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Name of Condition Normal labou Mwapcouk正常情况下的劳动mwapcouk名称.doc

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Name of Condition Normal labou Mwapcouk正常情况下的劳动mwapcouk名称

2.12: Normal labour Recognise the onset of labour Symptoms and signs of labour are: Painful regular contractions (midwife attention at 5 mins apart) Cervical dilatation and effacement A show (passage of the cervical mucus plug) – may occur up to a few days before labour Spontaneous rupture of membranes (SROM) – may occur up to a few days before labour Labour is diagnosed when there are regular painful contractions + effaced cervix which is 3cm or more dilated +/- a show or ROM. There are three stages of labour: 1st Stage = Onset of established labour to full cervical dilatation. This can be further divided into: The latent phase. This is characterised by irregular uterine contractions and slow cervical dilatation/effacement to approximately 3cm. About 2/3rd of phase 1 – lasts 24hrs nullip and 16 hrs otherwise. The active phase, where dilatation should occur at approximately 1-2cm/hour in the nullip and 2-3cm/hour in the primip. There should be regular, coordinated uterine contractions. 2nd Stage = From full dilatation (10 cm) to birth of the baby. The second stage should be 3 hours in a primip (or 2hours without regional anaesthesia) and 2hours (or 1hour without regional anaesthesia) in multip’s 3rd stage = From birth of the baby until delivery of placenta and membranes. This usually takes 10mins, over 30 is abnormal but may not require intervention. The course of normal labour therefore is: Stage Nulliparous Multiparous First 6-18 hours 2-10 hours Second 30mins-3 hours 5-30 mins Third 5-30 mins 5-30 mins Progress in Labour The progress of labour is monitored using a partogram, which plots foetal HR, cervical dilatation/station of presenting part, maternal HR and BP over time. Drug administration can also be plotted, as can urine dipstick results. The progress of labour depends on the: Passage Passenger Powers Passage This consists of the bony pelvis (inlet, cavity and outlet) PLUS the soft tissue of the uterus, cervix, vagina, pelvic floor and perineum.