Labor management involves defining labor, listing the stages of labor, and discussing the management of each stage as well as abnormal labor. Labor begins with the onset of regular uterine contractions and ends with delivery of the newborn and placenta. It has four stages: 1) onset of labor to full cervical dilation; 2) full dilation to delivery of fetus; 3) delivery of fetus to delivery of placenta; 4) one to two hours after placenta delivery. The WHO partograph is a graphic record of labor that allows monitoring of labor progress and fetal/maternal condition to facilitate early detection and management of abnormalities.
This document discusses antenatal care (ANC). It begins with the historical background of ANC, noting it was introduced in the US in the early 1900s by social reformers and nurses. It then outlines the organization, objectives, and models of ANC, including the traditional routine model and the focused ANC model recommended by WHO. The main activities covered in ANC are described, such as health screening, counseling, birth preparedness, and monitoring fetal well-being. Key interventions like immunizations and treatment for conditions like malaria and anemia are also highlighted.
Maternal and child health (MCH) services aim to provide comprehensive healthcare to pregnant women, mothers, and young children. The key goals are to reduce mortality and morbidity during pregnancy and childbirth, promote healthy growth and development of children, and regulate fertility through family planning services. MCH services include antenatal, natal, and postnatal care for mothers as well as immunizations, nutrition monitoring, and illness treatment for children from birth to age five. The document outlines the various components and objectives of MCH at each stage of care.
This document provides guidance for routine antenatal care for healthy pregnant women. It summarizes information that should be provided to women at various stages of pregnancy, including lifestyle considerations, screening tests, fetal development and birth preparation. The guidance emphasizes woman-centered care and informed decision making. Healthcare professionals are advised to offer consistent information to enable women to make choices about their care.
The WHO Guideline on Antenatal Care (2016) provides recommendations on antenatal care for pregnant women. It was developed through a review of evidence on interventions during antenatal care and consideration of factors like benefits, harms, feasibility and equity. The guideline contains 49 recommendations grouped into nutritional interventions, maternal and fetal assessment, preventive measures, common symptoms, and health systems interventions. The recommendations provide advice on issues like nutrition, tests, preventative treatments, and care models to improve outcomes for women and babies.
The document discusses strategies to promote institutional deliveries, specifically in Primary Health Centres (PHCs). It outlines the benefits of institutional deliveries including access to skilled birth attendants, equipment, treatment of complications, and neonatal care. PHCs are promoted as they are nearby, well-equipped to handle normal deliveries, and have no financial constraints. Community awareness is raised through various IEC activities by frontline workers. Antenatal checkups, immunizations, and identification of high-risk mothers are emphasized. PHCs aim to be open 24/7 with trained staff, drugs, and equipment to handle deliveries and referrals.
This document discusses the importance of skilled birth attendants in managing normal pregnancies and childbirth, as well as identifying and referring complications in women and newborns. It states that about 15% of pregnancies develop complications that cannot be predicted and some may be life-threatening. The World Health Organization defines a skilled birth attendant as a health professional trained to manage uncomplicated pregnancies and childbirth, as well as identify, manage, and refer complications. The document emphasizes the need for timely intervention in obstetric emergencies and notes the increased risk of casualties when midwifery skills are absent. It outlines the knowledge and skills needed in training community health workers to take on roles as skilled birth attendants.
Guidelines for antenatal care and skilled attendance at birth by ANMs/LHVs/SNsAnil Mishra
Abstract:
Prepared by the MOHFW in 2010 to strengthen and operationalise the 24X7 PHCs and designated FRUs in handling Basic and Comprehensive Obstetric Care including Care at Birth, this guideline reorients the service providers particularly the Auxiliary Nurse Midwives (ANMs), Staff Nurses (SNs), and Lady Health Visitors (LHVs) for providing skilled care during pregnancy and childbirth.
Keywords: Maternal Health, Newborn Child Health, Quality of Care, Health workers, ANC, Obstetric care, Guidelines, Government
Year of Publication: 2010
Source: MoHFW
This document discusses postnatal care policies, programs, and implementation in Nepal. It provides an overview of the aims of postnatal care, importance of PNC, complications addressed, WHO recommendations on PNC timing and services, Nepal's PNC policies and national health strategies, PNC programs in Nepal, challenges to effective PNC, and recommendations to strengthen PNC. Key policies and plans aim to reduce maternal mortality, increase births attended by skilled birth attendants, and expand PNC services. Gaps in PNC utilization still exist in rural areas and among disadvantaged groups.
This document discusses antenatal care (ANC). It begins with the historical background of ANC, noting it was introduced in the US in the early 1900s by social reformers and nurses. It then outlines the organization, objectives, and models of ANC, including the traditional routine model and the focused ANC model recommended by WHO. The main activities covered in ANC are described, such as health screening, counseling, birth preparedness, and monitoring fetal well-being. Key interventions like immunizations and treatment for conditions like malaria and anemia are also highlighted.
Maternal and child health (MCH) services aim to provide comprehensive healthcare to pregnant women, mothers, and young children. The key goals are to reduce mortality and morbidity during pregnancy and childbirth, promote healthy growth and development of children, and regulate fertility through family planning services. MCH services include antenatal, natal, and postnatal care for mothers as well as immunizations, nutrition monitoring, and illness treatment for children from birth to age five. The document outlines the various components and objectives of MCH at each stage of care.
This document provides guidance for routine antenatal care for healthy pregnant women. It summarizes information that should be provided to women at various stages of pregnancy, including lifestyle considerations, screening tests, fetal development and birth preparation. The guidance emphasizes woman-centered care and informed decision making. Healthcare professionals are advised to offer consistent information to enable women to make choices about their care.
