Normal labour occurs when there is a single fetus in the vertex position that is delivered spontaneously through the birth canal at term with no complications for the fetus or mother. Labour is divided into three stages: the first stage from onset of labour until full cervical dilation, the second stage from full dilation until delivery of the fetus, and the third stage from delivery of the fetus until delivery of the placenta. Abnormal labour can occur if the duration of pregnancy is less than 37 weeks or more than 42 weeks, or if the duration of labour is more than 24 hours or less than 3 hours.

1. Normal labour
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2. Obstetric
• Sceince which deals with female pregnant woman
pregnant
labour
perperium
Composed of

3. Labour
Labour is
normal
when
Mature single fetaus
Presented by vertex
Spontaneous in onset
No complication to
fetous or mother
Through birth canal
At term { within 24 h }

4. Presentation
of
fetous
Cephalic
Breech
shoulder
Face
vertix
brow

5. Vertix
postion
Left occipito
anterior
Right occipito
anterior
Left occipito
posterior
Right occipito
posterior

6. Abnormal labour
ECOLOGICAL
ANALYSIS
Duration of
pregnancy
less than 37
week or
more
Duration of
pregnancy
is 42 week
or more
The course
of labour
lasting more
than 24 h
The cource
of labour
lasting less
than 3 h
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7. Onset of labour
Abdominal
pain
referred
back
Contraction
increased
and not
relieve by
sedation
Hardening
of uterus
regular
True
labour
pain
Show
Rupture of
membrane
Discharge
of mucous
mixed
with blood
Gush of
amniotic
fluid

8. Stages of labour
The first stage The third stage
Start
end
Onset of
labour
Full cervical
dilatation
start
end
Reach full
diatation
Expulsion of
the fetous
start
end
Delivary of
fetous
Expulsion of
placenta
The second stage

9. 9
Project Analysis
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5,980,650.32

10. Management of first stage of labour
Management of second stage of
labour
Electro
modalities
› .
TENS
› FREQUENCY 80 -120 HZ
› Pulse width 150 µs
› Intensity : tingling
 Comfortable position
 Deep breathing exercise
 Not bearing down
 Message on lumbar region
 Relaxation technique as
diversion drill
Lithotomy postion
Bearing down
Panting exercise
Episiotomy
TENS

11. Episiotomy
. EPISIOTOMY A surgically
planned incision on the
perineum and the posterior
vaginal wall during the second
stage of labor
 To enlarge the vaginal
introitus
 Facilitate easy and safe
delivery of the fetus
 To minimize overstretching
and rupture of the perineal
muscles and fascia
 to reduce the stress and
strain on the fetal head.

12. • In elastic
(rigid)
perineum
• Anticipating
perineal tear
• Operative
delivery
Previous perineal
surgery
COMMON
INDICATIONS
breech,
occipitoposterior
or face delivery
threatened
perineal injury in
primigravidae
INDICATIONS of episiotomy

13. Types of episiotomy
a) Median
b)Mediolateral

14. Thank You