SlideShare una empresa de Scribd logo
1 de 203
Group A  16th Batch Faculty Of Medicine USJP. Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Labour ,[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
The  Pelvis ,[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Deeper  view Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Anatomy of the fetal skull Vault  mainly consists of 2 parietal bones, parts of occipital, frontal and temporal bones. Bones are joined to each other by soft  unossified membranes, known as sutures.  Group A,16th Batch,FMS,USJP. skull vault face base
Superior and lateral view of fetal skull ,[object Object],Group A,16th Batch,FMS,USJP. 1. Coronal Suture 2. Anterior Fontanelle 3. Anterolateral Fontanelle 4. Squamosal Suture 5. Posterolateral Fontanelle 6. Lambdoidal Suture 7. External Acoustic Meatus 8. Sagittal Suture
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Fontanelles Junctions between  sutures are known as Fontanelles   Group A,16th Batch,FMS,USJP.
Importance of Fontanelles ,[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Lateral and posterior view of moulding of the foetal skull Group A,16th Batch,FMS,USJP.
The diameters of the skull ,[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Exact physiological mechanism of initiation of parturition is still unknown. But there are some processes that are of particular importance. Group A,16th Batch,FMS,USJP.
What happens prior to initiation of labour? That means last 4-5 weeks of gestation. ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Onset of labour. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
During 1 st  stage of labour. ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
HISTORY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
ABDOMINAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
VAGINAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Cardiotocography is a  method of monitoring   fetal heart rate  (indirect method)  by using ultrasound technique. Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Analyzing a CTG report ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
1. Foetal heart rate ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
2.Baseline variability of Foetal heart rate ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
3. Accelerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
4.Decelerations ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
In Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
THE PARTOGRAM Group A,16th Batch,FMS,USJP.
THE PARTOGRAM ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
THE PARTOGRAM Group A,16th Batch,FMS,USJP. Foetal Conditions Progress of Labour Maternal Conditions
The Components Assessed by the Partogram ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
contd… ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
contd… ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
contd… ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP. Demonstrating lines
PARTOGRAM Group A,16th Batch,FMS,USJP. ALERT LINE ACTION LINE LSCS
The Importance of the Partogram ,[object Object],Group A,16th Batch,FMS,USJP.
Partogram is a, ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP. Observation of the colour of the liqour Mainly - fresh meconium staining If Meconium is present – watch more closely for signs of fetal distress  Thin meconium -  not much of a risk Thick meconium - more dangerous Fetal heart rate   -checked every 15 minutes If suspicious / eg- fetal bradicardia Apply CTG and monitor Maternal information write here; Date EDD POA BP Blood Gp Blood taken for DT
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Secondary Arrest of Active Phase •   Definition  – No change in cervical dilatation over a period of 2hrs.   Cervix becomes oedematous. Can occur at 4-7 cm dilatation   or as a protracted Deceleration phase    • Aetiology  – CephaloPelvic Disproportion [often absolute]  – Foetal head malposition or malpresentation    [breech]   – Insufficient uterine action  – Excessive sedation  • Outcome  – Will require LSCS. If protracted deceleration  beware   of  shoulder impaction  Group A,16th Batch,FMS,USJP.
 
Aim ,[object Object]
Preparation in the ward  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Preparation in the labour room ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Preparation in the labour room…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Group A,16th Batch,FMS,USJP.
DEFINITION ,[object Object]
INDICATIONS  FOR  INDUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BISHOPS SCORE  IN  INDUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],score 0 1 2 3  Dilation of cervix 0 1 or 2 3 or 4 5 or more Consistency  of  cervix firm medium soft - Length  of  cervical  canal >2 2 _1 1_ 0.5 <0.5 Position  of  cervix posterior central anterior - Station  of  presenting  part -3 -2 -1 or 0  Below  spines
METHODS   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SYNTOCINON ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROSTAGLANDIN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
AMNIOTOMY  (ARM) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FOLEY  CATHETER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Foley  catheter insertion
COMPLICATIONS IN  INDUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],DESCENT Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
1 st  stage of labour  Latent phase Active phase Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Effacement…..   ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management of first stage of labour ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Second stage ,[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP. 2nd  stage Phase 1( Passive Phase): a) No maternal urge to push b) Fetal head is high c) Sagittal suture is in the  transverse position  Phase 2( Active Phase): a) Maternal urge to push is present b) Fetal head is low c) Sagittal suture is in the anterior-posterior position d) bearing down sensation
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Diagnosis of 2nd stage Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management of second stage of labour ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Episiotomy Group A,16th Batch,FMS,USJP.
What is an Episiotomy ? Group A,16th Batch,FMS,USJP. Definition An episiotomy is a surgical incision made in the perineum, the area between the vagina and anus. Episiotomies are done during the second stage of labor to expand the opening of the vagina to prevent tearing of the area during the delivery of the baby.
Why ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Types of episiotomy ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
How to do it ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Infiltration of perineal tissue with local anaesthetic  Group A,16th Batch,FMS,USJP.
Performing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
REPAIR OF EPISIOTOMY   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Repair of episiotomy    Group A,16th Batch,FMS,USJP.
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Aim ,[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Third stage Active management The vulva of the mother should be inspected for tears and repaired Mother should be closely monitored in the labour room for 2 hours. 3. Controlled cord traction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4. Examine the placenta for missing cotelydons 1. Oxytocics-10IU of syntocinon Given after delivery of anterior shoulder. 2.Cord clamp-close to vulva Group A,16th Batch,FMS,USJP.
Controlled cord traction Clamp the cord close to the perineum using sponge forceps. Hold the clamped cord and the end of forceps with one hand. Place the other hand just above the woman’s pubic bone and stabilize the uterus by applying counter traction during controlled cord traction. This helps prevent inversion of the uterus. Keep slight tension on the cord and await a strong uterine contraction (2–3 minutes).  Group A,16th Batch,FMS,USJP.
When the uterus becomes rounded or the cord lengthens, very gently pull downward on the cord to deliver the placenta. Do not wait for a gush of blood before applying traction on the cord. Continue to apply counter traction to the uterus with the other hand.  If the placenta does not descend during 30–40 seconds of controlled cord traction (i.e. there are no signs of placental separation), do not continue to pull on the cord:  Gently hold the cord and wait until the uterus is well contracted again. If necessary, use a sponge forceps to clamp the cord closer to the perineum as it lengthens; With the next contraction, repeat controlled cord traction with counter traction.  Never apply cord traction (pull) without applying counter traction (push) above the pubic bone with the other hand.  Group A,16th Batch,FMS,USJP.
1 2 3 4 5 6 Group A,16th Batch,FMS,USJP.
7 8 Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
DEFINITION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Forceps delivery ,[object Object],[object Object],Group A,16th Batch,FMS,USJP. handle lock blade fenestra shank Cephalic curve Pelvic curve
Classification of forceps deliveries ,[object Object],Group A,16th Batch,FMS,USJP. High cavity forceps Biparietal diameter is still above the inlet .head not engaged
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP. Most widely used type Use for outlet&low cavity deliveries  Used in outlet & low cavity deliveries There is a sliing lock No pelvic curve so it allows fetal head to rotate inside the pelvis Uses for mid cavity deliveries Types of obstetric forceps Wrigley’s forceps Simpson’s forceps kieeland’s forceps
Pre-requesites for forceps delivery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Complications after forceps delivery  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Ventouse delivery   ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Indications for vacuum dlivery ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Contraindications for ventouse delivery ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Basic rules for delivery with ventous ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Complicatons of ventouse delivery ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
PAIN RELIEF IN LABOUR
PAIN IN LABOUR IS NOT BENEFICIAL EITHER TO MOTHER OR FETUS PAIN DYSFUNCTIONAL LABOUR UTERINE  VASOCONSTRICTION FETAL ACIDOSIS HYPERVENTILATION Pco 2 MATERNAL  CATECHOLAMINES PLACENTA PERFUSION
WHAT ARE THE METHODS AVAILABLE? ,[object Object],[object Object],[object Object],[object Object]
PHARMACOLOGICAL METHODS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ADVANTAGES:- These drugs can be administered even by midwives without involvement of medical staff ,[object Object],[object Object],[object Object],[object Object]
INHALATIONAL ANALGESIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lower segment caesarean section. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.
Introduction. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Causes of maternal deaths worldwide. Group A,16th Batch,FMS,USJP.
Etiology… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Uterine atony & PPH with fundal massage. Group A,16th Batch,FMS,USJP.
Etiology. ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Risk Factors  –  Primary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Risk Factors –  Primary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Risk Factors  – Secondary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management.  – Primary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management.  – Primary PPH contd. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Bakri balloon catheter. Group A,16th Batch,FMS,USJP.
Condom attached to a catheter which can be inflated with saline after introducing in to the uterine cavity. Group A,16th Batch,FMS,USJP.
Management.  – Primary PPH contd.   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management.  – Primary PPH contd. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
B-Lynch suture. Group A,16th Batch,FMS,USJP.
Management  – Secondary PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Management  –  Secondary PPH contd. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Prevention of PPH. ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Controlled cord traction. Group A,16th Batch,FMS,USJP.
Manual removal of the placenta. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
History ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
ALWAYS CHECK ; ,[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
SIGNS ,[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
GENARAL EXAMINATION ,[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
ABDOMINAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
VAGINAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
TREATEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
MANAGEMENT OF LABOUR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Group A,16th Batch,FMS,USJP.
Group A,16th Batch,FMS,USJP.

