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Labour tutorial
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- 2. Normal Labour &Delivery Definition of labour: Physical processes at the end of pregnancy including opening of the cervix and contractions of the uterus that lead to delivery of the fetus
- 3. Components of normallabour Powers Passages Passenger
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- 9. Passenger Fetal size Fetal presentation Fetalposition Moulding
- 11. Mechanism of birth Engagein transverse position Rotate in mid-pelvis Flexed descent onto perineum Crowning Extension of neck Restitution Delivery anterior shoulder Delivery posterior shoulder
- 13. Diagnosis of labour Regularpainful contractions resulting in progressive change of the cervix +/- show +/- rupture of membranes
- 14. Stages of labour Firststage Onset of labour until full dilatation of cervix Second stage Full dilation of cervix until delivery of baby Third stage Delivery of baby until complete delivery of placenta and membranes
- 15. Partogram - Maternal Name/ DOB /Gestation Medical / Obstetrical issues HR / BP/ Temp Urinalysis
- 16. Partogram - Fetal Gestationalage Fetal heart rate Liquor
- 17. Partogram - Progress Uterinecontractions Cervical dilatation Descent of presenting part Caput / Moulding Fetal position
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- 19. Partogram - delivery Timeof birth Gender of infant Birthweight Apgar scores at 1/5 mins Cord gas Resuscitation Complications
- 20. Abnormal Labour &Delivery
- 21. What can gowrong? Powers Poor contractions/Maternal effort Passages Small pelvis/Pelvic shape Passenger Big baby/Presentation/Malposition
- 22. Abnormal powers Artificial ruptureof membranes Oxytocin infusion Change position Encouragement
- 23. Passages / Passenger Cannotinfluence pelvic size / fetal wt Can correct malposition / descent Oxytocin infusion Change position Assisted birth
- 24. Primary arrest 0 1 2 3 4 5 6 7 8 9 10 2 46 8 10 12 Dilatation
- 25. Secondary arrest 0 1 2 3 4 5 6 7 8 9 10 6 810 12 14 Dilatation
- 26. Arrest in SecondStage 0 1 2 3 4 5 6 7 8 9 10 6 8 10 12 14 16 Dilatation
- 27. Types of assistedbirth Forceps Vacuum / Ventouse Caesarean section
- 31. Forceps / Vacuum- Indications Prolonged second stage Suspected fetal compromise Maternal medical conditions
- 32. Forceps / Vacuum- Criteria Expertise Consent Analgesia Fully dilated / membranes ruptured Bladder empty Position known Fully engaged Station @/below spines
- 33. Complications Failed attempt Trauma tobaby Trauma to mother
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- 38. Indications Maternal condition Fetal condition Prolongedpregnancy Prolonged rupture of membranes Hypertensive disorders Fetal growth / well-being Medical disorders Maternal request
- 39. Methods Artificial rupture ofmembranes Prostaglandin
- 40. Risks Dates / prematurity Failedinduction Long/difficult labour Interventions Neonatal complications