The WHO Guideline on Antenatal Care (2016) provides recommendations on antenatal care for pregnant women. It was developed through a review of evidence on interventions during antenatal care and consideration of factors like benefits, harms, feasibility and equity. The guideline contains 49 recommendations grouped into nutritional interventions, maternal and fetal assessment, preventive measures, common symptoms, and health systems interventions. The recommendations provide advice on issues like nutrition, tests, preventative treatments, and care models to improve outcomes for women and babies.
The document discusses strategies to promote institutional deliveries, specifically in Primary Health Centres (PHCs). It outlines the benefits of institutional deliveries including access to skilled birth attendants, equipment, treatment of complications, and neonatal care. PHCs are promoted as they are nearby, well-equipped to handle normal deliveries, and have no financial constraints. Community awareness is raised through various IEC activities by frontline workers. Antenatal checkups, immunizations, and identification of high-risk mothers are emphasized. PHCs aim to be open 24/7 with trained staff, drugs, and equipment to handle deliveries and referrals.
This document discusses the importance of skilled birth attendants in managing normal pregnancies and childbirth, as well as identifying and referring complications in women and newborns. It states that about 15% of pregnancies develop complications that cannot be predicted and some may be life-threatening. The World Health Organization defines a skilled birth attendant as a health professional trained to manage uncomplicated pregnancies and childbirth, as well as identify, manage, and refer complications. The document emphasizes the need for timely intervention in obstetric emergencies and notes the increased risk of casualties when midwifery skills are absent. It outlines the knowledge and skills needed in training community health workers to take on roles as skilled birth attendants.
Guidelines for antenatal care and skilled attendance at birth by ANMs/LHVs/SNsAnil Mishra
Abstract:
Prepared by the MOHFW in 2010 to strengthen and operationalise the 24X7 PHCs and designated FRUs in handling Basic and Comprehensive Obstetric Care including Care at Birth, this guideline reorients the service providers particularly the Auxiliary Nurse Midwives (ANMs), Staff Nurses (SNs), and Lady Health Visitors (LHVs) for providing skilled care during pregnancy and childbirth.
Keywords: Maternal Health, Newborn Child Health, Quality of Care, Health workers, ANC, Obstetric care, Guidelines, Government
Year of Publication: 2010
Source: MoHFW
This document discusses postnatal care policies, programs, and implementation in Nepal. It provides an overview of the aims of postnatal care, importance of PNC, complications addressed, WHO recommendations on PNC timing and services, Nepal's PNC policies and national health strategies, PNC programs in Nepal, challenges to effective PNC, and recommendations to strengthen PNC. Key policies and plans aim to reduce maternal mortality, increase births attended by skilled birth attendants, and expand PNC services. Gaps in PNC utilization still exist in rural areas and among disadvantaged groups.
This document outlines the key components of preconception care, which includes performing a thorough risk assessment through medical history, family history, lifestyle factors, immunizations and testing for infectious diseases. The goals are to identify any conditions that could impact a pregnancy and allow for interventions to improve outcomes. A complete preconception evaluation involves counseling on nutrition, contraception, genetic risks and making any necessary referrals. Done correctly, preconception counseling can help reduce risks and complications during pregnancy through education and encouraging healthy habits prior to conception.
The document discusses maternal and child health nursing. It aims to ensure the health of expectant and nursing mothers as well as healthy children. Key aspects covered include prenatal care, tetanus immunization, micronutrient supplementation, clean and safe delivery practices both at home and in health facilities, and postpartum care. Emergency obstetric and newborn care are also addressed through strategies like BEmONC and CEmONC. The philosophy of maternal and child health nursing is presented as being community-centered, research-based, and protecting family rights.
Preconception care involves providing health interventions to women and couples before conception to improve health and reduce risk factors. It aims to secure optimal health for both parents to improve chances of conception and reduce risks of complications. Key components of preconception care include screening for nutritional deficiencies, genetic conditions, infections like HIV, and risk behaviors like tobacco use. It also involves health promotion, counseling, and treating existing conditions to help ensure women and their partners are healthy when they conceive.
Preparation for parenthood ,childbirth and importance ofKavirajput1
This document discusses the importance of preparation for parenthood, childbirth, and institutional delivery. It outlines the goals of parenthood as promoting survival, economic self-sufficiency, and self-actualization. It emphasizes the importance of physical, psychological, and financial preparedness for parenthood and childbirth. Psychological preparation involves reducing fear and building confidence through education. Institutional delivery is also recommended, as it provides trained healthcare professionals, emergency care, hygienic conditions, and round-the-clock supervision for better outcomes for both mother and child.
The document discusses preventive obstetrics and outlines its objectives and key measures. [1] Preventive obstetrics aims to promote the health of the mother and baby during pregnancy, childbirth, and the postpartum period through routine care and early detection of issues. [2] It focuses on antenatal, intranatal, and postnatal nursing care. [3] Key aspects of antenatal nursing discussed include preconception counseling, essential antenatal services, screening and preparing expectant mothers.
The document provides background information on the implementation of maternal, newborn, adolescent and child health care services in Myanmar using a continuum of care approach. It was developed in accordance with the National Health Plan and short term strategic plans for reproductive health, child health development and adolescent health development. The services were initially implemented in 10 townships in 2011 and have since expanded to 200 townships. The services are delivered through family-oriented, population-oriented, and individual-oriented channels and coordinated at the national and sub-national levels.
