The document discusses normal labour and delivery, defining it as the spontaneous expulsion of a single, mature fetus between 37-42 weeks of gestation through the birth canal without complications. It describes the stages of labour as first, second and third stage. The first stage involves cervical dilation and effacement in latent and active phases. Contractions increase in frequency and strength during this stage. The second stage begins with full dilation and ends with baby's birth. The third stage involves delivery of the placenta. Factors influencing labour progress like passenger, passage and power are also summarized.
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
nurses/doctor will insert two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen. During this part of the exam, your doctor will check the size and shape of your uterus and ovaries, noting any tender areas or unusual growths.
Cervical ripening is the preparation of the cervix for labour and delivery. The Bishop score is the commonest used methodology to assess it. For more like this visit my page on YouTube https://www.youtube.com/@mudiagaakpoghene2243
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
nurses/doctor will insert two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen. During this part of the exam, your doctor will check the size and shape of your uterus and ovaries, noting any tender areas or unusual growths.
Cervical ripening is the preparation of the cervix for labour and delivery. The Bishop score is the commonest used methodology to assess it. For more like this visit my page on YouTube https://www.youtube.com/@mudiagaakpoghene2243
Obstetrics and Gynecological Nursing
The PPT contains detailed information about Abnormal uterine action, its classifications, causes, sign and symptoms and management.
This topic includes Introduction for analgesia and anesthesia used in obstetrics, maternal risk factors for anesthesia, anatomical and physiological considerations, analgesia during labour and delivery, sedatives and analgesia, opioid analgesics, combination of narcotics and antiemetics, inhalation methods, commonly used local anesthesia in obstetrics, spinal anesthesia, infiltration anesthesia, patient controlled anesthesia, psychoprophylaxis, general anesthesia for cesarean section, complication of general anesthesia and its management.
AMNIOINFUSION--
definition-An amnioinfusion is a technique of instilling an isotonic fluid {such as a normal saline or lactated ringer’s solution} into the amniotic cavity during labor to relieve umbilical cord compression and alleviate fetal distress from severe prolonged variable decelerations in the presence of oligohydramnios.
INDICATIONS
Fetal heart rate abnormalities
APGAR scores for those with low scores
Asphyxia during time of birth
Decreasing the rates of cesarean birth related with FHR problem
PROCEDURE
The amnio infusion procedure involves the use of an intrauterine pressure catheter (IUPC), or a single or double lumen type of IUPC.
The IUPC has been designed to attain an accurate monitoring of uterine contractions among women in the intrapartum period.
It has a special port from which the saline fluid or lactated ringer’s solution is being injected, passing through the tubing and going its way into the uterus.
An IUPC is inserted through standard technique once the membranes ruptures, and then it is attached to intravenous extension tubing. If IUPC is not available, a pediatric nasogastric tube can be used instead.
Lactated ringer’s solution without dextrose is infused into the amniotic cavity; normal saline can be an acceptable fluid alternative
Assisting Physician with Amnioinfusion
Explain the procedure to the patient.
Assist in dorsal recumbent position. Assist with draping and exposing vaginal area.
Connect IUPC tubing to IV fluid, flush
Connect the catheter to the monitor cable
Assist physician with insertion of double lumen IUPC and connect IV tubing to the amnioport to begin amnioinfusion.
Fourth stage of labor: The hour or two after delivery when the tone of the uterus is reestablished as the uterus contracts again, expelling any remaining contents. These contractions are hastened by breastfeeding, which stimulates production of the hormone oxytocin.
Obstetrics and Gynecological Nursing
The PPT contains detailed information about Abnormal uterine action, its classifications, causes, sign and symptoms and management.
This topic includes Introduction for analgesia and anesthesia used in obstetrics, maternal risk factors for anesthesia, anatomical and physiological considerations, analgesia during labour and delivery, sedatives and analgesia, opioid analgesics, combination of narcotics and antiemetics, inhalation methods, commonly used local anesthesia in obstetrics, spinal anesthesia, infiltration anesthesia, patient controlled anesthesia, psychoprophylaxis, general anesthesia for cesarean section, complication of general anesthesia and its management.
AMNIOINFUSION--
definition-An amnioinfusion is a technique of instilling an isotonic fluid {such as a normal saline or lactated ringer’s solution} into the amniotic cavity during labor to relieve umbilical cord compression and alleviate fetal distress from severe prolonged variable decelerations in the presence of oligohydramnios.
INDICATIONS
Fetal heart rate abnormalities
APGAR scores for those with low scores
Asphyxia during time of birth
Decreasing the rates of cesarean birth related with FHR problem
PROCEDURE
The amnio infusion procedure involves the use of an intrauterine pressure catheter (IUPC), or a single or double lumen type of IUPC.
The IUPC has been designed to attain an accurate monitoring of uterine contractions among women in the intrapartum period.
It has a special port from which the saline fluid or lactated ringer’s solution is being injected, passing through the tubing and going its way into the uterus.
An IUPC is inserted through standard technique once the membranes ruptures, and then it is attached to intravenous extension tubing. If IUPC is not available, a pediatric nasogastric tube can be used instead.
