SlideShare a Scribd company logo
Group A  16th Batch Faculty Of Medicine USJP. Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Labour ,[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
The  Pelvis ,[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Deeper  view Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Anatomy of the fetal skull Vault  mainly consists of 2 parietal bones, parts of occipital, frontal and temporal bones. Bones are joined to each other by soft  unossified membranes, known as sutures.  Group A,16th Batch,FMS,USJP. skull vault face base
Superior and lateral view of fetal skull ,[object Object],Group A,16th Batch,FMS,USJP. 1. Coronal Suture 2. Anterior Fontanelle 3. Anterolateral Fontanelle 4. Squamosal Suture 5. Posterolateral Fontanelle 6. Lambdoidal Suture 7. External Acoustic Meatus 8. Sagittal Suture
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Fontanelles Junctions between  sutures are known as Fontanelles   Group A,16th Batch,FMS,USJP.
Importance of Fontanelles ,[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Lateral and posterior view of moulding of the foetal skull Group A,16th Batch,FMS,USJP.
The diameters of the skull ,[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Exact physiological mechanism of initiation of parturition is still unknown. But there are some processes that are of particular importance. Group A,16th Batch,FMS,USJP.
What happens prior to initiation of labour? That means last 4-5 weeks of gestation. ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Onset of labour. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
During 1 st  stage of labour. ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
HISTORY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
ABDOMINAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
VAGINAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Cardiotocography is a  method of monitoring   fetal heart rate  (indirect method)  by using ultrasound technique. Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Analyzing a CTG report ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
1. Foetal heart rate ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
2.Baseline variability of Foetal heart rate ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
3. Accelerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
4.Decelerations ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
In Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
THE PARTOGRAM Group A,16th Batch,FMS,USJP.
THE PARTOGRAM ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
THE PARTOGRAM Group A,16th Batch,FMS,USJP. Foetal Conditions Progress of Labour Maternal Conditions
The Components Assessed by the Partogram ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
contd… ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
contd… ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
contd… ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP. Demonstrating lines
PARTOGRAM Group A,16th Batch,FMS,USJP. ALERT LINE ACTION LINE LSCS
The Importance of the Partogram ,[object Object],Group A,16th Batch,FMS,USJP.
Partogram is a, ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP. Observation of the colour of the liqour Mainly - fresh meconium staining If Meconium is present – watch more closely for signs of fetal distress  Thin meconium -  not much of a risk Thick meconium - more dangerous Fetal heart rate   -checked every 15 minutes If suspicious / eg- fetal bradicardia Apply CTG and monitor Maternal information write here; Date EDD POA BP Blood Gp Blood taken for DT
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Secondary Arrest of Active Phase •   Definition  – No change in cervical dilatation over a period of 2hrs.   Cervix becomes oedematous. Can occur at 4-7 cm dilatation   or as a protracted Deceleration phase    • Aetiology  – CephaloPelvic Disproportion [often absolute]  – Foetal head malposition or malpresentation    [breech]   – Insufficient uterine action  – Excessive sedation  • Outcome  – Will require LSCS. If protracted deceleration  beware   of  shoulder impaction  Group A,16th Batch,FMS,USJP.
 
