Labor and Delivery

صفحه 1:


صفحه 2:
What is Labor? Course of Labor * Demonstratin x g progressive cervical changes, in the presence of regular, frequent, painful uterine contractions ‏مره‎ © x TTT TT ert 5 x Ex a eas Cervical Dilatation in Centimeters Hours of Labor 

صفحه 3:
STAGES OF LABOR (Stage of Cervical Dilation) Begins with onset of regular contractiona and ends with complete dilation Latent —> Active =< Transitional ) (6-10 cm) “First Stage- _ 3۷ (Stage of Expulsion) Begins with complete cervical dilation and ends with delivery of fetus. - Second Stage - (Placental Stage) Begins immediately after fetus is born and ends when the placenta is delivered - Third Stage - (Maternal Homeostatic Stabilization Stage) Begins after the delivery of ‘the placenta and continues for one to four hours after delivery. - Fourth Stage 5 

صفحه 4:
Phases of Labor During First Stage * Latency (0 to 3 cm) ۳ a \ * Prodromal, early, prelim Vi | | | * 4-24 hours ‏للها‎ ‎Tho Progression of Labour ۰ Active (4 to 7 cm) * 3to 5 hours ٠ Transition (8 to 10 cm) / ۳۱۳۲ * % to 2 hours ‏.سكام‎ [een fe 01022025 6 

صفحه 5:
Physiologic Forces of Labor ¢ Frequency of contractions ° Effectiveness of pushing 

صفحه 6:
Can You Figure Out The 0 - Duration | - Intensity F -Froquanay Te توس 

صفحه 7:
Uterine Contractions Uterus Uterus between during 9 contractions ° Palpation ° Timing ° Frequency * Duration * strength 1 1 = = 

صفحه 8:
Birth Passage ° Size of maternal pelvis ° Type of maternal pelvis ° Ability of cervix to dilate ° Ability of vaginal canal to distend 

صفحه 9:
‎Pratypelod‏ سس دمجم مير ‎ ‎erty ‏أ‎ aig Incidence in Ferner soe 2siewhte 30% a ‏یبد‎ ‎shape ‎Round ylndsic shape Long narow ovat Heart-orwangulrshoped _Fltened Wide, short ovat roughout Widepubicarch Anteroposterior diameteris inlet Narrow lameters _‘Tanaverse ameter vie but (Degrees o reser longer thon tansveve diam- throughout Narrow puble anteroposterior lometer short ster Narow publ rch ach ‏سس‎ ‎Progr for Vaginal ith ‏امم :30 لمم‎ More avorablethan ano or Poor Poor Wide dlametcrsand.gertie _playpelloid pei shape cunves thoughout ‏رس ني‎ be born noe ‎put postelor postion. (Crom vara. 8. 8 Moines 05 ‏موم او ملد‎ nate rung St Lous M.S Sandee) Fig. 22-4, Pelvis shapes. 

صفحه 10:
Dilation and Effacement مت Fully dilated. fully effaced 

صفحه 11:
Fetal Head Copyright’ Te nctrow ta Compinis ne Prmistlon ‏وی مه مهو موه‎ Anterior fontanel Frontal bone Parietal bone ‘Sphenoid Tontanel Posterior. ano + sphenoid fontanel © ‘Temporal bone Mastois fontanel o1j022025 ad 

صفحه 12:


صفحه 13:
° Fetal attitud 3 ° Fetal lie 

صفحه 14:
Vertex prosetation Miltary ‏امس‎ Brew presentation Face presantation Complete sin Moderateflexion Partial flexion Fallestension (extension) [Fontes Jars 8 tray 6, abl O06 Nalin ‏إن فحة] يمسم نه‎ St Lave WO, Snes) Fig. 26-3. Cephalic presentations. 01j022025 14 

صفحه 15:
Frank breech Full breech Single footling breech ] €, Jomo, 8 Mara, 8,8 Asi. 905) Uterine a St Lai WB, aur) Fig. 25-4. Breech presentations. 

