Normal labor and delivery involves 3 stages: 1) dilation of the cervix, 2) delivery of the baby, and 3) delivery of the placenta. The fetus moves through the birth canal via engagement, descent, flexion, internal rotation, extension, and external rotation. Labor is considered normal if it is spontaneous in onset, involves a single cephalic fetus at term, lasts less than 12 hours for first-time mothers and 8 hours for others, and results in an unassisted vaginal birth.
Overview
While it takes nine months to grow a full-term baby, labor and delivery occurs in a matter of days or even hours. However, it’s the process of labor and delivery that tends to occupy the minds of expectant parents the most.
Read on if you have questions and concerns around the signs and length of labor, and how to manage pain.
Signs of labor
Labor has started or is coming soon if you experience symptoms such as:
increased pressure in the uterus
a change of energy levels
a bloody mucus discharge
Real labor has most likely arrived when contractions become regular and are painful.
Braxton Hicks contractions
Many women experience irregular contractions sometime after 20 weeks of pregnancy. Known as Braxton Hicks contractions, they’re typically painless. At most, they’re uncomfortable and are irregular.
Braxton Hicks contractions can sometimes be triggered by an increase in either mother or baby’s activity, or a full bladder. No one fully understands the role Braxton Hicks contractions play in pregnancy.
They may promote blood flow, help maintain uterine health during the pregnancy, or prepare the uterus for childbirth.
Braxton Hicks contractions don’t cause the cervix to dilate. Painful or regular contractions aren’t likely to be Braxton Hicks. Instead, they’re the type of contractions that should lead you to call your doctor.
Overview
While it takes nine months to grow a full-term baby, labor and delivery occurs in a matter of days or even hours. However, it’s the process of labor and delivery that tends to occupy the minds of expectant parents the most.
Read on if you have questions and concerns around the signs and length of labor, and how to manage pain.
Signs of labor
Labor has started or is coming soon if you experience symptoms such as:
increased pressure in the uterus
a change of energy levels
a bloody mucus discharge
Real labor has most likely arrived when contractions become regular and are painful.
Braxton Hicks contractions
Many women experience irregular contractions sometime after 20 weeks of pregnancy. Known as Braxton Hicks contractions, they’re typically painless. At most, they’re uncomfortable and are irregular.
Braxton Hicks contractions can sometimes be triggered by an increase in either mother or baby’s activity, or a full bladder. No one fully understands the role Braxton Hicks contractions play in pregnancy.
They may promote blood flow, help maintain uterine health during the pregnancy, or prepare the uterus for childbirth.
Braxton Hicks contractions don’t cause the cervix to dilate. Painful or regular contractions aren’t likely to be Braxton Hicks. Instead, they’re the type of contractions that should lead you to call your doctor.
Normal Labour & Nursing Management of First stage of LabourNeha Parmar
Definition of normal labor, Terminology , events of labour, causes of labour, signs , stages of labour , signs and symptoms of labour, diagnosis in first stage of labour, Partograph, difference between true labour and false labour ,nursing management of first stage of labour.
A Partograph is a graphical record of progress during labor.
Progress is measured by cervical dilatation against time in hours, as well as by providing a record of the important conditions of the mother and fetus that may arise during the process
Stages of normal labor- easy explanation for Nursing Students(B.Sc & GNM)...
Introduction, definition of normal labor, definition of normal labor by WHO, Mechanism of labor, stages of labor, Intrapartum management of Labor, pain control.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
This presentation includes all the events , its sign and symptoms about IOL as well as management of women in the first stage of labor and how to assess the women in labor with the help of partograph.
Pathophysiology of Normal Labor:
A series of events that take place in female genital organs to expel the product of conception that are fetus, placenta, membranes) out of womb through the vagina into the outer world. We further describe pathogenesis and features of different stages of labor
Normal Labour & Nursing Management of First stage of LabourNeha Parmar
Definition of normal labor, Terminology , events of labour, causes of labour, signs , stages of labour , signs and symptoms of labour, diagnosis in first stage of labour, Partograph, difference between true labour and false labour ,nursing management of first stage of labour.
A Partograph is a graphical record of progress during labor.
Progress is measured by cervical dilatation against time in hours, as well as by providing a record of the important conditions of the mother and fetus that may arise during the process
Stages of normal labor- easy explanation for Nursing Students(B.Sc & GNM)...
