MANAGEMENT OF LABOUR
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Transcript of MANAGEMENT OF LABOUR
Role of nurse on management in
labor
DEFINITION
Labor is a process by which the fetus, Placenta and membranes are expelled through birth canal.
Series of events that take place in the genital organs in an effort to expel the viable products of conception out of the womb through the vagina in to outer world is called labour.
STAGE OF LABOUR
FIRST STAGE:- It starts from onset of true labor pain and ends with full dilatation of cervix. It’s average duration 12hrs in primigravida and 6hrs in multipara.
SECOND STAGE:- It starts from the full dilatation of cervix and ends with expulsion of fetus from the birth canal.
THIRD STAGE:- It begins after expulsion of fetus and ends with expulsion of the Placenta & membrane.
FOURTH STAGE:- It is the stage of observation for at least one hour after expulsion.
MANAGEMENT OF FIRST STAGE LABOUR
Enema
Perineal shave
Food & Fluids by mouth
Intravenous infusion
Position & Ambulation
Medication
Monitoring Maternal physiological changes
Vital sign
Renal system
GI changes
Haematological changes
Monitoring Of Fetal Wellbeing
Evaluation Of Maternal Wellbeing
Vital sign
Bladder care
Urine test
Hydration
Bodily Care Of Progress Of Labour
Back rub
Abdominal rub
Effleurage
EVALUTION OF PROGRESS OF LABOUR:
Partogram –
Partogram is a graphic recording of the salient features of labour status. In the management of women in labour partogram serves to validate the normal progress of labour and to facilitate early identification of deviations from normal pattern.
Maternal vital signsUterine contractionsFetal heart rateVaginal examination findingsFluid balance Urine analysisDrugs administered
MANAGEMENT OF SECOND STAGE OF LABOUR:
Vital Sign
Bladder care
Hydration & General condition
Maternal pushing effort
Analgesia & Anaesthesia
Perineal integrity
Episiotomy
Evaluation of progress of labor
Contraction Pain
Length of Second Stage
Descend & Station
Progress through the mechanism labor
PREPARATION FOR THE DELIVERY:Location of the delivery Position for the deliveryGeneral preparationCONDUCTION OF DELIVERY:Clamping and cutting the Umbilical cordImmediate care of the Newborn
MANAGEMENT OF THIRD STAGE OF LABOUR:
Delivery of the Placenta & Membrane.
Sign of placental separation
•Fresh blood loss
•Lengthening of the cord
•Fundus becomes rounder,smaller & more mobile in the abdomen
Expectant management
Assisted expulsion
•Controlled cord traction
•Expression by fundal pressure
Use of Oxytocic agent.
Examination of Placenta & Membrane.
Immediate care to mother & baby.
MANAGEMENT OF FOURTH STAGE LABOUR:
Evaluation & Inspection
•Evaluation of Uterus
•Inspection of Cervix
•Repair
•Perineal Cleansing & Positioning Of Leg
Continuing Case Monitoring:
Vital sign check
Palpation of the fundus of uterus for contractility
Massage of uterus and expression of clots
Measurement of fundus
Inspection of the perineum
Inspection of bladder
Inspection and change of perineal pad
THANK YOU
Mrs. Kalyani RathLecturer, KINS