Successfully reported this slideshow.

Normal labour, first stage by Yin Moe

1,639 views

Published on

  • Be the first to comment

Normal labour, first stage by Yin Moe

  1. 1. Dr. Yin Moe Han Senior LecturerObstetrics & Gynaecology Department School of Medicine, UCSI University
  2. 2. NORMAL LABOUR  normal, mature, alive  vertex presentation  spontaneous expulsion  per vaginum  within 24 hours  without complications07/31/12 1st Stage - Dr. Yin Moe Han 2
  3. 3. 07/31/12 1st Stage - Dr. Yin Moe Han 3
  4. 4. STAGES OF LABOUR First stage of labour Second stage of labour Third stage of labour Fourth stage of labour07/31/12 1st Stage - Dr. Yin Moe Han 4
  5. 5. FIRST STAGE OF LABOUR onset of labour 8-12 hours full dilatation of the cervix (10 cm) Latent Phase –--- 0 – 3 cm Active Phase –--- 4 – 10 cm07/31/12 1st Stage - Dr. Yin Moe Han 5
  6. 6. SECOND STAGE OF LABOUR full dilatation of the cervix up to 1 hour birth of the foetus07/31/12 1st Stage - Dr. Yin Moe Han 6
  7. 7. THIRD STAGE OF LABOUR birth of the foetus 5 - 15 mins not > 30 mins delivery of placenta and membranes07/31/12 1st Stage - Dr. Yin Moe Han 7
  8. 8. FOURTH STAGE OF LABOUR UP TO 2 HOURS AFTER DELIVERY07/31/12 1st Stage - Dr. Yin Moe Han 8
  9. 9. 07/31/12 1st Stage - Dr. Yin Moe Han 9
  10. 10. DIAGNOSIS OF LABOUR1. Diagnosis and confirmation of labour2. Diagnosis of stage and phase of labour3. Assessment of engagement and descent of the fetus4. Identification of presentation and position of the fetus07/31/12 1st Stage - Dr. Yin Moe Han 10
  11. 11. DIAGNOSIS AND CONFIRMATION OF LABOUR Suspect or anticipate labour if the woman has :  Intermittent abdominal pain  Associated with blood-stained mucus discharge (show)  Watery vaginal discharge or a sudden gush of water Confirm the onset of labour if there is :  Cervical effacement—the progressive shortening and thinning of the cervix during labour  Cervical dilatation—the increase in diameter of the cervical opening measured in centimetres  07/31/12 1st Stage - Dr. Yin Moe Han 11
  12. 12. EFFACEMENT AND DILATATION OF THE CERVIX  07/31/12 1st Stage - Dr. Yin Moe Han 12
  13. 13. DESCENT Abdominal palpation Descent of the fetal head Assess descent  in terms of fifths of fetal head palpable above the symphysis pubis Head entirely above the symphysis pubis  five-fifths (5/5) palpable Head entirely below the symphysis pubis  zero-fifths (0/5) palpable  07/31/12 1st Stage - Dr. Yin Moe Han 13
  14. 14. 07/31/12 1st Stage - Dr. Yin Moe Han 14
  15. 15. MECHANISM OF NORMAL LABOUR Cardinal movements of labour (LOA) Engagement and Flexion   Internal rotation to OA descent External rotation Restitution Extension07/31/12 1st Stage - Dr. Yin Moe Han 15
  16. 16. ENGAGEMENT AND DESCENT07/31/12 1st Stage - Dr. Yin Moe Han 16
  17. 17. FLEXION07/31/12 1st Stage - Dr. Yin Moe Han 17
  18. 18. INTERNAL ROTATION TO OA07/31/12 1st Stage - Dr. Yin Moe Han 18
  19. 19. EXTENSION07/31/12 1st Stage - Dr. Yin Moe Han 19
  20. 20. RESTITUTION07/31/12 1st Stage - Dr. Yin Moe Han 20
  21. 21. EXTERNAL ROTATION07/31/12 1st Stage - Dr. Yin Moe Han 21
  22. 22. DELIVERY OF ANTERIOR SHOULDER07/31/12 1st Stage - Dr. Yin Moe Han 22
  23. 23. BODY BORN BY LATERAL FLEXION07/31/12 1st Stage - Dr. Yin Moe Han 23
  24. 24. 07/31/12 1st Stage - Dr. Yin Moe Han 24
  25. 25. ASSESSMENT OF PROGRESS OF LABOUR  latent phase  measuring changes in cervical effacement and dilatation  active phase  measuring the rate of cervical dilatation and fetal descent  second stage  assessing further fetal descent07/31/12 1st Stage - Dr. Yin Moe Han 25
  26. 26. PROGRESS OF THE FIRST STAGE OF LABOUR Plot on a partograph once the woman enters the active phase of labour.  Alternatively, plot a simple graph of cervical dilatation (cm) on the vertical axis against time (hours) on the horizontal axis.07/31/12 1st Stage - Dr. Yin Moe Han 26
  27. 27. VAGINAL EXAMINATIONS 1st stage of labour - 4 hourly  Cervix not dilated on 1st VE  may not be possible to 2 stage of labour - hourly nd diagnose labour After rupture of the membranes  If contractions persist Record following after each VE  re-examine the woman  colour of amniotic fluid after 4 hours for cervical  cervical dilatation changes  descent (can also be assessed abdominally)  if there is effacement and dilatation, the woman is in labour Plot the findings on partograph  if there is no change, the diagnosis is false labour07/31/12 1st Stage - Dr. Yin Moe Han 27
  28. 28. Tha nk You07/31/12 1st Stage - Dr. Yin Moe Han 28

×