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Mechanism of normal labour

Normal labour

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Mechanism of normal labour

  1. 1. MECHANISM OF NORMAL LABOUR Alexandria faculty of medicine Rania Hesham Abd El-Galil
  2. 2. Normal labour criteria of normal labour  Spontaneous expulsion  of a single  full term  Living & viable  presented by vertex,  Through normal passage  within a reasonable time  without major surgical intervention  without complications to the mother, or the fetus
  3. 3. Onset of N.Labour True Labour pain “crietria” The “show” Uterine contractions Cervical effacement, Dil. &formation of fore waters
  4. 4. Stages of Normal Labour
  5. 5. The first stage
  6. 6. The first stage 1-Cervical effacement
  7. 7. The first stage  Cervical dilatation
  8. 8. The second stage  Mechanism of n.labour Descend Flexion Internal rotation Crowning Extension Restitution Internal rotation of shoulder External rotation of head Lateral flexion of body Delivery
  9. 9. The second stage  Descent  Synclitism  (asynclitism-posterior parietal bone presentation-Litzmann’s obliquity).  (asynclitism-anterior parietal bone presentation-Naegele’s obliquity).
  10. 10. The second stage  Engagement  Station zero
  11. 11. The second stage  Increased flexion Occipitofrontal diameter Suboccipitobregmatic diameter > flexion
  12. 12. The second stage  Internal rotation
  13. 13. The second stage  Extension
  14. 14. The second stage  Restitution and external rotation
  15. 15. The second stage  Delivery of the shoulders & expulsion
  16. 16. The second stage
  17. 17. The Third stage  Placenta delivery
  18. 18. The third stage 1- Mathews-Duncan mechanism The leading edge of the placenta separates first and the placenta is delivered with its rawsurface exposed. 2- Schultz mechanism If the placenta is inserted at the fundus and central area separates first, the placenta inverts and draws the membranes after it, covering the raw surface (inverted umbrella)
  19. 19. Management of the labour “2nd stage”  DELIVERY OF THE HEAD 1) Control the delivery of the head to prevent laceration 2) Performed episiotomy if requires 3) Performed Ritgen’s method 4) Cleared the airway after delivery of the had
  20. 20. Management of the labour “2nd stage”  EPISIOTOMY "..is a surgical incision into the perineum to enlarge the space at the outlet
  21. 21. Management of the labour “2nd stage”  Repair of Episiotomy Continuous sutures Interrupted sutures Interrupted suture or subcuticular

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Normal labour

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