Introduction, definition of normal labor, definition of normal labor by WHO, Mechanism of labor, stages of labor, Intrapartum management of Labor, pain control.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
This presentation includes all the events , its sign and symptoms about IOL as well as management of women in the first stage of labor and how to assess the women in labor with the help of partograph.
Pathophysiology of Normal Labor:
A series of events that take place in female genital organs to expel the product of conception that are fetus, placenta, membranes) out of womb through the vagina into the outer world. We further describe pathogenesis and features of different stages of labor
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Introduction..
Labor :
regular uterine contractions of sufficient frequency, intensity, and duration that
lead to progressive cervical dilatation, effacement and descent of presenting part.
3 Ps of labour: powers, the passages and the passenger.
If any of the 3Ps are unfavourable, labour is likely to be abnormal resulting in the
need for intervention
3. Maternal Anatomy
• The pelvic inlet:
Transverse diameter is 13.5 cm >
Anterior–posterior (A–P) diameter is
11.0 cm.
The fetal head enters the pelvis
orientated in a transverse position in
keeping with the wider transverse
diameter.
The angle of the inlet is normally 60°
4. Maternal Anatomy
• The Midpelvis
It is almost round, as the transverse and A-P are
similar at 12cm.
The ischial spines are palpable vaginally and are used
as important landmarks to:
1. To assess the descent of the presenting part on
vaginal examination (e.g. station 0 is at the level
of the ischial spines)
2. To provide a local anaesthetic pudendal nerve
block.
5. Maternal Anatomy
• The Pelvic Outlet
The transverse is the widest diameter at
the inlet, but at the outlet it is the AP
diameter
The fetal head must rotate from a
transverse to an AP position as it passes
through the pelvis
8. Fetal Anatomy
At the time of labour, the sutures
joining the bones of the vault are
soft, un-ossified membranes.
The sutures of the fetal face and
the skull base are firmly united.
9. Fetal Anatomy
Fetal skull moulding:
Sutures are not fixed which allows the bones
to move together and even to overlap.
The parietal bones usually slide over the
frontal and occipital bones
Moulding reduces the diameters of the fetal
head and encourages progress through the
bony pelvis, while still protecting the
underlying brain
11. Physiology of Labor
• The cervix: softens, shortens, thins out (effacement) and dilates for
labour to progress.
• The uterus: changes from a state of relaxation to an active state of regular
contractions to facilitate transit of the fetus through the birth canal.
• Each contraction must be followed by a resting phase in order to maintain
placental blood flow and adequate perfusion of the fetus.
• The pressure of the presenting part on the pelvic floor muscles produces
a maternal urge to push.
12. Physiology of Labor
The uterus
• Uterine contractions happens in response to an increase in intracellular
calcium.
• Prostaglandins and oxytocin increase intracellular free calcium ions.
• Progressive shortening of the uterine smooth muscle cells is called
retraction and occurs in the cells of the upper part of the uterus
• Retraction results in the development of the thicker, actively contracting
‘upper segment’ and the lower segment of the uterus becomes thinner
and more stretched
13. • Contraction intervals of 2–4
minutes (i.e. 2 in 10 increasing to
4–5 in 10 in advanced labour)
• Their duration varies from 30 to 60
seconds or longer.
• The intensity or amplitude of the
intrauterine pressure during a
contraction averages between 30
and 60 mmHg. ( 200 MVU)
14. Physiology of Labor
The cervix
• Under the influence of prostaglandins, there is an increase in proteolytic
activity and a reduction in collagen and elastin.
• Dermatan sulphate is replaced by the more hydrophilic hyaluronic acid,
which results in an increase in water content of the cervix.
• Causing cervical softening or ‘ripening’, so that when contractions begin
the processes of effacement and dilatation start.
15. Diagnosis of labor
The onset of labour can be defined as the presence of strong regular
painful contractions resulting in progressive cervical change
Loss of a ‘show’ or spontaneous rupture of the membranes (SROM) does
not define the onset of labour
16. Diagnosis of true labor pain
History
• A history of regular painful uterine contraction in every 5- 8
min, accompanied by the history of a bloody show or
spontaneous rupture of membrane
Physical examination
• Reduction of interval between uterine contractions
• Abdominal pain of increasing intensity
• Cervical effacement (≥ 50%)
• Cervical dilation (≥ 2 cm)
17.
18. Normal labor
Spontaneous onset
Single cephalic presentation.
37-42 weeks of gestation
No artificial interventions.
Unassisted spontaneous vaginal delivery.