Lactated ringer’s solution without dextrose is infused into the amniotic cavity; normal saline can be an acceptable fluid alternative
Assisting Physician with Amnioinfusion
Explain the procedure to the patient.
Assist in dorsal recumbent position. Assist with draping and exposing vaginal area.
Connect IUPC tubing to IV fluid, flush
Connect the catheter to the monitor cable
Assist physician with insertion of double lumen IUPC and connect IV tubing to the amnioport to begin amnioinfusion.
Fourth stage of labor: The hour or two after delivery when the tone of the uterus is reestablished as the uterus contracts again, expelling any remaining contents. These contractions are hastened by breastfeeding, which stimulates production of the hormone oxytocin.
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.
Series of events that takes place in the genital organ in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called labour.
there are four stages of labour.
a detail study on normal labour ( definition, stages of labour, management ,p...martinshaji
The World Health Organization (WHO) defines normal birth as follows: The birth is spontaneous in onset and low risk at the start of labor and remains so throughout labor and delivery. The infant is born spontaneously in the vertex position between 37 and 42 weeks of pregnancy. this is study on detailed study on physiology and stages of normal labour .
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HIV discrimination among health providers in Malaysia by Dr RubzDr. Rubz
Although doctors took oath that they will treat everyone the best they can and without judging anyone but discrimination still exist especially in HIV affected people. Due to this issue, Pertubuhan Advokasi Masyarakat Terpinggir Malaysia has taken a step to engage with doctors at government sector and desensitize them and find the line to stand together.
Testicular cancer for public awareness by Dr RubzDr. Rubz
A presentation prepared for Charity Dinner with Fun Charity. All the profits of the event will go to FReHA (a NGO which supports women's and reproductive health.)
Prostate cancer for public awareness by DR RUBZDr. Rubz
A presentation prepared for Charity Dinner with Fun Charity. All the profits of the event will go to FReHA (a NGO which supports women's and reproductive health.)
Breast Cancer for public awareness by Dr RubzDr. Rubz
A presentation prepared for Charity Dinner with Fun Charity. All the profits of the event will go to FReHA (a NGO which supports women's and reproductive health.)
This is the first phase (qualitative) of the current project we are working on with the supervision of University Malaya and Yale School of Medicine.It will be publish as IBBS 2013 by end of the year. This slide is just a rough picture of what we are doing at the moment. This is copyright protected!
1. NORMAL LABOUR AND DELIVERY Prof Dr MOHD AZHAR MN ROYAL COLLEGE OF MEDICINE PERAK APRIL 2005 DEPARTMENT OF OBST & GYNAE RCMP
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3. Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY WHAT IS NORMAL LABOUR ?
4. NORMAL LABOUR APRIL 2005 DEPARTMENT OF OBST & GYNAE RCMP Labour is defined as the onset of regular painful contractions with progressive cervical effacement and dilatation of the cervix accompanied by descent of the presenting part . DEFINITIONS
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7. Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY WHAT FACTORS INFLUENCE PROGRESS OF LABOUR ?
8. LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY FACTORS THAT INFLUENCE PROGRESS OF LABOUR Passenger Passage 3 "P" Power
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11. THE NORMAL FEMALE PELVIS Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY The important diameters of the female pelvis : Anteroposterior Oblique Transverse BRIM 11 – 11.5 12 12.5 CAVITY 12 12 12 OUTLET 12.5 12 11- 11.5 Diameters (cm)
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14. THE FETAL SKULL Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY MOULDING OF THE FETAL SKULL MOULDING ’ is the ability of the fetal head to change its shape and so to adapt itself to the unyielding maternal pelvis during the progress of labour. This property is of the greatest value in the progress of labour.