This document discusses maternal and child health (MCH) services which provide comprehensive healthcare for pregnant women, new mothers, and young children. The objectives of MCH include reducing mortality and morbidity for both mothers and children, regulating fertility, and promoting physical and mental growth. Maternal healthcare includes antenatal, natal (delivery), and postnatal care. Antenatal care involves regular checkups during pregnancy to monitor health and identify risks. Natal care focuses on ensuring a safe delivery. Postnatal care aims to restore the health of the mother and baby and provide education on childcare and family planning.
Obsterics and Gynaecology-
introduction-Preventive obstetrics is the concept of prevention or early detection of particular health deviations through routine periodic examinations and screening .
The concept of preventive obstetrics concerns with the concepts of the health & wellbeing of the mother her baby during the antenatal,intranatal & postnatal period.
The goal of the preventive obstetrics is the delivery of a healthy infant by a healthy mother at the end of a healthy pregnancy.
Pregnancy & child birth normal physiological
process that change from conception to
delivery.
Objectives
To promote , protect and maintain the health of the mother during pregnancy.
To detect “high risk” cases and give them special attention
To foresee complications and prevent them.
To remove anxiety and dread associated with delivery
The document discusses preconception care and preparing for parenthood. It defines preconception counseling as counseling couples about pregnancy before conception to modify risks. The goals are to improve knowledge and behaviors related to preconception care and reduce risks of adverse pregnancy outcomes. Components of preconception care include risk assessment, health promotion, and interventions. Barriers include unintended pregnancies and limited access to healthcare. Preparing for parenthood involves the decision to have children and ensuring physical, emotional, and financial readiness through education, counseling during pregnancy, and supportive services after birth.
Maternity and child health care programmeskeshavapavan
The document discusses maternal and child health care services provided at primary health care centers in rural India. It outlines antenatal care including registration, checkups and services; intrapartum care including normal and assisted deliveries; postnatal home visits and newborn care. It also discusses care of children including immunizations and nutrition, family planning services, and adolescent and school health programs. The primary health centers aim to provide these essential services to reduce preventable maternal, newborn and child deaths.
The document discusses Integrated Management of Neonatal and Childhood Illness (IMNCI), an integrated approach to child health that focuses on well-being from birth to 5 years old. IMNCI aims to reduce mortality, illness, and disability in children while promoting growth and development. It includes both preventative and curative elements implemented by families, communities, and health facilities. Key aspects of IMNCI include assessing children for danger signs and illnesses, classifying conditions, treating illnesses, counseling caretakers, and conducting home visits for young infants to promote health. The approach uses standardized case management, focuses on common causes of mortality, and improves health worker skills through evidence-based training.
The document summarizes India's Integrated Child Development Services (ICDS) program. It details the objectives of ICDS which are to improve nutrition for preschool-aged children and mothers, reduce mortality and morbidity, and facilitate childhood development. It describes the services provided like supplementary nutrition, immunizations, health checkups, and preschool education. It outlines the roles of Anganwadi workers and helpers who are part of the ICDS team and deliver these services at the community level.
This document discusses the importance of institutional deliveries in India. It notes that India has high maternal and child mortality rates. Institutional deliveries, where birth takes place at a medical facility with trained staff, can help reduce these rates by providing proper medical care and addressing complications. However, utilization of institutional delivery services remains low in India due to various socioeconomic barriers like poverty, lack of education, and distance from health facilities. The National Rural Health Mission and Janani Suraksha Yojana aim to increase institutional deliveries among poor women through cash incentives and improving access to healthcare.
This document discusses maternal health care for paramedics. It covers topics like obstetrics, management of pregnancy and labor under normal and abnormal circumstances, social obstetrics, social pediatrics, maternal and child health services, the need for specialized primary health services for mothers and children, national programs, targets populations, assessing needs, identifying high-risk pregnancies, normal pregnancy and possible complications by trimester, the role of trained birth attendants, and warning signs during pregnancy and labor.
National, state, and institutional standards and policies provide the legal and ethical framework that governs midwifery practice. Midwives must be licensed by the state where they practice and follow both national standards of practice and policies of the institutions where they work. Professional negligence and malpractice issues can arise if a midwife breaches her duty of care or causes injury through improper care. The ethical principles of beneficence, non-maleficence, respect for autonomy, and justice guide midwives in providing care and making decisions. Preparing for parenthood involves addressing lifestyle, health, financial, and psychological factors before conception to help ensure a healthy pregnancy and baby.
This document discusses preconception care, including its definition, components, elements, benefits, and the role of midwives. Preconception care involves providing health interventions to women and couples before conception to detect risks, manage health conditions, promote nutrition and family planning. Key elements addressed include nutritional needs, genetic history, maternal age, environmental hazards and maternal history. The benefits of preconception care are reducing unintended pregnancy and birth defects, as well as promoting healthy behaviors and pregnancy outcomes. Midwives play an important role in educating and screening women to identify risks and plan interventions.
Skilled Birth Attendant (SBA) training aims to improve maternal and newborn health outcomes by developing the skills of birth attendants. The document outlines SBA training conducted in Rajasthan, which focuses on managing normal pregnancies and deliveries, identifying and managing complications, and essential newborn care. It describes a 3-level training approach, monitoring efforts, and the goal of having skilled attendants at all levels to reduce maternal and infant mortality rates.
This document provides information about normal labor, including definitions, objectives, factors affecting normal labor, signs of onset, and the stages of labor. It defines labor as the process of expelling the fetus through the birth canal after viability. The four objectives are to define normal vs abnormal labor, explain factors affecting normal labor, distinguish the signs of onset, and identify the stages of labor. It describes the three main factors as power (uterine contractions), passage (changes in uterus, cervix, etc.), and passenger (fetus). It also outlines the signs of onset such as lightening, cervical changes, and false vs true labor pains. Finally, it explains the four stages of labor in detail including first stage cervical dilation, second
Prolonged pregnancy and abnormal uterine contractions (4) (1).pdfxzd4w6hgj4
The document summarizes key information about prolonged pregnancy and abnormal uterine action during labor and delivery. It discusses definitions of post-term pregnancy, risks of post-term pregnancy like increased mortality and morbidity, and methods for managing prolonged pregnancy like induction of labor and monitoring with CTG and amniotic fluid measurement. It also covers topics like indications and contraindications for induction, methods of induction using prostaglandins or oxytocin, prolonged labor, obstructed labor and its complications.
