NORMAL LABORNORMAL LABOR

wang jingyinwang jingyin

Ⅰ Ⅰ . . DefinitionDefinition Delivery is the process by which the Delivery is the process by which the

mature or nearly mature (fetus and mature or nearly mature (fetus and placenta) are expelled from the placenta) are expelled from the maternal body.maternal body.

The term delivery refers to the labor The term delivery refers to the labor occurring between the beginning of the occurring between the beginning of the 37w to 42w.37w to 42w.

The premature delivery refers to the The premature delivery refers to the labor occurring between the 28w to the labor occurring between the 28w to the 37w.37w.

The postdelivery refers to the labor The postdelivery refers to the labor occurring over 42w.occurring over 42w.

Ⅱ Ⅱ . . Agents of laborAgents of labor

1. Mechanical theory 1. Mechanical theory 机械性理论机械性理论 2. Endocrine regulating theory 2. Endocrine regulating theory

内分泌控制理论内分泌控制理论 3. Neurohumor theory 3. Neurohumor theory 神经介质理论神经介质理论

Ⅲ Ⅲ ..Factors affecting labor.Factors affecting labor. There are four factors affecting labor: There are four factors affecting labor:

expulsive force, the fetus (line position expulsive force, the fetus (line position and presentation of fetus), passage (the and presentation of fetus), passage (the bony pelvis and soft tissue), and bony pelvis and soft tissue), and psychological factors.psychological factors.

If the four factors accommodate each If the four factors accommodate each other, the fetus may be easily delivery, other, the fetus may be easily delivery, otherwise difficult delivery may occur.otherwise difficult delivery may occur.

1. 1. The powers The powers 产力产力 1) uterine contraction1) uterine contraction

rhythm rhythm 节律性节律性

symmetry symmetry 对称性对称性polarity polarity 极性极性retraction retraction 缩复作用缩复作用

2) abdominal muscles and diaphragm2) abdominal muscles and diaphragm

腹肌、膈肌腹肌、膈肌 3) levator 3) levator 肛提肌肛提肌

2. 2. Birth canal Birth canal 产道产道 1) bony pelvis 1) bony pelvis 骨产道骨产道 pelvic inlet plane pelvic inlet plane 骨盆入口平面骨盆入口平面

mid plane of pelvis mid plane of pelvis 中骨盆平面中骨盆平面

pelvic outlet plane pelvic outlet plane 骨盆出口平面骨盆出口平面

2) the soft part of the birth canal 2) the soft part of the birth canal 软产道软产道 formation of lower segment formation of lower segment

changes in the cervixchanges in the cervix

changes in the floor of pelvis, vagina changes in the floor of pelvis, vagina and perineumand perineum

3. 3. The fetus The fetus 胎儿胎儿 1) size of the fetus1) size of the fetus

2) position of the fetus 2) position of the fetus 胎位胎位 3) abnormality of the fetus 3) abnormality of the fetus 胎儿畸形胎儿畸形

4. Psychological factors 4. Psychological factors 精神心理因精神心理因素素

Ⅳ Ⅳ. . The mechanism of normal labor in vertex The mechanism of normal labor in vertex presentationpresentation

1. Engagement 1. Engagement 衔接衔接 2. Descent 2. Descent 下降下降 3. Flexion 3. Flexion 俯屈俯屈 4. Internal rotation 4. Internal rotation 内旋转内旋转 5. Extension 5. Extension 仰伸仰伸 6. Restitution and external rotation 6. Restitution and external rotation 复位、外旋转复位、外旋转 7. Expulsion of fetus 7. Expulsion of fetus 胎儿娩出胎儿娩出

Ⅴ Ⅴ. . Threatened labor and in laborThreatened labor and in labor 1. Threatened labor 1. Threatened labor 先兆临产先兆临产 1) false labor 1) false labor 假临产假临产 2) lightening 2) lightening 胎儿下降感胎儿下降感 3) show 3) show 见红见红

2. In labor 2. In labor 临产临产

Ⅵ Ⅵ. . Total stage of labor Total stage of labor 总产程总产程 1. The first stage or dilatation of the 1. The first stage or dilatation of the

cervical OS cervical OS 初产妇 初产妇 1111 －－ 1212hh

经产妇 经产妇 66 －－ 88hh

2. The second stage or expulsion of the 2. The second stage or expulsion of the fetusfetus 初产妇 初产妇 11 －－ 22hh

经产妇 数分钟－经产妇 数分钟－ 11hh

3. The third stage or expulsion of the 3. The third stage or expulsion of the placenta 5placenta 5 －－ 15min15min

Ⅶ Ⅶ. . Clinical course and treatment in Clinical course and treatment in first first stagestage

1. Uterine contraction 1. Uterine contraction 子宫收缩子宫收缩 2. Fetal heart rate2. Fetal heart rate 3. Dilatation of the cervix and descent 3. Dilatation of the cervix and descent of the of the

fetal headfetal head 4. Rupture of membranes4. Rupture of membranes 5. General menagement5. General menagement

Ⅷ Ⅷ. Clinical course and treatment in . Clinical course and treatment in second stagesecond stage

1. Clinical findings1. Clinical findings

2. Treatment 2. Treatment

Ⅸ Ⅸ. . Clinical course and treatment in Clinical course and treatment in third stagethird stage

1. Clinical findings1. Clinical findings

2. treatment2. treatment