Aim ,[object Object]
Preparation in the ward  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Preparation in the labour room ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Preparation in the labour room…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Group A,16th Batch,FMS,USJP.
DEFINITION ,[object Object]
INDICATIONS  FOR  INDUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BISHOPS SCORE  IN  INDUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],score 0 1 2 3  Dilation of cervix 0 1 or 2 3 or 4 5 or more Consistency  of  cervix firm medium soft - Length  of  cervical  canal >2 2 _1 1_ 0.5 <0.5 Position  of  cervix posterior central anterior - Station  of  presenting  part -3 -2 -1 or 0  Below  spines
METHODS   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SYNTOCINON ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROSTAGLANDIN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
AMNIOTOMY  (ARM) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FOLEY  CATHETER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Foley  catheter insertion
COMPLICATIONS IN  INDUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],DESCENT Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
1 st  stage of labour  Latent phase Active phase Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Effacement…..   ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management of first stage of labour ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Second stage ,[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP. 2nd  stage Phase 1( Passive Phase): a) No maternal urge to push b) Fetal head is high c) Sagittal suture is in the  transverse position  Phase 2( Active Phase): a) Maternal urge to push is present b) Fetal head is low c) Sagittal suture is in the anterior-posterior position d) bearing down sensation
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Diagnosis of 2nd stage Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management of second stage of labour ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Episiotomy Group A,16th Batch,FMS,USJP.
What is an Episiotomy ? Group A,16th Batch,FMS,USJP. Definition An episiotomy is a surgical incision made in the perineum, the area between the vagina and anus. Episiotomies are done during the second stage of labor to expand the opening of the vagina to prevent tearing of the area during the delivery of the baby.
Why ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Types of episiotomy ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
How to do it ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Infiltration of perineal tissue with local anaesthetic  Group A,16th Batch,FMS,USJP.
Performing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
REPAIR OF EPISIOTOMY   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Repair of episiotomy    Group A,16th Batch,FMS,USJP.
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Aim ,[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Third stage Active management The vulva of the mother should be inspected for tears and repaired Mother should be closely monitored in the labour room for 2 hours. 3. Controlled cord traction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4. Examine the placenta for missing cotelydons 1. Oxytocics-10IU of syntocinon Given after delivery of anterior shoulder. 2.Cord clamp-close to vulva Group A,16th Batch,FMS,USJP.
Controlled cord traction Clamp the cord close to the perineum using sponge forceps. Hold the clamped cord and the end of forceps with one hand. Place the other hand just above the woman’s pubic bone and stabilize the uterus by applying counter traction during controlled cord traction. This helps prevent inversion of the uterus. Keep slight tension on the cord and await a strong uterine contraction (2–3 minutes).  Group A,16th Batch,FMS,USJP.
When the uterus becomes rounded or the cord lengthens, very gently pull downward on the cord to deliver the placenta. Do not wait for a gush of blood before applying traction on the cord. Continue to apply counter traction to the uterus with the other hand.  If the placenta does not descend during 30–40 seconds of controlled cord traction (i.e. there are no signs of placental separation), do not continue to pull on the cord:  Gently hold the cord and wait until the uterus is well contracted again. If necessary, use a sponge forceps to clamp the cord closer to the perineum as it lengthens; With the next contraction, repeat controlled cord traction with counter traction.  Never apply cord traction (pull) without applying counter traction (push) above the pubic bone with the other hand.  Group A,16th Batch,FMS,USJP.
1 2 3 4 5 6 Group A,16th Batch,FMS,USJP.
7 8 Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
DEFINITION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Forceps delivery ,[object Object],[object Object],Group A,16th Batch,FMS,USJP. handle lock blade fenestra shank Cephalic curve Pelvic curve
Classification of forceps deliveries ,[object Object],Group A,16th Batch,FMS,USJP. High cavity forceps Biparietal diameter is still above the inlet .head not engaged
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP. Most widely used type Use for outlet&low cavity deliveries  Used in outlet & low cavity deliveries There is a sliing lock No pelvic curve so it allows fetal head to rotate inside the pelvis Uses for mid cavity deliveries Types of obstetric forceps Wrigley’s forceps Simpson’s forceps kieeland’s forceps
Pre-requesites for forceps delivery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Complications after forceps delivery  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Ventouse delivery   ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Indications for vacuum dlivery ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Contraindications for ventouse delivery ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Basic rules for delivery with ventous ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Complicatons of ventouse delivery ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
PAIN RELIEF IN LABOUR
PAIN IN LABOUR IS NOT BENEFICIAL EITHER TO MOTHER OR FETUS PAIN DYSFUNCTIONAL LABOUR UTERINE  VASOCONSTRICTION FETAL ACIDOSIS HYPERVENTILATION Pco 2 MATERNAL  CATECHOLAMINES PLACENTA PERFUSION
WHAT ARE THE METHODS AVAILABLE? ,[object Object],[object Object],[object Object],[object Object]
PHARMACOLOGICAL METHODS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ADVANTAGES:- These drugs can be administered even by midwives without involvement of medical staff ,[object Object],[object Object],[object Object],[object Object]
INHALATIONAL ANALGESIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lower segment caesarean section. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Introduction. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Causes of maternal deaths worldwide. Group A,16th Batch,FMS,USJP.
Etiology… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Uterine atony & PPH with fundal massage. Group A,16th Batch,FMS,USJP.
Etiology. ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Risk Factors  –  Primary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Risk Factors –  Primary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Risk Factors  – Secondary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management.  – Primary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management.  – Primary PPH contd. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Bakri balloon catheter. Group A,16th Batch,FMS,USJP.
Condom attached to a catheter which can be inflated with saline after introducing in to the uterine cavity. Group A,16th Batch,FMS,USJP.
Management.  – Primary PPH contd.   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management.  – Primary PPH contd. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
B-Lynch suture. Group A,16th Batch,FMS,USJP.
Management  – Secondary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management  –  Secondary PPH contd. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Prevention of PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Controlled cord traction. Group A,16th Batch,FMS,USJP.
Manual removal of the placenta. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
History ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
ALWAYS CHECK ; ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
SIGNS ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
GENARAL EXAMINATION ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
ABDOMINAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
VAGINAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
TREATEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
MANAGEMENT OF LABOUR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.