Más contenido relacionado

La actualidad más candente

La actualidad más candente (20)

Abnormal labour
Abnormal labourAbnormal labour
Abnormal labour
 
ECLAMPSIA
ECLAMPSIAECLAMPSIA
ECLAMPSIA
 
Fetal distress
Fetal distressFetal distress
Fetal distress
 
Induction of labor
Induction of laborInduction of labor
Induction of labor
 
Malposition
MalpositionMalposition
Malposition
 
Cervical ripening and the bishop score
Cervical ripening and the bishop scoreCervical ripening and the bishop score
Cervical ripening and the bishop score
 
Preterm labour
Preterm labourPreterm labour
Preterm labour
 
Prelabour Rupture of Membrane (PROM) by Sunil Kumar Daha
Prelabour Rupture of Membrane (PROM) by Sunil Kumar DahaPrelabour Rupture of Membrane (PROM) by Sunil Kumar Daha
Prelabour Rupture of Membrane (PROM) by Sunil Kumar Daha
 
Vacuum Delivery
Vacuum DeliveryVacuum Delivery
Vacuum Delivery
 
Face presentation
Face presentationFace presentation
Face presentation
 
Occipito posterior positition
Occipito posterior posititionOccipito posterior positition
Occipito posterior positition
 
Occipito posterior position
Occipito posterior positionOccipito posterior position
Occipito posterior position
 
3rd stage of labour and its complications
3rd stage of labour and its complications3rd stage of labour and its complications
3rd stage of labour and its complications
 
Puerprium ,peurpral fever and peurpral sepsis (1)
Puerprium ,peurpral fever and peurpral sepsis (1)Puerprium ,peurpral fever and peurpral sepsis (1)
Puerprium ,peurpral fever and peurpral sepsis (1)
 
Perineal lacerations
Perineal lacerationsPerineal lacerations
Perineal lacerations
 
Bleeding in Early Pregnancy
Bleeding in Early PregnancyBleeding in Early Pregnancy
Bleeding in Early Pregnancy
 
Malpresentations
MalpresentationsMalpresentations
Malpresentations
 
Management of Preterm labor
 Management of Preterm labor Management of Preterm labor
Management of Preterm labor
 
presentaion on perineal tear
presentaion on perineal tearpresentaion on perineal tear
presentaion on perineal tear
 
