUR:
Partogram is a graphic recording of the salient features
of labour status. In the management of women in labour
partogram serves to validate the normal progress of labour
and to facilitate early identification of deviations from
Maternal vital signs
Fetal heart rate
Vaginal examination findings
MANAGEMENT OF SECOND STAGE OF LABOUR:
Hydration & General condition
Maternal pushing effort
Analgesia & Anaesthesia
Evaluation of progress of labor
Length of Second Stage
Descend & Station
Progress through the mechanism labor
PREPARATION FOR THE DELIVERY:
Location of the delivery
Position for the delivery
CONDUCTION OF DELIVERY:
Clamping and cutting the Umbilical
Immediate care of the Newborn
MANAGEMENT OF THIRD STAGE OF LABOUR:
Delivery of the Placenta & Membrane.
Sign of placental separation
•Fresh blood loss
•Lengthening of the cord
•Fundus becomes rounder,smaller & more mobile in the abdomen
•Controlled cord traction
•Expression by fundal pressure
Use of Oxytocic agent.
Examination of Placenta & Membrane.
Immediate care to mother & baby.
MANAGEMENT OF FOURTH STAGE LABOUR:
Evaluation & Inspection
•Evaluation of Uterus
•Inspection of Cervix
•Perineal Cleansing & Positioning Of Leg
Continuing Case Monitoring:
Vital sign check
Palpation of the fundus of uterus for contractility
Massage of uterus and expression of clots
Measurement of fundus
Inspection of the perineum
Inspection of bladder
Inspection and change of perineal pad
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