This document outlines the key components of preconception care, which includes performing a thorough risk assessment through medical history, family history, lifestyle factors, immunizations and testing for infectious diseases. The goals are to identify any conditions that could impact a pregnancy and allow for interventions to improve outcomes. A complete preconception evaluation involves counseling on nutrition, contraception, genetic risks and making any necessary referrals. Done correctly, preconception counseling can help reduce risks and complications during pregnancy through education and encouraging healthy habits prior to conception.
The document discusses maternal and child health nursing. It aims to ensure the health of expectant and nursing mothers as well as healthy children. Key aspects covered include prenatal care, tetanus immunization, micronutrient supplementation, clean and safe delivery practices both at home and in health facilities, and postpartum care. Emergency obstetric and newborn care are also addressed through strategies like BEmONC and CEmONC. The philosophy of maternal and child health nursing is presented as being community-centered, research-based, and protecting family rights.
Preconception care involves providing health interventions to women and couples before conception to improve health and reduce risk factors. It aims to secure optimal health for both parents to improve chances of conception and reduce risks of complications. Key components of preconception care include screening for nutritional deficiencies, genetic conditions, infections like HIV, and risk behaviors like tobacco use. It also involves health promotion, counseling, and treating existing conditions to help ensure women and their partners are healthy when they conceive.
Preparation for parenthood ,childbirth and importance ofKavirajput1
This document discusses the importance of preparation for parenthood, childbirth, and institutional delivery. It outlines the goals of parenthood as promoting survival, economic self-sufficiency, and self-actualization. It emphasizes the importance of physical, psychological, and financial preparedness for parenthood and childbirth. Psychological preparation involves reducing fear and building confidence through education. Institutional delivery is also recommended, as it provides trained healthcare professionals, emergency care, hygienic conditions, and round-the-clock supervision for better outcomes for both mother and child.
The document discusses preventive obstetrics and outlines its objectives and key measures. [1] Preventive obstetrics aims to promote the health of the mother and baby during pregnancy, childbirth, and the postpartum period through routine care and early detection of issues. [2] It focuses on antenatal, intranatal, and postnatal nursing care. [3] Key aspects of antenatal nursing discussed include preconception counseling, essential antenatal services, screening and preparing expectant mothers.
The document provides background information on the implementation of maternal, newborn, adolescent and child health care services in Myanmar using a continuum of care approach. It was developed in accordance with the National Health Plan and short term strategic plans for reproductive health, child health development and adolescent health development. The services were initially implemented in 10 townships in 2011 and have since expanded to 200 townships. The services are delivered through family-oriented, population-oriented, and individual-oriented channels and coordinated at the national and sub-national levels.
This document discusses maternal and child health (MCH) services which provide comprehensive healthcare for pregnant women, new mothers, and young children. The objectives of MCH include reducing mortality and morbidity for both mothers and children, regulating fertility, and promoting physical and mental growth. Maternal healthcare includes antenatal, natal (delivery), and postnatal care. Antenatal care involves regular checkups during pregnancy to monitor health and identify risks. Natal care focuses on ensuring a safe delivery. Postnatal care aims to restore the health of the mother and baby and provide education on childcare and family planning.
Obsterics and Gynaecology-
introduction-Preventive obstetrics is the concept of prevention or early detection of particular health deviations through routine periodic examinations and screening .
The concept of preventive obstetrics concerns with the concepts of the health & wellbeing of the mother her baby during the antenatal,intranatal & postnatal period.
The goal of the preventive obstetrics is the delivery of a healthy infant by a healthy mother at the end of a healthy pregnancy.
Pregnancy & child birth normal physiological
process that change from conception to
delivery.
Objectives
To promote , protect and maintain the health of the mother during pregnancy.
To detect “high risk” cases and give them special attention
To foresee complications and prevent them.
To remove anxiety and dread associated with delivery
The document discusses preconception care and preparing for parenthood. It defines preconception counseling as counseling couples about pregnancy before conception to modify risks. The goals are to improve knowledge and behaviors related to preconception care and reduce risks of adverse pregnancy outcomes. Components of preconception care include risk assessment, health promotion, and interventions. Barriers include unintended pregnancies and limited access to healthcare. Preparing for parenthood involves the decision to have children and ensuring physical, emotional, and financial readiness through education, counseling during pregnancy, and supportive services after birth.
Maternity and child health care programmeskeshavapavan
The document discusses maternal and child health care services provided at primary health care centers in rural India. It outlines antenatal care including registration, checkups and services; intrapartum care including normal and assisted deliveries; postnatal home visits and newborn care. It also discusses care of children including immunizations and nutrition, family planning services, and adolescent and school health programs. The primary health centers aim to provide these essential services to reduce preventable maternal, newborn and child deaths.
The document discusses Integrated Management of Neonatal and Childhood Illness (IMNCI), an integrated approach to child health that focuses on well-being from birth to 5 years old. IMNCI aims to reduce mortality, illness, and disability in children while promoting growth and development. It includes both preventative and curative elements implemented by families, communities, and health facilities. Key aspects of IMNCI include assessing children for danger signs and illnesses, classifying conditions, treating illnesses, counseling caretakers, and conducting home visits for young infants to promote health. The approach uses standardized case management, focuses on common causes of mortality, and improves health worker skills through evidence-based training.