صفحه 16:


صفحه 17:
Passage FETAL STATION ‎ead to ecers )‏ ملت ‎° Engagement ° Station ¢ Fetal position ‎Im At Zr. Frome is APs. (mOn yay Olt ‎ ‎ ‎01022025 0 ‎ ‎ ‎ 

صفحه 18:
+4 STATION AND DELIVERY Nurse, why didn't you tell me she was 80 close to delivery? 15 minutes ago she was at 

صفحه 19:
Psychosocial considerations ° Mental and physical preparation for childbirth * Sociocultural values ° Previous experience ۰ Support 01/02/2025 0 « Emotional status 

صفحه 20:
Admission to Labor Suite ° History * Contractions = ¢ When they last ate * Vital signs ۰ Ultrasound ٠: ‎Q‏ همه ‎ ‎ ‎ ‎ 

صفحه 21:
Membranes Rupture * 600 to 800 cc * Color * Odor = * Consistency ° Nitrazine Paper the fetus in the uterus 2 همه 

صفحه 22:
م 5 ۳۵00 

صفحه 23:
External fetal monitoring ° Two belts ° Uterine contractions * Fetal heart monitoring ° benefits * negatives ‘Extornal Fetal Hoart Rate Monitoring و همه 

صفحه 24:
و —— Internal fetal monitoring Fetal scalp electrode (FSE), an internal fetal heart monitor = Intrauterine pressure catheter (UPC), an internal contraction monitor ADAM, 01022025 @ 

صفحه 25:
Fetal heart variability 11 سل ‎Ct tet 3‏ 

صفحه 26:
Early decelerations 

صفحه 27:
و همه ° Uteroplacental Late decelerations 

صفحه 28:
Variable decelerations 01022025 © aaa aaa a 

صفحه 29:
Cardinal movements ° Descent ° Flexion ° Internal rotatio ° Extension ° Restitution * External rotaticl ° Expulsion 

صفحه 30:
Fetus moving through the Palwic 5 

صفحه 31:
Placental delivery * Contraction * Globular uterus = ۰ Cord lengthens ° Rush of vaginal blood 01022025 

صفحه 32:
Causes of Pain in Labor Grretchieg oP the vervix ‏ديل‎ diaiod & ‏تخد‎ Gtretchtag oP the terior bya 

صفحه 33:
Causes of Pain in Labor QDpteuios oF te vaged oad ‏بو‎ Ovwpression oP the verve youdia to veruix & lower vere resourses ‏رای من‎ bhidder, vevtucr durtay Petal dese ۴ اوه اجه من ملسم مت صبا 

صفحه 34:
Factors affecting Mothers Response to Pain in Labor * Preparation - Knowledge and confidence gained through childbirth classes * Cultural influences on expression of pain * Maternal fatigue, anxiety, sleep deprivation 

صفحه 35:
Methods of Pain Relief ° Nonpharmacological © Childbirth m = * Breathing Techniques * Relaxation Techniques * Touch * Focusing attention on one object 

صفحه 36:
۵ Breathing Methods Basic principles * Comfortable position * Chest breathing * Focal point * Verbal and non-verbal cues * Cleansing breath Rhythmic chest Shallow chest Pant-blow Exhalation pushing (01/02/2025, 

صفحه 37:
Non-Pharmacological ٠ Listening to music; subdued lignting ~~ Imagery * Applying heat and cold * Massage (lower back); Counterpressure * TENS * Position Changes 

صفحه 38:
Pain Management * Narcotic Analgesics * Timing = ° Effect on labor * Common meds used * Stadol ° Nubain 

صفحه 39:
Pain Relief in Labor * Criteria for administering an analgesic: * Needs to be in active phase of labor * If give in latent phase - it may slow labor » If give in transition phase - can lead to neonatal respiratory depression 

صفحه 40:
Regional Anesthesia Epidural Space Spinal Cord #۳ Epidural a Spinal a4 HL Pudendal ۱ Epidural pinal Fluid Catheter Side effects * Hypotension * Bladder distention 

صفحه 41:
Nursing Care related to an epidural ¢ Preparation * Assess platelet count - must be normal * Empty bladder * Assess vital signs for baseline ° IV fluids ¢ Following * Assess V/S - especially the B/P because the main side effect is hypotension * Rotate position between right and left side-lying * Assess bladder and catheterize as needed * Assess for other side effects and intervene تسس تا 

صفحه 42:
Variations of the breech presentation Complete Incomplete Frank breech breech breech ®ADAM. 0102202542 

صفحه 43: