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Stages of Labor and Management Guide

The document outlines the stages of labor and normal labor times. It discusses the partogram used to graphically represent labor progress. Contraction strength and frequency are important indicators. Prolonged labor is defined differently for primary and multiparous women. Instrumental delivery may be needed if stage 2 is prolonged.

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zahra
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7 views2 pages

Stages of Labor and Management Guide

The document outlines the stages of labor and normal labor times. It discusses the partogram used to graphically represent labor progress. Contraction strength and frequency are important indicators. Prolonged labor is defined differently for primary and multiparous women. Instrumental delivery may be needed if stage 2 is prolonged.

Uploaded by

zahra
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as TXT, PDF, TXT or read online on Scribd

Labor stages:

1st stage: dilation on cervix start to complete(10cm is complete)


2nd: dilation of cervix to delivery if fetus
3rd: fetus—> placenta delivery

Partogram/partograph:
Graphical representation of labor

4-5 contractions per 10 mins normal

Dysfunctional uterine contractions are less than 80-120 mmHg(strength of


contractions)—> wont be able to deliver baby

Inefficient uterine contractions we rupture uterine membranes to facilitate contr..


then we give oxytocin infusion drops—-> we can inc till 64 drops per min.
Then we observe cervical dilation and contractions , if not improved then c
section.

+3 head at perenium
0 head at ischial spines
-3 head not engaged

Per vaginal exam should be every 4hrs,


If abnormal progress then every 2 hrs

Primary gravida: 1cm/hr dilation


Multi : 0.5cm /hr

Stage 2 : for primary gravida should be no more rhan 2hrs(baby shiuld be sileverd
in 2 hrs orherwise prolonged labor and we need insteumental delivery)
Multi gravida should be 1 hr .


Mild, moderate, strong contactions ——> strength of contractions boxes.
CTG: 2 probes fetal heart and pressure monitor.

Labor stages:
Normal labor time:
PG: 8hrs . Max 18hrs should not go further. Prolonged is beyond 12hrs.
MG: 5hrs . Max 12 hrs . Prolonged is beyond 6hrs.

Stage 1: 2-6hrs
Latent phase: start of contraction to 4cm . (Should be managaed at home, walking
oral fluids)

Active phase:4cm —> 10cm( PG 1cm/hr MG:0.5cm/hr)


Membrane rupture. If still not dilated then give oxytocin.
Ringer lactate solution/drip: cento
64drops/min max.
4-6 hrs we can wait . After then c section.

Stage 2:
Passive: full dilation to pt not exerting expulsive forces.
Active: when pt starts exerting expulsive force herself.
If stage 2 prolonged then maternal morbidity increases.
PG: 2hrs
MG: 1 hr

Insteuments can be used when:


Cephalic presentation
Head below or at 0 cm
Membranes should be ruptured
Cervix should be fully dilated.
Only then we can use foreceps/instruments

Inlet :
AP 11.5cm
Transverse13.5cm

Outlet
AP 13.5
tran11.5

Midcavity 12.5 cm both ap and transnequal

Mechanism: 7 steps of normal labor


1engagement: presenting part enters pelvic inlet
2. Descent:
3. Flexion: of head
4. Internal rotation. Due to to and fro movemet.
5. Extension
6. Restitution
7. External rotation

Oxf handbook

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