The document summarizes India's Integrated Child Development Services (ICDS) program. It details the objectives of ICDS which are to improve nutrition for preschool-aged children and mothers, reduce mortality and morbidity, and facilitate childhood development. It describes the services provided like supplementary nutrition, immunizations, health checkups, and preschool education. It outlines the roles of Anganwadi workers and helpers who are part of the ICDS team and deliver these services at the community level.
This document discusses the importance of institutional deliveries in India. It notes that India has high maternal and child mortality rates. Institutional deliveries, where birth takes place at a medical facility with trained staff, can help reduce these rates by providing proper medical care and addressing complications. However, utilization of institutional delivery services remains low in India due to various socioeconomic barriers like poverty, lack of education, and distance from health facilities. The National Rural Health Mission and Janani Suraksha Yojana aim to increase institutional deliveries among poor women through cash incentives and improving access to healthcare.
This document discusses maternal health care for paramedics. It covers topics like obstetrics, management of pregnancy and labor under normal and abnormal circumstances, social obstetrics, social pediatrics, maternal and child health services, the need for specialized primary health services for mothers and children, national programs, targets populations, assessing needs, identifying high-risk pregnancies, normal pregnancy and possible complications by trimester, the role of trained birth attendants, and warning signs during pregnancy and labor.
National, state, and institutional standards and policies provide the legal and ethical framework that governs midwifery practice. Midwives must be licensed by the state where they practice and follow both national standards of practice and policies of the institutions where they work. Professional negligence and malpractice issues can arise if a midwife breaches her duty of care or causes injury through improper care. The ethical principles of beneficence, non-maleficence, respect for autonomy, and justice guide midwives in providing care and making decisions. Preparing for parenthood involves addressing lifestyle, health, financial, and psychological factors before conception to help ensure a healthy pregnancy and baby.
This document discusses preconception care, including its definition, components, elements, benefits, and the role of midwives. Preconception care involves providing health interventions to women and couples before conception to detect risks, manage health conditions, promote nutrition and family planning. Key elements addressed include nutritional needs, genetic history, maternal age, environmental hazards and maternal history. The benefits of preconception care are reducing unintended pregnancy and birth defects, as well as promoting healthy behaviors and pregnancy outcomes. Midwives play an important role in educating and screening women to identify risks and plan interventions.
Skilled Birth Attendant (SBA) training aims to improve maternal and newborn health outcomes by developing the skills of birth attendants. The document outlines SBA training conducted in Rajasthan, which focuses on managing normal pregnancies and deliveries, identifying and managing complications, and essential newborn care. It describes a 3-level training approach, monitoring efforts, and the goal of having skilled attendants at all levels to reduce maternal and infant mortality rates.
This document provides information about normal labor, including definitions, objectives, factors affecting normal labor, signs of onset, and the stages of labor. It defines labor as the process of expelling the fetus through the birth canal after viability. The four objectives are to define normal vs abnormal labor, explain factors affecting normal labor, distinguish the signs of onset, and identify the stages of labor. It describes the three main factors as power (uterine contractions), passage (changes in uterus, cervix, etc.), and passenger (fetus). It also outlines the signs of onset such as lightening, cervical changes, and false vs true labor pains. Finally, it explains the four stages of labor in detail including first stage cervical dilation, second
Prolonged pregnancy and abnormal uterine contractions (4) (1).pdfxzd4w6hgj4
The document summarizes key information about prolonged pregnancy and abnormal uterine action during labor and delivery. It discusses definitions of post-term pregnancy, risks of post-term pregnancy like increased mortality and morbidity, and methods for managing prolonged pregnancy like induction of labor and monitoring with CTG and amniotic fluid measurement. It also covers topics like indications and contraindications for induction, methods of induction using prostaglandins or oxytocin, prolonged labor, obstructed labor and its complications.
This document provides an overview of abnormal labour, including definitions, causes, signs and symptoms, diagnosis, management, and specific types such as prolonged labour and maternal injuries. Abnormal labour is defined as labour that does not meet normal time limits and milestones. It can be caused by issues with uterine contractions, pelvic abnormalities, large babies, or psychological factors. Prolonged labour increases risks for both mother and baby. Management may include accelerating labour through drugs or proceeding with c-section if needed. Maternal injuries from labour include perineal tears, vaginal tears, cervical tears, and vulval hematoma, which require repair or drainage. The document also describes different types of abnormal uterine action.
This document describes prolonged and obstructed labor. It defines prolonged labor as when the first and second stages of labor last more than 18 hours total. Obstructed labor occurs when there is poor or no progress despite strong contractions, usually due to issues with the fetus (fault in passenger) or birth canal (fault in passage). Causes include cephalopelvic disproportion, malpositions, big baby, or contracted pelvis. Diagnosis involves assessing cervical dilation rate and fetal descent rate with a partograph. Treatment depends on the stage of labor affected and may include oxytocics, analgesics, assisted delivery, or C-section. Complications can be serious for both mother and baby if not resolved.
Nursing management during labor and birth two dunncbear1996
This document provides an overview of nursing management during labor and birth. It discusses assessing the patient and fetus, managing pain, positioning during labor, and nursing care during each stage of labor including the first, second, third and fourth stages. Non-pharmacological and pharmacological pain management techniques are outlined as well as potential complications from interventions like epidurals. The document also provides examples of NCLEX questions related to labor and delivery nursing care.
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 LABOR.. (EUTOCIA) ABNORMAL LABOR ALSO EXPLAINED. Series of events that take place in the genital organs in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called LABOR.
