《正常分娩妇科七年制教学课件.ppt》由会员分享，可在线阅读，更多相关《正常分娩妇科七年制教学课件.ppt（21页珍藏版）》请在三一办公上搜索。
1、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):37-42weekspre-term delivery:28-37 weekspost-term delivery:42 weeksAbortion:28 weeks85%of women spontaneous labo
2、r and delivery between 37-42 weeks LMP:last menstrual periodEDC: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 durationuterus can be felt to harden du
3、ring contraction lasting about 30-45 secondsinterval between contractions to be 5 minthe 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*FlexionDecen
4、tInternal rotationExtensionExternal rotation,Symptoms and signs of the onset of the labor,Painful uterine contractiona showeffacement and dilation of the cervixrupture of membranes,The showThe mucus plug is expelled from the cervixmixing with a little blood the rupture of the membranesat any time du
5、ring laboreffacement and dilation of the cervixto 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 to 10cm,8h)The second stage:10 cm to the delivery of the infant,2hThe third stage:delivery of the infant to delivery
6、 of the placenta,30mThe fourth stage:2 hours after delivery of the placenta,Management of normal labor,The first stage:education,eating,voiding,position(sitting,reclining,recumbent)monitoring of the fetal heart rate,dilation of cervix and frequency severity of uterus contractions(auscultation or ele
7、ctronic monitoring),The second stage,:-2 hourfetal heart ratematernal conditions:pulse,blood pressure,respiratory rate,temperature,urine output,fluid intake evaluation of progress of labor cervical dilation,station,position of the presenting part,status of membranes,meconium,blood,Pushing:with the o
8、nset of each contraction,the mother is encouraged to inhale,hold her breath,and pushincrease in intra-abdominal pressureaiding in fetal descent through the birth cacal.,Head visible on vulval gapping*Crowning of head*Laceration or EpisiotomyDelivery of fetusDeal with umbilical cord,the third stage:,
9、waiting for up to 30 minthe uterus decreases in sizedelivery of placenta(spontaneously,manuallyinspection of the birth canalevaluated for lacerations,“The fourth stage”,postpartum uterine hemorrhage,1%uterus palpation through the abdominal wall is repeatsthe amount of blood on pads are monitoredpulse and BP are monitored use of drug:oxytocin,THANKS FOR YOUR ATTENTION,Lin Jianhua M.D.,Ph.D.,ProfessorDep.of Obstet.&Gynecol.Renji Hospital Affiliated to SJTU School of Medicine,