15. THE FETAL SKULL Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY Diameters of the fetal skull – anterior posterior diameters A B C D E F G AB ~ Suboccipto bregmatic – 9.5 AC ~ Submento bregmatic – 9.5 DE ~ Occipito frontal ~ 11.0 FG ~ Mento vertical – 13.5
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18. LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY WHAT INITIATE LABOUR “ ONSET OF LABOUR”
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20. LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY DIAGNOSIS OF LABOUR
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22. LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY DESCRIBE THE STAGES OF LABOUR
23. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” STAGES OF LABOUR Labour can be divided into three stages , which are unequal in length. The third stage is that of separation and expulsion of placenta and membranes and also involves the control of bleeding. It begins after the birth of the baby and ends with the expulsion of the placenta and membranes. This is the shortest stage, lasting up to 30 minutes, with an average length of 5 to 10 minutes. There is no difference in duration for nulliparous and parous . The second stage of labour begins with complete dilatation of the cervix and ends with the birth of the baby. The duration is about 1 to 1½ hours in nulliparas and about 30 to 45 minutes in parous women. It begins with the onset of true labour contractions and ends when the cervix is fully dilated (10 cm). Cervical effacement and dilatation occur in the first stage First stage of labour consists of two phases:- latent and active . The first stage of labour is the longest for both nulliparous and parous women. THIRD STAGE SECOND STAGE FIRST STAGE
27. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” WHAT HAPPEN DURING THE FIRST STAGE OF LABOUR
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31. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” Do Uterine Contractions Affect Fetal Heart Rate? Uterine contractions can affect fetal heart rate by increasing or decreasing that rate in association with any given contraction. The three primary mechanisms by which uterine contractions can cause a decrease in fetal heart rate are compression of: · Fetal head · Umbilical cord · Uterine myometrial vessels FETAL HEART CHANGES
42. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MANAGEMENT FIRST STAGE OF LABOUR
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50. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MONITORING FETAL HEART How Do Uterine Contractions Affect Fetal Heart Rate? Uterine contractions can affect fetal heart rate by increasing or decreasing that rate in association with any given contraction. The three primary mechanisms by which uterine contractions can cause a decrease in fetal heart rate are compression of: · Fetal head · Umbilical cord · Uterine myometrial vessels
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52. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MONITORING FETAL HEART To detect fetal hypoxia NORMAL ABNORMAL
54. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” RECORDING THE PROGRESS OF LABOUR PATIENT INFORMATION FETAL INFORMATION ~ fetal well being LABOUR INFORMATION ~ Dilatation ~ Descent ~ Contraction MEDICATIONS MATERNAL INFORMATION ~ Well being PARTOGRAM
55. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” RECORDING THE PROGRESS OF LABOUR - Partogram Patient information : Fill out name, gravida, para, hospital number, date and time of admission and time of ruptured membranes. Fetal heart rate : Record every half hour. Amniotic fluid : Record the colour of amniotic fluid at every vaginal examination: I: membranes intact; C: membranes ruptured, clear fluid; M: meconium-stained fluid; B: blood-stained fluid. Moulding : 1: sutures apposed; 2: sutures overlapped but reducible; 3: sutures overlapped and not reducible.
56. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” RECORDING THE PROGRESS OF LABOUR - Partogram Cervical dilatation : Assessed at every vaginal examination and marked with a cross ( X ). Begin plotting on the partograph at 3 cm. Station : recorded as a circle ( O ) at every vaginal examination. Contractions : Chart every half hour; palpate the number of contractions in 10 minutes and their duration in seconds. Less than 20 seconds: Between 20 and 40 seconds: More than 40 seconds: Assess the progress of labour:
57. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” RECORDING THE PROGRESS OF LABOUR - Partogram Oxytocin : Record the amount of oxytocin every 30 minutes when used. Drugs given : Record any additional drugs given – e.g. Pethidine Pulse : Record every 30 minutes and mark with a dot (●). Blood pressure : Record every 4 hours and mark with arrows ( ) Temperature : Record every 2 hours. Protein, acetone and volume: Record every time urine is passed. Progress of maternal well being:
58. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MANAGEMENT SECOND STAGE OF LABOUR
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69. LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY THE MECHANISMS OF NORMAL LABOUR - Occiput anterior -
70. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” Occiput anterior (OA) Anterior Pubis Sacrum Posterior Right Left Occipital bone
71. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” Occiput anterior positions
72. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MECHANISM OF LABOUR for occiput anterior The “mechanism of labour” refers to the sequencing of events related to posturing and positioning that allows the baby to find the “easiest way out”. For a normal mechanism of labour to occur, both the fetal and maternal factors must be harmonious. DEFINITION:
73. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MECHANISM OF LABOUR for occiput anterior Events of mechanism of labour: F: Flexion and descent I: Internal rotation of the fetal head C: Crowning E: Extension R: Restitution I : Internal rotation of the shoulders E: External rotation of the fetal head L: Lateral flexion of the body
74. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MECHANISM OF LABOUR for occiput anterior (OA) Descend Flexion Internal rotation Crowning Extension Restitution Internal rotation of shoulder External rotation of head Lateral flexion of body LOA LOA OA LOA OA OA LOT Delivery F I C E R I E L
75. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MANAGEMENT THIRD STAGE OF LABOUR
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78. LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY WHAT ARE THE SIGNS OF PLACENTA SEPARATION
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81. LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOUR
82. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MANAGEMENT OF THE THIRD STAGE OF LABOUR ACTIVE MANAGEMENT OF THE THIRD STAGE Active management of the third stage (active delivery of the placenta) helps prevent postpartum haemorrhage . Active management of the third stage of labour includes: ~ use of oxytocin ~ controlled cord traction, and ~ uterine massage .
83. NORMAL LABOUR AND DELIVERY Prof DR MOHD AZHAR – “NOMAL LABOUR & DELIVERY” MANAGEMENT OF THE THIRD STAGE OF LABOUR ACTIVE MANAGEMENT OF THE THIRD STAGE ~ Use of oxytocin Oxytocic drugs should be given with the birth of the anterior shoulder. Syntocinon is the most used oxytocic known to be effective; the addition of ergometrine may reduce blood loss. SYNTOMETRINE (oxytocin 5 IU + ergometrine 0.5 mg) – widely used