正常分娩-妇科七年制教学课件.ppt

Normal Labor and Delivery(AFE)正常分娩 Lin Jianhua M.D., Ph.D., Professor Department Of Obstetrics Gynecology Renji Hospital Affiliated to SJTU School of Medicine definition Term delivery(labor): 37-42weeks pre-term delivery: 28- 37 weeks post-term delivery:? 42 weeks Abortion: 28 weeks 85% of women spontaneous labor and delivery between 37-42 weeks LMP :last menstrual period EDC: expected date of confinememt The four factors for labor Force (contraction) birth canal (bony canal) fetus (lie,position ,presentation,weight) psychical-factors The contractions increase in frequency and duration uterus can be felt to harden during contraction lasting about 30-45 seconds interval between contractions to be 5 min’ the pain of labor is a character NST CST Bony pelvis The planes of pelvis inlet plane (promontory) mid plane of pelvis(ischial spines) outlet plane(two intersecting triangles) Mechanism of labor Engagement* Flexion Decent Internal rotation Extension External rotation Symptoms and signs of the onset of the labor Painful uterine contraction a show effacement and dilation of the cervix rupture of membranes The show The mucus plug is expelled from the cervix mixing with a little blood the rupture of the membranes at any time during labor effacement and dilation of the cervix to be short,taken up,dilated Stages of labor The first stage: onset of labor to full cervical dilation(10cm) the latent phase ( onest to 3cm, 16h) the active phase(3cm to 10cm, 8h) The second stage: 10 cm to the delivery of the infant, 2h The third stage: delivery of the infant to delivery of the placenta, 30m’ The fourth stage: 2 hours after delivery of the placenta Management of normal labor The first stage: education, eating, voiding, position(sitting, reclining, recumbent) monitoring