Normal labor paramedics


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a normal child birth, pelvis structure and fetus presentation.
By Dr. Eyal Sheiner, Israel.

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Normal labor paramedics

  1. 1. NORMAL LABOR AND DELIVERY Eyal Sheiner M.D. Soroka University Medical Center
  2. 2. <ul><li>&quot;Labor&quot;: Contractions and cervical dilatation </li></ul><ul><li>Passenger </li></ul><ul><li>Power </li></ul><ul><li>Passageway ( Pelvis) </li></ul>
  3. 4. The final common pathway of this stimulation is the creation of rhythmic membrane depolarization in the myometrial cells resulting in an increase in intrauterine pressure. Power
  4. 5. Uterine contractions <ul><li>Smooth muscle, but painful </li></ul>
  5. 6. Passenger Presentation Lie Position, Station
  6. 8. Diameters of the fetal head at term
  7. 9. Locating the sagittal suture by vaginal examination
  8. 11. Longitudinal lie. Cephalic presentation. Differences in attitude of fetal body in (A) vertex, (B) sinciput, (C) brow and (D) face presentations. Note changes in fetal attitude in relation to fetal vertex as the fetal head becomes less flexed
  9. 13. Transverse lie. Right acromiodorsoposterior position (RADP) The shoulder of the fetus is to the mother’s right, and the back is posterior
  10. 14. Longitudinal lie. Vertex presentation A. Right occiput posterior (ROP) B. Right occiput transverse (ROT)
  11. 15. When the lowermost portion of the fetal head is above the ischial spines, the biparietal diameter of the head is not likely to have passed through the pelvic inlet and therefore is not engaged (P = sacral promontory , Sym = symphysis pubis).
  12. 16. Head not engaged
  13. 17. Engagement
  14. 20. Normal female pelvis with the false and true pelvis identified
  15. 21. The four parent pelvic types of the Caldwell-Moloy classification A line passing through the widest transverse diameter divides the inlet into posterior (P) and anterior (A) segments.
  16. 22. (I) Gynaecoid pelvis (50%) Best suited for child bearing, fortunately most common
  17. 23. Gynecoid pelvis
  18. 24. (II) Android pelvis (20%) It is a male type, not favorable for delivery
  19. 25. Android pelvis
  20. 26. Gynecoid VS Android
  21. 27. Stages of labor <ul><li>The first stage is cervical dilatation </li></ul><ul><li>The second stage is labor and delivery of the baby </li></ul><ul><li>The third stage is delivery of the placenta or afterbirth </li></ul><ul><li>On average it takes about 12 to 14 hours for nulliparous patients and about eight hours for multiparas. </li></ul>
  22. 28. First stage <ul><li>The first stage of labor results in the cervix dilating to a full 10 centimeters and consists of latent and active phases. </li></ul>
  23. 30. Active Phase <ul><li>The cervix will dilate to 10 centimeters </li></ul><ul><li>Contractions become intense </li></ul>
  24. 31. Second stage <ul><li>Once the cervix has dilated to 10 centimeters, the work of the second stage begins--delivering the baby. </li></ul><ul><li>Involuntary urge to push. </li></ul><ul><li>This stage can last anywhere from minutes to three hours </li></ul>
  25. 33. The third stage Placental separation
  26. 34. Latent phase This phase can be reached over a period of days or in as little as two to six hours