![Page 1: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/1.jpg)
![Page 2: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/2.jpg)
Definition:
Childbirth is the period from the onset of regular uterine
contractions until expulsion of the placenta . .
![Page 3: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/3.jpg)
–at the onset of labor the position of the fetus with respect to the birth canal is critical to the route of the
delivery .
–It is important to know the fetal position within the uterine cavity at
the onset of labor
![Page 4: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/4.jpg)
Fetal lie : is the relation of the long axis of the fetus to that of the mother it
is either longitudinal 99% or transverse or oblique (due polyhyd ,p.p ,ulnine
anomali)
![Page 5: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/5.jpg)
Fetal presentation is the portion of the fetal body that is either fore most within
the birth canal or closest proximity to it.
![Page 6: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/6.jpg)
1(cephalic presentation.
•It is classified according to relation ship
between the head and the body of the fetus.
![Page 7: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/7.jpg)
2 (face presentation
•Fetal neck sharply extended so that the
occiput and back come in contact
![Page 8: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/8.jpg)
3(brown presentation
•Partially extended head .is the greatest diameter 13.5cm fronto bregmatic
![Page 9: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/9.jpg)
4(Breech. presentation
eith.Frankcompletfootling.
Delivery usually by cls
![Page 10: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/10.jpg)
![Page 11: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/11.jpg)
Fetal postion
•Relation ship of an chosen portion of the fetal presenting pant to the Rt or Lt .side
of birth canal
![Page 12: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/12.jpg)
Labor with.Occiput presentation.
•1)in the most of the cases the vertex inter the pelvis with the sagittal suture lying in
transverse pelvic diameter .
•(L.O.T. )40%
•(R.O.T. )20%
![Page 13: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/13.jpg)
Cardinal movements in the mechanism of labor and
Delivery in left .occiput. anterior position
Descent
Flexion
Internal rotation
External rotation
Expulsion
![Page 14: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/14.jpg)
Descent:
•This movement is the First requisite for the birth of New born .
•usually follow the engagement .
•
![Page 15: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/15.jpg)
Descent occe due to
•1)pressure of the A.F
•2)Direct pressure to the breech by contraction.
•3)bearing down of maternal abd .muscles.
•4)extention of fetal body.
![Page 16: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/16.jpg)
Flexion:
•When descending head meets resistance from cervix –walls of the pelvis or pelvic floor
•This results in the chin brought into more contact with the fetal thorax.
•-and the suboccipitobregmatic diameter . will be presentation
![Page 17: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/17.jpg)
Internal Rotation
•This movement consists of turning of the head in such a manner that the occiput gradually moves toward the symphysis
pubis .anteriorly
![Page 18: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/18.jpg)
Extension
•After internal Rotation the sharply flexed head reaches the vulva and undergoes
extension
![Page 19: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/19.jpg)
External Rotation–The delivered head undergoes restitution .to
oblique position followed by complition of external
•rotation to transverse position .
![Page 20: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/20.jpg)
Expulsion
•Immediately after external Rotation . the anterior shoulder appears under
symphysis and the perineum soon becames. Distended by post shoulder
![Page 21: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/21.jpg)
![Page 22: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/22.jpg)
2 (onset of labor.•The plysiological processes in human
pregnancy that result in initiation of labor remain poorly defined .
•uterotonin production .
•elevation of the uterotonin receptors in myometriam
![Page 23: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/23.jpg)
Progesterone Estrogen
Reloxin Corticotrophin Releasing hormone (CRH)
Prostaglandins
oxytocin receptors .
Fetal ACTH
![Page 24: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/24.jpg)
Characteristics of normal labor
• Latent phase•defined as the point at whitch the pt. has
regular contraction and cervical dilatation less than 5cm
• avaragble duration is 12hr
•
![Page 25: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/25.jpg)
First stage of laborRegular uterine contraction lead
To cervical dilatation
Formation of distinct lower uterine and upper segments
Duration 4.9 hour
![Page 26: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/26.jpg)
![Page 27: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/27.jpg)
Second stage of labor
•This stage begins when cervical dilatation is complete and ende with
Fetal delivery.
•Duration: 50 min up to2hr in nullparus 20 min 1hr in multi para.
![Page 28: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/28.jpg)
Third stage of labor
•From expulsion of the fetus till the Delivery of placenta it is 30 min
![Page 29: Normal Labor and Delivery by Dr.Nawal ALsinany](https://reader035.vdocuments.us/reader035/viewer/2022062217/568147ee550346895db527fa/html5/thumbnails/29.jpg)