NORMAL LABOR AND DELIVERY - Operational Medici.PPT

NORMAL LABOR AND DELIVERY SFC WARD Terminology Gravida - number of pregnancies Para - number of pregnancies carried to viability and delivered Primigravida - pregnant for first time Multigravida - pregnant more than once Viability - able to survive outside the womb (24+ weeks gestation) Nulliparous - never carried a pregnancy to viability Multiparous - has had two or more deliveries that were carried to viability Duration of Pregnancy Average 280 days or 40 weeks (9 lunar months) Estimated Date of Confinement (EDC) Nagele’s rule Date of first day of LMP Subtract 3 months Add 7 days Accurate to plus or minus 2.5 weeks First Stage of Labor Begins with onset of coordinated contractions leading to dilation of cervical os and ends with complete dilation (10 cm) of the cervical os. False Labor (Braxton Hicks contractions) Cervix fails to dilate greater than 2 cm Duration of first stage - Primigravida: 12 hours Multiparous: 7 hours or less First Stage of LaborContractions Interval 10 to 20 minutes between contractions: early labor 3 to 5 minutes between contractions: late labor Duration 20 second long contraction: early labor 40 to 80 second long contraction: late labor Quality Uterus can be dented (poor quality): early labor Uterus is hard (good quality): late labor First Stage of Labor Management Take VS between contractions Fetal Heart Rate should be between 120 - 160 BPM Mother should be coached to relax and conserve energy between contractions Assessing Progress of Labor Vaginal Exam Cervix Soft or Hard Effaced or Thick Dilatation Presentation Part (cephalic, breech, shoulder) Flexion, Extension Station Second Stage of Labor Begins with complete dilation of the cervix and ends with delivery of fetus Duration of Second Stage - Primigravida: 50 minutes Multiparous: 20 minutes or less Contractions Interval: 2 to 3 minutes Duration: 50 to 100 seconds Second Stage of Labor Management Mother may feel urge to push, coach to push only during a contraction once the cervix h