Rupture of the uterus
Rupture of the uterusRupture of the uterus
Rupture of the uterus
 

Similar a Normal Labour

Obstetric terminology
Obstetric terminologyObstetric terminology
Obstetric terminologyberbets
 
Uterine Cavitary Lesions Lab Report
Uterine Cavitary Lesions Lab ReportUterine Cavitary Lesions Lab Report
Uterine Cavitary Lesions Lab ReportTiffany Miller
 
Managing normal labor
Managing normal laborManaging normal labor
Managing normal laborEneutron
 
Labor dystocia
Labor dystociaLabor dystocia
Labor dystociaCubic Zeal
 
Intrapartum fetal monitering
Intrapartum fetal moniteringIntrapartum fetal monitering
Intrapartum fetal moniteringdrmcbansal
 
Antepartum testing
Antepartum testingAntepartum testing
Antepartum testingDebbie Fritz
 
Physiology of labor
Physiology of laborPhysiology of labor
Physiology of laborsarahracal
 
Physiotherapy In Surgical Condition (Labour) 3rd year
Physiotherapy In Surgical Condition (Labour) 3rd  yearPhysiotherapy In Surgical Condition (Labour) 3rd  year
Physiotherapy In Surgical Condition (Labour) 3rd yearKonika Akter
 
Tracheo esophageal fistula
Tracheo esophageal fistula Tracheo esophageal fistula
Tracheo esophageal fistula Dr.Manish Kumar
 
Tracheo esophageal fistula
Tracheo esophageal fistulaTracheo esophageal fistula
Tracheo esophageal fistulaDr.Manish Kumar
 
History and clinical examination in obstetrics
History and clinical examination in obstetricsHistory and clinical examination in obstetrics
History and clinical examination in obstetricsdr shabnam naz shaikh
 
Displacement of the uterus
Displacement of the uterusDisplacement of the uterus
Displacement of the uterusahmed afify
 
obstetrical emergencies
obstetrical emergenciesobstetrical emergencies
obstetrical emergenciesSaima Habeeb
 
Late pregnancy bleeding
Late pregnancy bleedingLate pregnancy bleeding
Late pregnancy bleedingEneutron
 
Effects of anesthesia on mother and baby
Effects of anesthesia on mother and babyEffects of anesthesia on mother and baby
Effects of anesthesia on mother and babyDrVishal Kandhway
 
Oxytocics finalised-110713081015-phpapp02
Oxytocics finalised-110713081015-phpapp02Oxytocics finalised-110713081015-phpapp02
Oxytocics finalised-110713081015-phpapp02Richa Daniel
 

Similar a Normal Labour (20)

Obstetric terminology
Obstetric terminologyObstetric terminology
Obstetric terminology
 
Uterine Cavitary Lesions Lab Report
Uterine Cavitary Lesions Lab ReportUterine Cavitary Lesions Lab Report
Uterine Cavitary Lesions Lab Report
 
Managing normal labor
Managing normal laborManaging normal labor
Managing normal labor
 
process of Normal labor (1).ppt
process of Normal labor (1).pptprocess of Normal labor (1).ppt
process of Normal labor (1).ppt
 
Labor dystocia
Labor dystociaLabor dystocia
Labor dystocia
 
Normal labour
 	Normal labour			 	Normal labour
Normal labour
 
Intrapartum fetal monitering
Intrapartum fetal moniteringIntrapartum fetal monitering
Intrapartum fetal monitering
 
Antepartum testing
Antepartum testingAntepartum testing
Antepartum testing
 
poor progress of labour
poor progress of labourpoor progress of labour
poor progress of labour
 
Physiology of labor
Physiology of laborPhysiology of labor
Physiology of labor
 
Physiotherapy In Surgical Condition (Labour) 3rd year
Physiotherapy In Surgical Condition (Labour) 3rd  yearPhysiotherapy In Surgical Condition (Labour) 3rd  year
Physiotherapy In Surgical Condition (Labour) 3rd year
 