More Related Content

What's hot

Physiological changes during pregnancy
Physiological changes during pregnancyPhysiological changes during pregnancy
Physiological changes during pregnancy
Salini Mandal
 
post partum haemorrhage
post partum haemorrhagepost partum haemorrhage
post partum haemorrhage
farranajwa
 
Normal labour presentation by UM
Normal labour presentation by UMNormal labour presentation by UM
Normal labour presentation by UMDr. Rubz
 
physiology and mecanism of labour
physiology and mecanism of labourphysiology and mecanism of labour
physiology and mecanism of labour
Manu Aravind
 
Assisted vaginal delivery
Assisted vaginal deliveryAssisted vaginal delivery
Assisted vaginal delivery
Waill Altimeemi
 
Abnormal labor
Abnormal laborAbnormal labor
Abnormal labor
Engidaw Ambelu
 
cesarean section
cesarean sectioncesarean section
cesarean section
Ibrahim Awale
 
Prolonged and obstructed labour
Prolonged and obstructed labourProlonged and obstructed labour
Prolonged and obstructed labour
SREEVIDYA UMMADISETTI
 
Polyhydramios
PolyhydramiosPolyhydramios
Polyhydramiosraj kumar
 
Rh negative pregnancy
Rh negative pregnancyRh negative pregnancy
Rh negative pregnancy
obgymgmcri
 
Stages Of Labour
Stages Of LabourStages Of Labour
Stages Of LabourCarolyn m
 
Rupture of the uterus
Rupture of the uterusRupture of the uterus
Rupture of the uterusFahad Zakwan
 
Cephalopelvic disproportion 2021
Cephalopelvic disproportion   2021Cephalopelvic disproportion   2021
Cephalopelvic disproportion 2021
OBGYN Notes
 
Obstructed labor management
Obstructed labor managementObstructed labor management
Obstructed labor management
Beka Aberra
 
Hyperemesis gravidarum
Hyperemesis gravidarumHyperemesis gravidarum
Hyperemesis gravidarum
Niranjan Chavan
 
Rupture uterus
Rupture uterusRupture uterus
Rupture uterus
muhammad al hennawy
 
Normal labour
Normal labourNormal labour
Normal labour
Nirsuba Gurung
 
3 malpresentations.warda (3)- FACE PRESENTATION
3 malpresentations.warda (3)- FACE PRESENTATION3 malpresentations.warda (3)- FACE PRESENTATION
3 malpresentations.warda (3)- FACE PRESENTATION
Osama Warda
 

What's hot (20)

Physiological changes during pregnancy
Physiological changes during pregnancyPhysiological changes during pregnancy
Physiological changes during pregnancy
 
post partum haemorrhage
post partum haemorrhagepost partum haemorrhage
post partum haemorrhage
 