Duration of <12 hours in nulliparous women, and <8 hours in multiparous women.
19. Stages Of Labor
There are three stages of labor:
• The first stage (stage of dilatation of the cervix) is from the onset of true labor
(regular uterine contractions) to complete dilatation of the cervix
• The second stage (stage of fetal delivery ) is from complete dilatation of the
cervix to the birth of the baby
• The third stage (stage of placental delivery) is from the birth of the baby to
delivery of the placenta.
20. Stages Of Labor
First stage
• It is the stage of cervical dilatation.
• Starts with the onset of true labor pain and ends with full dilatation of
the cervix i.e. 10 cm in diameter.
• It takes about 10-14 hours in primigravida and about 6-8 hours in
multipara
21. Phases of cervical dilatation
Latent phase:
• This is the first 3 cm of cervical dilatation which is slow takes about 8 hours
in nullipara and 4 hours in multipara.
Active phase:
• The time between the end of the latent phase (3–4 cm dilatation) and full
cervical dilatation (10 cm)
• Lasting between 2 and 6 hours, shorter in multiparous women
• Cervical dilatation during the active phase occurs typically at 1 cm/hour
or more
• It is considered abnormal if it occurs at less than 1 cm in 2 hours.
22. Stages Of Labor
Second stage
• It is the stage of expulsion of the fetus.
• Begins with full cervical dilatation and ends with the delivery of the
fetus.
• Its duration is about 50 minutes in primigravida and 20minutes in
multipara
• considered prolonged if more than one hour in multiparas and more than
2 hours in primigravidea
23. Phases Of Second stage of Labor
The ‘passive phase’
• The time between full dilatation and the onset of involuntary expulsive
contractions
• There is no maternal urge to push and the fetal head is still relatively high in the
pelvis.
The second phase ‘active second stage’.
• There is a maternal urge to push because the fetal head is low (often visible),
causing a reflex need to ‘bear down’
• normal active second stage should last no longer than 2 hours in a nulliparous
woman and 1 hour in multipara
24. Stages Of Labor
Third stage
• It is the stage of expulsion of the placenta and membranes.
• Begins after delivery of the fetus and ends with expulsion of the placenta
and membranes.
• Its duration is about 10-20 minutes in both primi and multipara. normally
not exceed 30 minutes with active management of third stage
25. Duration of Labor
Prolonged Labour
• labour lasting longer than 12 hours in nulliparous women and 8 hours in
multiparous women.
Precipitous labour
• defined as expulsion of the fetus within less than 3 hours of the onset of
regular contractions.
26. Mechanisms of labor
Fetal lie :
The relation of the fetal long axis to that of the mother
• Longitudinal
• Transverse
• Oblique
• A longitudinal lie is present in more than 99% of labors at term.
• Predisposing factors for transverse fetal position include
multiparity, placenta previa, hydramnios
27. Mechanisms of labor
Fetal presentation :
• The portion of the fetal body that is either foremost within the birth
canal or in the closest proximity to it.
• Cephalic 96.8%
• breech 2.7 %
• Shoulder 0.3%
• Compound 0.1%
28. Mechanisms of labor
Cephalic presentation
• Well flexed head (vertex or occiput presentation)
• Sinciput presentation (Military ) === transient
• Brow presentation 0.01 % === transient
• Face presentation 0.05%
• As labor progresses, sinciput and brow presentations almost always convert into
vertex or face presentations by neck flexion or extension, respectively.
29. Fetal Attitude:
Position of head with regard to
fetal spine (ie: degree of flexion or
extension)
• A - suboccipitobragmatic (vertex)
• B - occipitofrontal (military)
• C - mentovertical (brow )
• D - submintobragmatic (face)
** OP with occipitofrontal 11.5
Or suboccipitofrontal 10
34. Mechanisms of labor
Fetal position
• Relation ship of chosen portion of the fetal presenting part to the right or
left side of the birth canal (ROA, LOA , ROP, RMA…..)
• DOMINATOPRS:
Vertex
Face
Breech
Shoulder
• Occiput
• Mentum
• Sacrum
• Acromiun
35.
36.
37.
38.