UNCOORDINATED UTERINE ACTION in obstetrics and gynecologicalThangamjayarani
I. Prolonged labor is defined as labor lasting longer than 18-24 hours. It can occur when there are issues with uterine contractions (fault in power), the size and shape of the pelvis (fault in passage), or position of the baby (fault in passenger).
II. Precipitate labor is when the first and second stages are less than two hours. It is more common in multiparous women and can be caused by factors like a small baby in a favorable position or strong uterine contractions.
III. Management of prolonged labor involves careful evaluation, correcting dehydration, and definitive treatments like amniotomy, oxytocin infusion, or cesarean section if vaginal delivery is
1.1 Define and use correctly all of the key terms
1.2 Describe the signs of true labour and distinguish between true and false labour
1.3 Explain to the mother how to recognise the onset of true labour
1.4 Describe the characteristic features and mechanisms of the four stages of labour
1.5 Describe the seven cardinal movements made by the baby as it descends the birth canal in a normal labour
Management of the complications of second and third stages of labour - DUUM.pptxduumnwachukwu
This presentation covers
effective strategies for managing second and third-stage labour complications. We will discuss a clinical approach for providing optimal care to patients during these critical stages of childbirth
This document provides information on the stages of labor and management of the first stage of labor. It discusses the normal progression through the latent, active, and transition phases of the first stage. It also covers monitoring during labor including vital signs, contractions, and fetal heart rate. Active management of labor is described which includes interventions like amniotomy and oxytocin if progress is unsatisfactory. The nurse's role in caring for the woman in the first stage is also summarized.
This document discusses prolonged labor, obstructed labor, and dystocia caused by fetal anomalies. Prolonged labor is defined as the combined first and second stage of labor exceeding 18 hours. It can be caused by issues with cervical dilation, fetal descent, uterine contractions, or pelvic and fetal factors. Obstructed labor occurs when descent is arrested due to a mechanical obstruction in the birth canal or fetus. This can lead to exhaustion, dehydration, acidosis, and infection for the mother. Fetal risks include hypoxia, infection, head molding issues, and increased need for operative delivery. Prevention focuses on identifying risk factors. Treatment involves evaluating the cause and deciding between augmentation, assisted delivery, or C-
What possible complications to look for:
Antepartum haemorrhage
Pre-eclampsia
proteinuria and a rise in the blood pressure.
Cervical changes
Symphysis-fundus height measurement
below the 10th centile?
above the 90th centile?
This document discusses prolonged pregnancy and post-term pregnancy. It defines these terms as a pregnancy exceeding 42 weeks of gestation. It notes that prolonged pregnancy occurs in 2-12% of pregnancies and is often due to inaccurate dating. Babies born post-term are at higher risk for problems like respiratory distress, hypoglycemia, and intrauterine death. Management may involve monitoring the pregnancy or inducing labor between 41-42 weeks depending on the specific situation. Post-term babies may require support to prevent complications like hypoglycemia, hypothermia, or meconium aspiration.
Labour is considered prolonged if it lasts more than 12 hours. It can be caused by issues with the passageway (pelvis), passenger (baby), powers (contractions), or psyche (mental state). Prolonged labour risks maternal and fetal complications if neglected. Close monitoring is needed to detect obstruction early. Treatment depends on fetal viability but may include resuscitating the mother, controlling infection, relieving obstruction via c-section, and post-delivery care like antibiotics and bladder drainage. Abnormal uterine contractions can also prolong labour and are treated with oxytocin.
Abdominal pain during pregnancy can have many causes, both pregnancy-related and non-pregnancy related. Pregnancy-related causes include round ligament pain, Braxton Hicks contractions, preterm labor, placental problems, and liver issues related to conditions like preeclampsia. Non-pregnancy related causes include issues like appendicitis, kidney infections, and digestive system problems. A thorough physical exam and testing is needed to determine the cause, and treatment depends on the underlying issue and gestational age of the fetus. The well-being of both the mother and fetus must be closely monitored.
Please find the power point on Management of Preterm labor. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
The document describes the diagnosis of pregnancy through various signs and symptoms. It distinguishes between possible/presumptive signs (based on a woman's subjective reports), probable signs (combining subjective and objective findings), and positive signs (conclusive proof of pregnancy). Possible signs include missed period, morning sickness, breast changes, frequent urination, and quickening. Probable signs involve pelvic exam findings, abdominal enlargement, and ballottement. Positive signs are fetal heart tones, palpation of the fetus, ultrasound examination, and fetal movement. Diagnosis progresses from possible to probable to positive as the pregnancy advances.
Labor is the process by which uterine contractions result in cervical changes allowing passage of the fetus through the birth canal. It has three stages: first stage involves cervical effacement and dilation; second stage is birth of the fetus; third stage is placental delivery. Uterine contractions are regulated by hormones like progesterone and oxytocin. Contractions start in the fundus and spread across the uterus. The upper segment contracts and retracts while the lower segment dilates, aided by fetal pressing, to progress labor. Average first stage duration is 12 hours in primiparous and 6 hours in multiparous women.
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Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
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Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
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Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
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Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
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TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
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NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
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Emphysema is a disease condition of respiratory system.
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Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
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2. Learning objectives
• Define labor
• List the stages of labor
• Mention the managements of each stage of labor
• Discuss the abnormal labor
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3. Terminology
Labor: physiologic process of painful uterine contraction leading to
cervical effacement & dilatation with expulsion of the fetus, placenta &
membrane.
Parturition: Is bringing forth of young & requires well orchestrated
transformations in both uterine & cervical function.