Normal labour presentation by UM
Normal labour presentation by UMNormal labour presentation by UM
Normal labour presentation by UM
 
physiology and mecanism of labour
physiology and mecanism of labourphysiology and mecanism of labour
physiology and mecanism of labour
 
Assisted vaginal delivery
Assisted vaginal deliveryAssisted vaginal delivery
Assisted vaginal delivery
 
Abnormal labor
Abnormal laborAbnormal labor
Abnormal labor
 
cesarean section
cesarean sectioncesarean section
cesarean section
 
Prolonged and obstructed labour
Prolonged and obstructed labourProlonged and obstructed labour
Prolonged and obstructed labour
 
D&C
D&CD&C
D&C
 
Polyhydramios
PolyhydramiosPolyhydramios
Polyhydramios
 
Rh negative pregnancy
Rh negative pregnancyRh negative pregnancy
Rh negative pregnancy
 
Stages Of Labour
Stages Of LabourStages Of Labour
Stages Of Labour
 
Rupture of the uterus
Rupture of the uterusRupture of the uterus
Rupture of the uterus
 
Cephalopelvic disproportion 2021
Cephalopelvic disproportion   2021Cephalopelvic disproportion   2021
Cephalopelvic disproportion 2021
 
Obstructed labor management
Obstructed labor managementObstructed labor management
Obstructed labor management
 
Hyperemesis gravidarum
Hyperemesis gravidarumHyperemesis gravidarum
Hyperemesis gravidarum
 
Rupture uterus
Rupture uterusRupture uterus
Rupture uterus
 
Ectopic pregnancy
Ectopic pregnancyEctopic pregnancy
Ectopic pregnancy
 
Normal labour
Normal labourNormal labour
Normal labour
 
3 malpresentations.warda (3)- FACE PRESENTATION
3 malpresentations.warda (3)- FACE PRESENTATION3 malpresentations.warda (3)- FACE PRESENTATION
3 malpresentations.warda (3)- FACE PRESENTATION
 

Similar to Normal Labour

Obstetric terminology
Obstetric terminologyObstetric terminology
Obstetric terminologyberbets
 
Managing normal labor
Managing normal laborManaging normal labor
Managing normal labor
Eneutron
 
process of Normal labor (1).ppt
process of Normal labor (1).pptprocess of Normal labor (1).ppt
process of Normal labor (1).ppt
MohnnadHmoodAlgarayb
 
Labor dystocia
Labor dystociaLabor dystocia
Labor dystociaCubic Zeal
 
Intrapartum fetal monitering
Intrapartum fetal moniteringIntrapartum fetal monitering
Intrapartum fetal moniteringdrmcbansal
 
Antepartum testing
Antepartum testingAntepartum testing
Antepartum testing
Debbie Fritz
 
Physiology of labor
Physiology of laborPhysiology of labor
Physiology of labor
sarahracal
 
Physiotherapy In Surgical Condition (Labour) 3rd year
Physiotherapy In Surgical Condition (Labour) 3rd  yearPhysiotherapy In Surgical Condition (Labour) 3rd  year
Physiotherapy In Surgical Condition (Labour) 3rd year
Konika Akter
 
Tracheo esophageal fistula
Tracheo esophageal fistula Tracheo esophageal fistula
Tracheo esophageal fistula
Dr.Manish Kumar
 
Tracheo esophageal fistula
Tracheo esophageal fistulaTracheo esophageal fistula
Tracheo esophageal fistula
Dr.Manish Kumar
 
Labour and Partograph.pptx
Labour and Partograph.pptxLabour and Partograph.pptx
Labour and Partograph.pptx
NurulHanimAzahari
 
History and clinical examination in obstetrics
History and clinical examination in obstetricsHistory and clinical examination in obstetrics
History and clinical examination in obstetrics
dr shabnam naz shaikh
 
Displacement of the uterus
Displacement of the uterusDisplacement of the uterus
Displacement of the uterus
ahmed afify
 
obstetrical emergencies
obstetrical emergenciesobstetrical emergencies
obstetrical emergencies
Saima Habeeb
 
