pleno dystocia
Post on 14-Apr-2018
228 Views
Preview:
TRANSCRIPT
-
7/30/2019 Pleno Dystocia
1/8
-
7/30/2019 Pleno Dystocia
2/8
Rising level offetal adrenocortical hormones
especially cortisol in late pregnancy are a major
stimulus for the placenta to release a largeamount of estrogens
Rise in estrogens stimulates the
-myomerial cell of
the uterus to form
abundant oxytocin
receptors
-antagonise
progestrones
quieting influence
on uterine muscle.
Result in myometrium becomes increasingly
irritable, weak,
irregular uterine conctraction begins to occur.
( Braxton hicks contraction)
False labor As the birth nears...
Certain fetal
cells begin to
produce
oxytocin
causing the
placenta
release
prostaglandins
Both of this hormones are
powerful uterine muscles
stimulants
frequent and vigorouscontraction happens
at this point, the increasing emotionaland physical stressesactivate the
mothers hypothalamus, which signal
the for oxytocin release by the
posterior pituitary.
True Labourgreater contractile
force
-
7/30/2019 Pleno Dystocia
3/8
FALSE LABOR
Braxton Hicks contractions occurring at irregular intervals, sometimes with
some periods of regularity
never becoming any stronger
the intervals between contractions remain always the same
Braxton Hicks may go away after changing your activity
the cervix has not begun to dilate or thin out (efface).
TRUE LABOR
True labor begins with contractions occurring at regular intervals thatbecome stronger as the intervals between them gradually shorten
Sometimes contractions may start in the back and from there radiate
around to the abdomen, while you may feel back pain and/or
menstrual-type cramping instead ofa real contraction.
Contractions during true labor will intensify when walking
and does not go away when you change your activity
normal to notice a mucousy or blood-tinged discharge (Bloody show)
Bag of waters (membranes) may rupture.
Cervix begins to dilate and thin out (efface)
-
7/30/2019 Pleno Dystocia
4/8
-
7/30/2019 Pleno Dystocia
5/8
During the latent phase irregular contractions becomeprogressively better coordinated discomfort is minimal
the cervix effaces and dilates to 4 cmdifficult to time precisely, and durationvaries, averaging 8 h in nulliparas and 5h in multiparas.duration is considered abnormal if itlasts > 20 h in nulliparas or > 12 h in
multiparas
During the active phase the cervix becomes fully dilated, and the presentingpart descends well into the midpelvis
On average, the active phase lasts 5 to 7 h in nulliparasand 2 to 4 h in multiparasThe cervix should dilate 1.2 cm/h in nulliparas and 1.5cm/h in multiparasIf the membranes have not spontaneously ruptured,some clinicians use amniotomy (artificial rupture ofmembranes) routinely during the active phase.
Women may begin to feel the urge to bear down as thepresenting part descends into the pelvis
-
7/30/2019 Pleno Dystocia
6/8
The 2nd stage-Expulsion-the time from full cervicaldilation to delivery of the fetusOn average, it lasts 2 h in nulliparas (median 50min) and 1 h in multiparas (median 20 min)Strong contraction occur every 2-3 min and lastabout 1 minCrowning occurs when the largest dimension ofthe babys head distends to the vulva, episiotomy isdone to reduce tissue tearing.The babys neck extends as their head exits fromthe perineum.Once the head is delivered, the rest of the babys
body is delivered much more easily.After birth, the umbilical cord is clamped and cutStage 3placental stageCollectively called afterbirthDelivery of placenta and its attached fetalmembranes
Accomplished within 30 minutesStrong uterine conctractions thatcontinues afterbirth compress the uterineblood vessels, limit bleeding, and shearthe placenta off the uterine wall.It is important that all placental fragments
be removed to continued uterine bleedingafter birth (postpartum bleeding)
-
7/30/2019 Pleno Dystocia
7/8
-
7/30/2019 Pleno Dystocia
8/8
Second pregnancy
Descent 3/5
Descent Hodge 2
Inner pelvic
adequate
No Passage
ProblemFundal height X abdominal
circumferences37 X 95 = 3515g (3.515 kg)
Inner pelvic
adequate
Lowest Part Was head
No Passenger
problem
contraction 4.00-7.00 am
10.00am
Twice/ 10min interval,
Duration 25-30s
Thrice/ 10min interval
Duration 25-30sDescent 3/5
Descent Hodge 2
Inadequate
Power
top related