Parturition: Arbitrarily divided into four overlapping phases that
correspond to the major physiological transitions of the myometrium &
cervix during pregnancy
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4. Four phases of parturition from quiescence to involution
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6. Physiologic preparations of labor
• Lightening:
The settling of the fetal head into the pelvic brim.
• Braxton Hicks contractions:
During the last 4–8 weeks of pregnancy irregular, generally painless
uterine contractions occur with slowly increasing frequency.
The intensity may increase during the last weeks of pregnancy
• Bloody show:
Passage of a small amount of blood-tinged mucus from vagina, as the
cervix begins to soften, efface, and dilate.
May precede the onset of labor by as much as 72 hours
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7. Labor:
It starts with the onset of
regular uterine contraction &
ends with delivery of the
newborn & expulsion of
placenta.
It has four stages of labor.
Labor can be normal and abnormal
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8. Stage of labor
1st stage of labor
2nd stage of labor
3rd stage of labor
• From true onset of labor
• Up to full cervical dilatation
• From full cervical dilatation
• Up to delivery of the fetus
• From delivery of the fetus
• Up to delivery of the placenta
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9. 4th stage of labor:
• One to two hours after
delivery of the placenta.
• Because PPH is common @
this stage of labor
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10. •True contraction
•To 10cm cervical
dilatation
1st stage
•From full cervical
dilatation
•Till delivery of the
fetus
2nd stage of
labor
•Delivery of the
fetus
•To delivery of the
placenta
3rd stage
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11. First stage of labor:
It has two phases( active and latent)
Latent phase – onset of labor with slow cervical
dilation to 4-6 cm and variable duration
Active phase – faster rate of cervical change, 1.2 and
1.5 cm /hour in primi & multi respectively, regular
uterine contractions
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13. Admission criteria for labor
• All women with diagnosis of labor ( latent and active) with:
Ruptured membranes, or
Known risk factor
• All women with diagnosis of active labor with/without presence of rupture
of membranes or risk factor.
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14. Factors that affect the success of labor: 3p’s
Power:
• Uterine contraction
• Maternal bearing
down effort
• Pelvic floor muscles
Passenger: fetal
• Size
• Lie
• Presentation
• Attitude
• Position
• Anomaly
Passage:
• Bony pelvis
• Soft tissue
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15. Power
Uterine contraction can be assessed by:
• Observation
• Palpation
• External tocodynamometer
• Internal pressure catheter
Adequate contraction is:
• 3-5contraction/in 10 minutes/each staying for 40-60seconds
• 200-250 Montevideo
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25. 12/2/2019 25
Mechanism of labor
• Known as the cardinal movements,
involve changes in the position of the
fetus’s head during its passage in
labor.
• Described in relation to a vertex
presentation.
Cardinal movements:
• Engagement
• Descent
• Flexion
• Internal rotation
• Extension
• Restitution and external rotation
• Expulsion
26. True labor vs. False labor
True labor pain False labor pain
Regular Irregular
Increase progressively not
Lower abdomen & back Lower abdomen
Dilatation & effacement of cervix No effect on cervix
Not relieved by sedatives &
antispasmodics
Relieved
2612/2/2019
27. First stage of labor
• Two phases: latent and active
Latent phase: onset of labor to 3 cm cervical dilatation.
Active phase: 4cm – 10 cm cervical dilatation.
• Rate of cervical dilatation is 1.2cm/hr in primi & 1.5 cm/hr
for multi during active phase.
• Active phase of first stage of labor has three phases:
Acceleration,
Phase of maximal slope, and
Deceleration phases.
Average duration of first stage is 12 hrs in primi and 6 hrs
in multi.
2712/2/2019
28. Second stage of labor
SECOND STAGE OF
LABOR
• From 10cm of
cervical dilatation to
delivery
• Lasts an hour in
primi & 20 minutes
in multi.
• Rate of descent is
1cm/ hr in primi &
2cm/hr for multi.
THIRD STAGE OF
LABOR:
• Average duration is
15 minutes for
both(placenta
delivery)
FOURTH STAGE:
• First one to two
hours where PPH is
high.
• This stage is a
critical time for
monitoring of vital
signs and observe
for blood loss &
uterine contractility.
2812/2/2019
29. Events in first stage of labor
• Dilatation and effacement of cervix
• Full formation of lower uterine segment(LUS)
Main events are:
• Uterine contraction & retraction
• Bag of waters
• Fetal axis pressure in the proper direction
• Pressure by the presenting part.
Factors responsible
for dilatation:
2912/2/2019
31. Events in third stage of labor
Main events: have 4 phases
•Latent phase
•Contraction phase
•Detachment phase
•Expulsion phase
Two types of placental separation
•Central separation (Schultze):
•Retroplacental clot
•Most common(80%)
•Less blood loss
•Marginal separation (Mathews-Duncan):
•Separation starts at the margin
•Gush of blood as sign of separation
3112/2/2019
33. Active Phase Labor Protraction and Arrest
Active-phase disorders may be divided into protraction
and arrest disorders.
Protraction disorders reflect slower than normal
progress
Arrest disorders consist of complete cessation of
progress
12/2/2019 33
37. Labor management
Initial examination: On admission, record
• Record pertinent history
• Review the ANC chart
• Physical examination: BP, PR, Wt, Temp., RR
• Obstetric palpation
• Uterine contraction
• Fetal heart beat
3712/2/2019
38. Labor management
3812/2/2019
Cervical examination
Evaluation of extremities:
edema, varicosity, etc.
Other system evaluation depends
on patient complaint or
problems she had.
Investigations: urine analysis,
Hgb, rapid HIV testing if not
tested.