Late pregnancy bleeding
Late pregnancy bleedingLate pregnancy bleeding
Late pregnancy bleeding
Eneutron
 
Effects of anesthesia on mother and baby
Effects of anesthesia on mother and babyEffects of anesthesia on mother and baby
Effects of anesthesia on mother and baby
DrVishal Kandhway
 
Oxytocics finalised-110713081015-phpapp02
Oxytocics finalised-110713081015-phpapp02Oxytocics finalised-110713081015-phpapp02
Oxytocics finalised-110713081015-phpapp02Richa Daniel
 
Effects of anesthesia on mother &amp; baby
Effects of anesthesia on mother &amp; babyEffects of anesthesia on mother &amp; baby
Effects of anesthesia on mother &amp; baby
DrVishal Kandhway
 

Similar to Normal Labour (20)

Obstetric terminology
Obstetric terminologyObstetric terminology
Obstetric terminology
 
Managing normal labor
Managing normal laborManaging normal labor
Managing normal labor
 
process of Normal labor (1).ppt
process of Normal labor (1).pptprocess of Normal labor (1).ppt
process of Normal labor (1).ppt
 
Labor dystocia
Labor dystociaLabor dystocia
Labor dystocia
 
Normal labour
 	Normal labour			 	Normal labour
Normal labour
 
Intrapartum fetal monitering
Intrapartum fetal moniteringIntrapartum fetal monitering
Intrapartum fetal monitering
 
Antepartum testing
Antepartum testingAntepartum testing
Antepartum testing
 
poor progress of labour
poor progress of labourpoor progress of labour
poor progress of labour
 
Physiology of labor
Physiology of laborPhysiology of labor
Physiology of labor
 
Physiotherapy In Surgical Condition (Labour) 3rd year
Physiotherapy In Surgical Condition (Labour) 3rd  yearPhysiotherapy In Surgical Condition (Labour) 3rd  year
Physiotherapy In Surgical Condition (Labour) 3rd year
 
Tracheo esophageal fistula
Tracheo esophageal fistula Tracheo esophageal fistula
Tracheo esophageal fistula
 
Tracheo esophageal fistula
Tracheo esophageal fistulaTracheo esophageal fistula
Tracheo esophageal fistula
 
Labour and Partograph.pptx
Labour and Partograph.pptxLabour and Partograph.pptx
Labour and Partograph.pptx
 
History and clinical examination in obstetrics
History and clinical examination in obstetricsHistory and clinical examination in obstetrics
History and clinical examination in obstetrics
 
Displacement of the uterus
Displacement of the uterusDisplacement of the uterus
Displacement of the uterus
 
obstetrical emergencies
obstetrical emergenciesobstetrical emergencies
obstetrical emergencies
 
Late pregnancy bleeding
Late pregnancy bleedingLate pregnancy bleeding
Late pregnancy bleeding
 
Effects of anesthesia on mother and baby
Effects of anesthesia on mother and babyEffects of anesthesia on mother and baby
Effects of anesthesia on mother and baby
 
Oxytocics finalised-110713081015-phpapp02
Oxytocics finalised-110713081015-phpapp02Oxytocics finalised-110713081015-phpapp02
Oxytocics finalised-110713081015-phpapp02
 
Effects of anesthesia on mother &amp; baby
Effects of anesthesia on mother &amp; babyEffects of anesthesia on mother &amp; baby
Effects of anesthesia on mother &amp; baby
 

Recently uploaded

ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIONDACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
DR SETH JOTHAM
 
Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
Shweta
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
aljamhori teaching hospital
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
د.محمود نجيب
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
addon Scans
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
MedicoseAcademics
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
DR SETH JOTHAM
 
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
pal078100
 
New Drug Discovery and Development .....
New Drug Discovery and Development .....New Drug Discovery and Development .....
New Drug Discovery and Development .....
NEHA GUPTA
 
Cervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptxCervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidadeNovas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Prof. Marcus Renato de Carvalho
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Oleg Kshivets
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
Dr. Rabia Inam Gandapore
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
Swetaba Besh
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Saeid Safari
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
FFragrant
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
touseefaziz1
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Dr KHALID B.M
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
vimalpl1234
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
MedicoseAcademics
 

Recently uploaded (20)

ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIONDACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
 
Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
 
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
 
New Drug Discovery and Development .....
New Drug Discovery and Development .....New Drug Discovery and Development .....
New Drug Discovery and Development .....
 
Cervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptxCervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptx
 
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidadeNovas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
 

Normal Labour

  • 1. Group A 16th Batch Faculty Of Medicine USJP. Group A,16th Batch,FMS,USJP.
  • 3.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11. Deeper view Group A,16th Batch,FMS,USJP.
  • 14. Anatomy of the fetal skull Vault mainly consists of 2 parietal bones, parts of occipital, frontal and temporal bones. Bones are joined to each other by soft unossified membranes, known as sutures. Group A,16th Batch,FMS,USJP. skull vault face base
  • 15.
  • 16.
  • 17.
  • 18. Lateral and posterior view of moulding of the foetal skull Group A,16th Batch,FMS,USJP.
  • 19.
  • 20. Exact physiological mechanism of initiation of parturition is still unknown. But there are some processes that are of particular importance. Group A,16th Batch,FMS,USJP.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 36.
  • 38.
  • 39.
  • 42. Cardiotocography is a method of monitoring fetal heart rate (indirect method) by using ultrasound technique. Group A,16th Batch,FMS,USJP.
  • 43.
  • 44.
  • 45.
  • 46.
  • 48.
  • 49.
  • 50.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57. THE PARTOGRAM Group A,16th Batch,FMS,USJP.
  • 58.
  • 59. THE PARTOGRAM Group A,16th Batch,FMS,USJP. Foetal Conditions Progress of Labour Maternal Conditions
  • 60.
  • 61.
  • 62.
  • 63.
  • 64. PARTOGRAM Group A,16th Batch,FMS,USJP. ALERT LINE ACTION LINE LSCS
  • 65.
  • 66.
  • 67. Group A,16th Batch,FMS,USJP. Observation of the colour of the liqour Mainly - fresh meconium staining If Meconium is present – watch more closely for signs of fetal distress Thin meconium - not much of a risk Thick meconium - more dangerous Fetal heart rate -checked every 15 minutes If suspicious / eg- fetal bradicardia Apply CTG and monitor Maternal information write here; Date EDD POA BP Blood Gp Blood taken for DT
  • 68.
  • 69.
  • 70.
  • 72. Secondary Arrest of Active Phase • Definition – No change in cervical dilatation over a period of 2hrs. Cervix becomes oedematous. Can occur at 4-7 cm dilatation or as a protracted Deceleration phase • Aetiology – CephaloPelvic Disproportion [often absolute] – Foetal head malposition or malpresentation [breech] – Insufficient uterine action – Excessive sedation • Outcome – Will require LSCS. If protracted deceleration beware of shoulder impaction Group A,16th Batch,FMS,USJP.
  • 73.  
  • 74.
  • 75.
  • 76.
  • 77.
  • 79.
  • 80.
  • 81.
  • 82.
  • 83.
  • 84.
  • 85.
  • 86.
  • 87. Foley catheter insertion
  • 88.
  • 90.
  • 91.
  • 93.
  • 95.
  • 97.
  • 99.
  • 101.
  • 103.
  • 104.
  • 106. 1 st stage of labour Latent phase Active phase Group A,16th Batch,FMS,USJP.
  • 107.
  • 108.
  • 109.
  • 110.
  • 111.
  • 112.
  • 113.
  • 114. Group A,16th Batch,FMS,USJP. 2nd stage Phase 1( Passive Phase): a) No maternal urge to push b) Fetal head is high c) Sagittal suture is in the transverse position Phase 2( Active Phase): a) Maternal urge to push is present b) Fetal head is low c) Sagittal suture is in the anterior-posterior position d) bearing down sensation
  • 115.
  • 116.
  • 117.
  • 118.
  • 119.
  • 120.
  • 121.
  • 123.
  • 124. Episiotomy Group A,16th Batch,FMS,USJP.
