CHILDBIRTH NORMAL CHILDBIRTH ‘IN PARTU’ UNDERSTANDING
The process by which the baby, placenta and
amniotic membrane comes out of the mother's uterus. Normal Delivery Occur at term of gestation (> 37 weeks) No complications of pregnancy ‘In Partu’ labor Contracting uterine changes Changes in the cervix (opening, thinning) Ending with the birth of the complete placenta 3FACTORS CAUSING LABOR TO BEGIN
Decreased progesterone levels
Increased estrogen levels Release of oxytocin from neurohipofisis Increased levels of fetal prostaglanding and cortisol Increased uterine size followed by calcium release from sarcoplasma reticulum The Lowest pressure fetus on the cervix and lower uterine segment Aging of the placenta External factors SIGNS & SYMPTOMS ‘INPARTU’ 1. Cervical thinning and opening. 2. Uterine contractions that result in changes in the cervix (frequency at least 2 times in 10 minutes). 3. Mucus discharge mixed with blood through the vagina. IMPORTANT FACTORS IN LABOR
Passage (birth canal)
pelvic cavity, cervix, vagina Type of mother's pelvic cavity (image)Passage (birth canal) pangg pelvic cavity, cervix, vagina Type of mother's pelvic cavity PASSENGER’ (FETUS AND PLACENTA)
- Presentation, location, and position of the fetus
- Position and position of the placenta
- Estimated fetal weight, number of fetuses'
Power '(contraction) - frequency, duration, intensity
psychological (emotional status)
previous experience,
system support,
environment Position of mother's position at
delivery' labor progress DURING CHILDBIRTH KALA I
Cervical bleeding and opening accompanied by
expulsion of blood and mucus Starting from regular uterine contractions to complete cervical opening The duration depends on maternal parity (12 hours primi, 8 multi hours) Consists of a latent phase (± 8 hours) Lasts until the cervix opens 4 cm Active phase Lasts until the opening of the cervix 10 cm
Primi (1 cm / hour), multi (1-2 cm / hour)
Contractions: adequate (3 x /> in sec)
STAGE II FETAL EXPULSION
Starting from the complete opening of the cervix
the birth of the fetus Old ± 50 '(primi), ± 20' (multi) Symptoms and signs Mothers want to contract along with the occurrence of contractions Mothers feel there is an increase in pressure in the rectum Perineum protruding Vulva, vagina and sphincter ani Increased increased vaginal secretion in the vagina Definite signs of complete cervical opening Visible part of the baby's head vaginal introitus, vulva opening KALA III
Release and release of Old Palsenta: 15 ’
Bleeding ± 500 c Signs of detachment of the placenta Changes in shape and height of the uterus Long umbilical cord elongated Sudden and brief blood flow Active management Administration of oxytocin injections Controlled cord tension Containment of the uterine fundus KALA IV -Length: 1-2 hours after the placenta is born Monitor every 15 'in the first 1 hour and every 30' in the next 1 hour. - Uterine contractions - TTV - TFU Early detection of PP bleeding risk