Normal Labor and Delivery正常分娩.ppt

4th Maneuver: the Examiner changes the position by facing the patient’s feet. With two hands, assess the descent of the presenting part by locating the cephalic prominence or brow. To determine attitude – relationship of fetus to one another. Parameters of uterine contraction: Interval 10 to 20 minutes between contractions: early labor 3 to 5 minutes between contractions: late labor Duration 20 second long contraction: early labor 40 to 80 second long contraction: late labor Quality Uterus can be dented (poor quality): early labor Uterus is hard (good quality): late labor Intra-abdominal pressure: Increased intra-abdominal pressure (voluntary muscle contraction) compresses the uterus and adds to the power of the expulsion forces of the uterine contraction. Psychological responses: The birth experience influence the womans self confidence, self esteem, and her view of life, her relationships, and her children. Factors influencing a positive birth experience include: clear information on procedure positive support, not being alone sense of mastery, self- confidence trust in staff caring for her positive reaction to the pregnancy personal control over breathing Preparation for childbirth experience. Maternal position: Changing positions and moving around during birth offer several benefits, it facilitate fetal descend and rotation Squatting position enlarges the pelvic outlet by approximately 25% . The use of upright or lateral position compared with supine or lithotomy positions may: reduce the duration of the second stage of labor reduce the number of assisted deliveries( vacuum and forceps) Maternal position: reduce episiotomies and perineal tear contribute to fewer abnormal fetal heart increase comfort/ reduce request for pain medication enhance a sense of control reported by mothers alert the shape and size of the pelvis, which assist descent assist gravity to move the fetus downward reduce the length of labor Physiologic responses to labor: Maternal respon