  • 125. What is an Episiotomy ? Group A,16th Batch,FMS,USJP. Definition An episiotomy is a surgical incision made in the perineum, the area between the vagina and anus. Episiotomies are done during the second stage of labor to expand the opening of the vagina to prevent tearing of the area during the delivery of the baby.
  • 126.
  • 127.
  • 129.
  • 130. Infiltration of perineal tissue with local anaesthetic Group A,16th Batch,FMS,USJP.
  • 131.
  • 132.
  • 133. Repair of episiotomy   Group A,16th Batch,FMS,USJP.
  • 134.
  • 135.
  • 136.
  • 137.
  • 138. Controlled cord traction Clamp the cord close to the perineum using sponge forceps. Hold the clamped cord and the end of forceps with one hand. Place the other hand just above the woman’s pubic bone and stabilize the uterus by applying counter traction during controlled cord traction. This helps prevent inversion of the uterus. Keep slight tension on the cord and await a strong uterine contraction (2–3 minutes). Group A,16th Batch,FMS,USJP.
  • 139. When the uterus becomes rounded or the cord lengthens, very gently pull downward on the cord to deliver the placenta. Do not wait for a gush of blood before applying traction on the cord. Continue to apply counter traction to the uterus with the other hand. If the placenta does not descend during 30–40 seconds of controlled cord traction (i.e. there are no signs of placental separation), do not continue to pull on the cord: Gently hold the cord and wait until the uterus is well contracted again. If necessary, use a sponge forceps to clamp the cord closer to the perineum as it lengthens; With the next contraction, repeat controlled cord traction with counter traction. Never apply cord traction (pull) without applying counter traction (push) above the pubic bone with the other hand. Group A,16th Batch,FMS,USJP.
  • 140. 1 2 3 4 5 6 Group A,16th Batch,FMS,USJP.
  • 141. 7 8 Group A,16th Batch,FMS,USJP.
  • 143.
  • 144.
  • 145.
  • 146.
  • 147. Group A,16th Batch,FMS,USJP. Most widely used type Use for outlet&low cavity deliveries Used in outlet & low cavity deliveries There is a sliing lock No pelvic curve so it allows fetal head to rotate inside the pelvis Uses for mid cavity deliveries Types of obstetric forceps Wrigley’s forceps Simpson’s forceps kieeland’s forceps
  • 148.
  • 149.
  • 150.
  • 151.
  • 152.
  • 153.
  • 154.
  • 155.
  • 156.
  • 157. PAIN RELIEF IN LABOUR
  • 158. PAIN IN LABOUR IS NOT BENEFICIAL EITHER TO MOTHER OR FETUS PAIN DYSFUNCTIONAL LABOUR UTERINE VASOCONSTRICTION FETAL ACIDOSIS HYPERVENTILATION Pco 2 MATERNAL CATECHOLAMINES PLACENTA PERFUSION
  • 159.
  • 160.
  • 161.
  • 162.
  • 163.
  • 164.
  • 165.
  • 166.
  • 167.
  • 169.
  • 170. Causes of maternal deaths worldwide. Group A,16th Batch,FMS,USJP.
  • 171.
  • 172. Uterine atony & PPH with fundal massage. Group A,16th Batch,FMS,USJP.
  • 173.
  • 174.
  • 175.
  • 176.
  • 177.
  • 178.
  • 179. Bakri balloon catheter. Group A,16th Batch,FMS,USJP.
  • 180. Condom attached to a catheter which can be inflated with saline after introducing in to the uterine cavity. Group A,16th Batch,FMS,USJP.
  • 181.
  • 182.
  • 183. B-Lynch suture. Group A,16th Batch,FMS,USJP.
  • 184.
  • 185.
  • 186.
  • 187. Controlled cord traction. Group A,16th Batch,FMS,USJP.
  • 188.
  • 189.
  • 190.
  • 191.
  • 192.
  • 193.
  • 194.
  • 195.
  • 196.
  • 197.
  • 198.
  • 199.
  • 200.
  • 201.
  • 202.

Editor's Notes

  1. Shimmy - Start