39. Diagnosis Of Fetal Presentation & Position
• Abdominal palpation
• Vaginal examination:
- Presenting part
- Position
- Dilatation
- Effacement
- Station
- Pelvimetry
• Auscultation : arounf the umbilicus in longitdunal lie , below if cephalic and above if breech
43. The Mechanism Of Labor (OA)
Cardinal movements of labor
1. Engagement
2. Descent
3. Flexion
4. Internal Rotation
5. Extension
6. Restitution And External Rotation
7. Expulsion
44. The Mechanism Of Labor
Engagement
• Passage of widest diameter of
presenting(in transverse position) part
to level below the plane of the pelvic
inlet
• Occurs earlier in nulliparous women
(36 wks)
45. The Mechanism Of Labor
Descent
• Descent of the fetal head is needed before
flexion, internal rotation and extension can
occur
Flexion
• Occurs passively As the
• head descends into the narrower midpelvis
46. The Mechanism Of Labor
Internal Rotation
Rotation of presenting part from original position (transverse) to
anteroposterior position
If the head is well flexed, the occiput will be the leading point
47. The Mechanism Of Labor
Extension
The well-flexed head now extends
and the occiput escapes from
underneath the symphysis pubis and
distends the vulva.
This is known as ‘crowning’ of the
head.
48. Restitution
This slight rotation of the occiput
through one eighth
of the circle
The Mechanism Of Labor
External rotation
The shoulders have to rotate into the direct AP
plane, Then the occiput rotates through a
further one-eighth of a circle to the transverse
position.
49. The Mechanism Of Labor
Expulsion
The anterior shoulder is under the
symphysis pubis and delivers first, and
the posterior shoulder delivers
subsequently.
50. In occipito-posterior
Mechanism of labour is identical to OT &
anterior varieties
The occiput rotate to the symphysis pubis
through 135º instead of 90º or 45º
If rotation does not occur direct occiput
post or
Partial rotation transverse arrest
51. Management In First Stage
Vaginal examinations are usually performed every 4 hours to determine
when the active phase has been reached
Laboring woman should be allowed to assume the position she finds most
comfortable— this will be lateral recumbency most of the time
Sips of clear liquids, occasional ice chips are permitted
52. Management In Second Stage
The first sign of the second stage is likely to be an urge to push.
In all cases the baby should be delivered within 4 hours of reaching full
dilatation
Once the head has crowned, the perineum should be supported the
woman should be discouraged from bearing down by telling her to take
rapid, shallow breaths
To aid delivery of the shoulders, there should be gentle traction on the
head downwards and forwards until the anterior shoulder appears
beneath the pubis
53.
54. Fetal Care
Fetal monitoring:
• Low risk : every 30 min in first stage and 15 min in second stage
• High risk : every 15 min in first stage and every 5 min in the second stage
or continuous
55. Episiotomy
It is a second degree pereneal tear man made by scissors
Types: Midline, medio-lateral and lateral, Mediolateral is commonly used.
Indication: complicated vaginal delivery (breech, shoulder dystocia, forceps,
vacuum), scarring from female genital cutting or poorly healed third or fourth
degree tears and fetal distress.
56. Episiotomy
Wait to perform episiotomy until: the perineum is thinned out; and 3-4 cm of
the baby's head is visible during a contraction
Complications: Hematoma, infection and rarly necrotizing fasciitis
Episiotomy should be restricted to an indication
59. Management In Third Stage
Management of the third stage can be ‘active’ or ‘physiological’.
Physiological management
• Is where the placenta is delivered by maternal effort and no uterotonic drugs are
given to assist this process
Active management
• When the signs of placental separation are recognized, controlled cord traction is
used to expedite delivery of the placenta.
61. Oxytocin dose is 10 IU, intramuscularly. with intravenous access in place, 10-20 IU is
placed in 500-1000 mL of crystalloid and run quickly. With cesarean deliveries, 5 IU is
administered as an intravenous bolus, followed by a similar infusion.
Ergometrine dose: is 0.2-0.25 mg, some used 0.5 mg ; IM or IV.
Syntometrine (contains 0.5 mg of ergometrine with 5 IU of oxytocin);
Oxytocin and ergometrine acts within 30 seonds if given IV and oxytocin acts after 3
mints while ergometrine after 6-8 mints if given IM
Management In Third Stage
62. Advantages of Active Management
Advantage:
• reduction of the blood loss (60% reduction of blood loss )
Disadvantages:
• Constriction ring may occur with retention of the placenta.
• Avulsion of the cord if undue pressure is applied.
• Inversion of the uterus if fundus is pressed while the uterus is lax.
63. Placental Examination
Examination of the placenta & membranes:
• by exploring it on a plain surface to be sure that it is complete. If there is missed
part, exploration of the uterus is done under general anaesthesia.