• Fetal status: Presentation, position, station
• Cervical status: effacement, dilation
• Membrane status: rupture, fluid color, time
• Pelvic status: adequacy evaluation
39. Labor management
Patient preparation:
• No routine enema & perineal shaving
• No routine catheterization
Position:
• Can assume any position except supine.
Diet:
• Fluid diet, intravenous hydration when indicated.
3912/2/2019
40. Pain control:
• Psycho-prophylaxis
• Analgesics
• Epidural anesthesia
• Spinal anesthesia
• PCA
Aminotomy:
• Not performed routinely
• For Augmentation/induction
• Fetal distress
Antibiotic prophylaxis:
• When indicated
4012/2/2019
41. Monitoring:
• FHB every 30 minutes in low risk & every 15
minutes in high risk
• FHB has to be counted for a full minute just
after contraction.
• Uterine contraction every 30 minutes, monitor
for 10 minutes
• Pelvic evaluation every 4 hrs unless indicated.
• Maternal vital signs: BP & Temp. Q 2 Hourly
First
stage:
4112/2/2019
42. .
• Feels the desire to defecate.
• Contractions become more prolonged & painful.
• Desire to bear down during the contractions.
• Expulsive effort is accompanied by sustained expiratory
grunt.
• Full dilatation of the cervix (10 cm ) in between uterine
contractions is the most sure sign.
Second stage: signs and symptoms include:
12/2/2019 42
43. Monitoring:
• FHB every 15 minutes & 5 minutes in
low risk & high risk mothers respectively
• Monitor descent hourly.
2nd stage:
•Responsibility:
•Reduce risk of maternal perineal injury
•Prevent fetal injury
•Provide initial support to newborn
•Essential aseptic techniques
• No routine perineal massage
• Three pushes per contraction.
DELIVERY
4312/2/2019
44. Management:
Delivery of the
head: modified
Ritgen’s
maneuver
Delivery of
shoulders
Delivery of the
rest of body.
Clear oro-
pharynx
immediately
after delivery of
head(M before
N).
Nuchal cord has
to be slipped
over head if
loose or doubly
clamped & cut.
Cord clamping:
immediate with
in one minute
4412/2/2019
46. Signs of placental separation
Lengthening of
the umbilical
cord.
Uterus
becomes more
globular shape
& becomes
firmer.
Uterus rises in
the abdomen.
A gush of
blood occurs.
12/2/2019 46
49. Management
• Examination of genitalia
• Examination of placenta, membranes & cord
• Transfer of the parturient
• Discarding and disinfecting the equipment's.
• APGAR score
4912/2/2019
50. Apgar Score
Sign 0 Points 1 Point 2 Points
Heart rate(Pulse) Absent <100 bpm >100 bpm
Respiratory effort(R) Absent Slow, irregular Good, crying
Muscle tone(Activity) Flaccid Some flexion of
extremities
Active motion
Reflex
irritability(Grimace)
No response Grimace Vigorous cry
Color(Appearance) Blue, pale Body pink, extremities
blue
Completely pink
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51. Partograph
• Maternal - perinatal morbidity &
mortality
• Was developed to this endeavor
Early detection &
prevention of
abnormal &
prolonged labour
• Progress of labour and
• Condition of the mother & fetus .
It is the graphic
recording of
5112/2/2019
52. History of partograph
• In 1954 E. A. Freidman, described a normal cervical
dilation
• Divided first stage in to latent phase & active phase.
• First to show plotting cervical dilation Vs time
• His work has been foundation on which others built
5212/2/2019
53. History of partograph
• In 1969 Hendricks et al demonstrated that:
In the active phase of normal labour:
Rate of dilation of the cervix in primi & multipara varies very little &
There is no deceleration at the end of the first stage of labour.
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55. The WHO Partograph (1987)
•Devised by technical working group
•After examining most of the available
work on Partograph and their design
12/2/2019 55
57. The WHO partograph
• The active phase commences at 3 cm cervical
dilation
• The latent phase should not last longer than 8 hrs
• During active phase, the rate of cervical dilation
should not be slower than 1cm/hr
• Vaginal examination - infrequently as compatible
with safe practice (Q 4 hrs is recommended)
• Midwives and other personnel managing labor
may have difficulty in constructing alert and
action line ►pre-drawn lines
Principles:
5712/2/2019
58. Modified WHO Partograph
Modified WHO Partograph
•The WHO Partograph has been modified
to make it simpler and easier to
use(2001)
•The latent phase has been removed and
plotting begins in the active phase when
the cervix is 4 cm dilated. (it was 3 cm)
5812/2/2019
63. WHO partograph
For whom to use it:
• There shouldn’t be complications of pregnancy that require
immediate action.
• Make sure that the women is in labor
• It can be used for all labors in a hospital (including breech,
multiple pregnancy, previous C/S)
• In the peripheral health units
12/2/2019 63
64. Who should use it?
Health workers who are able to:
• Observe and conduct normal labour and delivery
• Perform vaginal examination in labor and assess
cervical dilatation accurately
• Plot cervical dilation accurately on graph against
time
Where to use it?
• No place for home delivery
12/2/2019 64
65. Advantages of partograph
• Prevention of prolonged labor
• Avoids unnecessary use of augmentation
• Hand over of patients
More precise and fluent
At a glance appreciation of preceding hours
of labor
12/2/2019 65
66. Pictorial (graphic or clear) display of events of labor:
• Clarifies recordings
• Avoids lengthy written notes
• Facilitates recognition of any omissions
• Saves time → Companionship
Considerable educational value:
• All interrelated variables of labor can be seen on a single paper
Low cost, feasible
Improved out come of labor →↑Credibility (trustworthiness) of formal health sector.
12/2/2019 66