final-5 p's of labor 3
DESCRIPTION
Powerpoint,Labor, midwiferyTRANSCRIPT
COMPONENTS OF LABOR
P’S IN LABOR & DELIVERY1. PASSAGEWAY
Woman’s pelvis and the birth canal2. PASSENGER
the fetus and placenta3. POWERS OF LABOR
force of uterine contractions4. POSITION OF THE MOTHER
5. PSYCHE/PSYCHOLOGIC RESPONSE of the mother
preserved so that afterward, labor can be viewed as a positive experience
1. PASSAGEWAY (BIRTH CANAL) THE PELVIS
FUNCTIONS OF FEMALE PELVIS allows movement of the body, especially
walking and running. permits the person to sit and kneel. adapted for child bearing, and because of
its increased width and rounded brim women are less speedy than men.
Pelvic bones
four pelvic bones Two
innominate( nameless) or hip bones
One sacrum One coccyx
Innominate bones:
1. Ilium2. Ischium3. Pubis
ILIUM the upper
flattened part of the hip bone
larger flared out part.
When the hand is placed on the hip it rests on the iliac crest, which is the upper border.
ISCHIUM thick lower part. has a large
prominence known as the ischium tuberosity, on which the body rests when sitting.
Behind and a little above the tuberosity is an inward projection, the ischial spine.
in labour the station of the fetal head is estimated in relation to the ischial spines.
PUBIS the anterior or front part
of the hip bone has a body and two oar
like projections, the superior ramus and the inferior ramus
The two pubic bones meet at the symphysis pubis and the two inferior rami from the pubic arch, merging into a similar ramus and the ischium.
The space enclosed by the body of the pubic bone, the rami and the ischium is called the OBTURATOR FORAMEN.
SACRUM a wedge shaped bone
consisting of five fused vertebrae
The upper border of the first sacral vertebra juts forward and is known as the sacral promontory
The anterior surface of the sacrum is concave and is referred to as the hollow of sacrum. Laterally the sacrum extends into a wing or ala.
COCCYX: a vestigial tail. A small bone
consists of four fused vertebra forming a small triangular bone.
During labor it moves backward, having more space for the delivery of the fetus this is called nodding.
Pelvic jointsThere are four
pelvic joints One symphysis
pubis Two sacroiliac
joints One sacro-
coccygeal joint
SYMPHYSIS PUBIS
formed at the junction of the two pubic bones, which are united by a pad of cartilage.
SACROILIAC JOINTS
these are the strongest joints in the body.
Joins the sacrum to the ilium and thus connect the spine to the pelvis.
SACRO COCCYGEAL JOINT
formed where the base of the coccyx articulate with the tip of the sacrum.
PELVIC BONE
Ligaments of the Pelvis
a short band of tough, flexible, fibrous connective tissue that connects two bones or cartilages or holds together a joint.
DIVISIONS OF THE PELVIS:FALSE PELVIS
superior half; upppet, larger but shallow division that supports the uterus in the abdominal cavity during pregnancy
divided by the linea terminalis into the false pelvis above this demarcation and the true pelvis below it.
the portion above the pelvic brim
TRUE PELVIS inferior half; lower, curved,
smaller portion constitutes the bony
passage /canal through which the fetus must pass through to be born vaginally.
L INEA TERMINALIS imaginary line that
separates the upper or false pelvis from the lower or true pelvis
DIVISIONS/PLANES OF THE PELVIS1. Pelvic Inlet
Upper portion;first pelvic plane; entrance to the true pelvis
Bounded by the upper border of the symphysis pubis,sacral promontory and linea terminalis
The anteroposterior(AP) points being the back side of the symphysis pubis and the sacral promontory, the smallest AP diameter called obstetrical Conjugate
2. Midpelvis(Pelvic Cavity) Between the boundaries for the
pelvic inlet and outlet The smallest diameter of the
midpelvis is the transverse or intraspinous diameter(between the 2 ischial spines)
3. Pelvic Outlet The plane of the pelvis that
lies at the level of the ischial tuberosities, the lower border of the symphysis pubis and coccyx
PELVIC DIAMETERS
1.Pelvic Inlet or Pelvic brim
Pelvic Inlet1. Palpation of pelvic brim:• The index & middle fingers are moved
along the pelvic brim.
IMPORTANT PELVIC
MEASUREMENTS AT 3 PLANES
1.Pelvic Inlet or Pelvic brim
DIAGONAL CONJUGATE (DC)
Widest anteroposterior diameter distance from the lower/ inferior
margin of the symphysis pubis to sacral promontory
measured by internal examination
ADEQUATE = 12.5 TO 13 CMS or more