Medical brain notes 11

  Introduction   In the previous units of this module, we have learnt much about pregnancy and care during the prenatal period. In this unit we will learn about the remarkable events that result in delivery of the baby. We shall discuss the physiology of labour, the factors that causes the onset of labour, signs of labour and how to alleviate the woman’s sufferings in labour.   Objectives At the end of lesson the learner will be able to   ·                Describe the changes that occur in the uterine tissue during labour.   ·                Describe the stages of labour   ·                Explain the spontaneous process of labor and how this may be enhanced or inhibited.   ·            ...

  Stages of labour   Labour is described in three stages the fourth stages is the first one hour after the delivery of placenta.   1. The First Stage “  This is the period from the onset of the true regular uterinecontractions until full dilatations of the cervical Os.” This is the period of cervical dilatation and it is described in phases.   Latent Phase:  this is the period prior to active stage oflabour. Time from spontaneous onset of labour until the cervix is 3-4cm dilated and the cervix shortens from 3cm to 0.5cm long. It may last 6-8hours in primip but much shorter in multiparous, the line on the partogram remains horizontal.   Active phase:  Is the period from 3-4cm to 10cm dilatation.The cervix undergoes more rapid dilatation, at the rate of about 1cm per hour. The line on the partogram rises rapidly. It last 2-6 hours but shorter in multiparous women.   2. Second Stage   This is that of expulsion of the fetus. “it is the perio...

  Duration of labor   There are wide variations in the duration of labor. The length of labor is influenced by party, time of the last delivery, type of pelvis, size and presentation of the fetus, strength and frequency of uterine contractions. The greatest part of labor is taken up by the first stage. The most important thing is the progress of labor provided the woman is comfortable and the fetus is well. The labor last longer in primigravidae than in multigravidae.   Some times primigravidae spend less time while multipara spend more time in labour. Evidences have shown that the use of Oxytocin and one-to-one care has reduced the period of labour considerably.   Calculation of duration of labour Example:   Date – 12/6/2008   Time:   Labour begins – 12:30a.m   OS fully dilated – 7.15a.m   Baby delivered – 7.25am.   Placenta & membranes delivered – 7.38a.m 1 st  Stage: 12.30 – 7.15a.m = 6hrs : 45mins 2 nd Stage : 7.15 – 7.25a.m...