Tracheo esophageal fistula
Tracheo esophageal fistula Tracheo esophageal fistula
Tracheo esophageal fistula
 
Tracheo esophageal fistula
Tracheo esophageal fistulaTracheo esophageal fistula
Tracheo esophageal fistula
 
Labour and Partograph.pptx
Labour and Partograph.pptxLabour and Partograph.pptx
Labour and Partograph.pptx
 
History and clinical examination in obstetrics
History and clinical examination in obstetricsHistory and clinical examination in obstetrics
History and clinical examination in obstetrics
 
Displacement of the uterus
Displacement of the uterusDisplacement of the uterus
Displacement of the uterus
 
obstetrical emergencies
obstetrical emergenciesobstetrical emergencies
obstetrical emergencies
 
Late pregnancy bleeding
Late pregnancy bleedingLate pregnancy bleeding
Late pregnancy bleeding
 
Effects of anesthesia on mother and baby
Effects of anesthesia on mother and babyEffects of anesthesia on mother and baby
Effects of anesthesia on mother and baby
 
Oxytocics finalised-110713081015-phpapp02
Oxytocics finalised-110713081015-phpapp02Oxytocics finalised-110713081015-phpapp02
Oxytocics finalised-110713081015-phpapp02
 

Último

AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.kishan singh tomar
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfDolisha Warbi
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfHongBiThi1
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.aarjukhadka22
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxMAsifAhmad
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Vaikunthan Rajaratnam
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 

Último (20)

AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 

Normal Labour

  • 1. Group A 16th Batch Faculty Of Medicine USJP. Group A,16th Batch,FMS,USJP.
  • 3.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11. Deeper view Group A,16th Batch,FMS,USJP.
  • 14. Anatomy of the fetal skull Vault mainly consists of 2 parietal bones, parts of occipital, frontal and temporal bones. Bones are joined to each other by soft unossified membranes, known as sutures. Group A,16th Batch,FMS,USJP. skull vault face base
  • 15.
  • 16.
  • 17.
  • 18. Lateral and posterior view of moulding of the foetal skull Group A,16th Batch,FMS,USJP.
  • 19.
  • 20. Exact physiological mechanism of initiation of parturition is still unknown. But there are some processes that are of particular importance. Group A,16th Batch,FMS,USJP.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 36.
  • 38.
  • 39.
  • 42. Cardiotocography is a method of monitoring fetal heart rate (indirect method) by using ultrasound technique. Group A,16th Batch,FMS,USJP.
  • 43.
  • 44.
  • 45.
  • 46.
  • 48.
  • 49.
  • 50.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57. THE PARTOGRAM Group A,16th Batch,FMS,USJP.
  • 58.
  • 59. THE PARTOGRAM Group A,16th Batch,FMS,USJP. Foetal Conditions Progress of Labour Maternal Conditions
  • 60.
  • 61.
  • 62.
  • 63.
  • 64. PARTOGRAM Group A,16th Batch,FMS,USJP. ALERT LINE ACTION LINE LSCS
  • 65.
  • 66.
  • 67. Group A,16th Batch,FMS,USJP. Observation of the colour of the liqour Mainly - fresh meconium staining If Meconium is present – watch more closely for signs of fetal distress Thin meconium - not much of a risk Thick meconium - more dangerous Fetal heart rate -checked every 15 minutes If suspicious / eg- fetal bradicardia Apply CTG and monitor Maternal information write here; Date EDD POA BP Blood Gp Blood taken for DT
  • 68.
  • 69.
  • 70.
  • 72. Secondary Arrest of Active Phase • Definition – No change in cervical dilatation over a period of 2hrs. Cervix becomes oedematous. Can occur at 4-7 cm dilatation or as a protracted Deceleration phase • Aetiology – CephaloPelvic Disproportion [often absolute] – Foetal head malposition or malpresentation [breech] – Insufficient uterine action – Excessive sedation • Outcome – Will require LSCS. If protracted deceleration beware of shoulder impaction Group A,16th Batch,FMS,USJP.
  • 73.  
  • 74.
  • 75.
  • 76.
  • 77.
  • 79.
  • 80.
  • 81.
  • 82.
  • 83.
  • 84.
  • 85.
  • 86.
  • 87. Foley catheter insertion
  • 88.
  • 90.
  • 91.
  • 93.
  • 95.
  • 97.
  • 99.
  • 101.
  • 103.
  • 104.
  • 106. 1 st stage of labour Latent phase Active phase Group A,16th Batch,FMS,USJP.
  • 107.
  • 108.
  • 109.
  • 110.
  • 111.
  • 112.
  • 113.
  • 114. Group A,16th Batch,FMS,USJP. 2nd stage Phase 1( Passive Phase): a) No maternal urge to push b) Fetal head is high c) Sagittal suture is in the transverse position Phase 2( Active Phase): a) Maternal urge to push is present b) Fetal head is low c) Sagittal suture is in the anterior-posterior position d) bearing down sensation
  • 115.
  • 116.
  • 117.
  • 118.
  • 119.
  • 120.
  • 121.
  • 123.
  • 124. Episiotomy Group A,16th Batch,FMS,USJP.
  • 125. What is an Episiotomy ? Group A,16th Batch,FMS,USJP. Definition An episiotomy is a surgical incision made in the perineum, the area between the vagina and anus. Episiotomies are done during the second stage of labor to expand the opening of the vagina to prevent tearing of the area during the delivery of the baby.
  • 126.
  • 127.
  • 129.
  • 130. Infiltration of perineal tissue with local anaesthetic Group A,16th Batch,FMS,USJP.
  • 131.
  • 132.
  • 133. Repair of episiotomy   Group A,16th Batch,FMS,USJP.
  • 134.
  • 135.
  • 136.
  • 137.
  • 138. Controlled cord traction Clamp the cord close to the perineum using sponge forceps. Hold the clamped cord and the end of forceps with one hand. Place the other hand just above the woman’s pubic bone and stabilize the uterus by applying counter traction during controlled cord traction. This helps prevent inversion of the uterus. Keep slight tension on the cord and await a strong uterine contraction (2–3 minutes). Group A,16th Batch,FMS,USJP.
  • 139. When the uterus becomes rounded or the cord lengthens, very gently pull downward on the cord to deliver the placenta. Do not wait for a gush of blood before applying traction on the cord. Continue to apply counter traction to the uterus with the other hand. If the placenta does not descend during 30–40 seconds of controlled cord traction (i.e. there are no signs of placental separation), do not continue to pull on the cord: Gently hold the cord and wait until the uterus is well contracted again. If necessary, use a sponge forceps to clamp the cord closer to the perineum as it lengthens; With the next contraction, repeat controlled cord traction with counter traction. Never apply cord traction (pull) without applying counter traction (push) above the pubic bone with the other hand. Group A,16th Batch,FMS,USJP.
  • 140. 1 2 3 4 5 6 Group A,16th Batch,FMS,USJP.
  • 141. 7 8 Group A,16th Batch,FMS,USJP.
  • 143.
  • 144.
  • 145.
  • 146.
  • 147. Group A,16th Batch,FMS,USJP. Most widely used type Use for outlet&low cavity deliveries Used in outlet & low cavity deliveries There is a sliing lock No pelvic curve so it allows fetal head to rotate inside the pelvis Uses for mid cavity deliveries Types of obstetric forceps Wrigley’s forceps Simpson’s forceps kieeland’s forceps
  • 148.
  • 149.
  • 150.
  • 151.
  • 152.
  • 153.
  • 154.
  • 155.
  • 156.
  • 157. PAIN RELIEF IN LABOUR
  • 158. PAIN IN LABOUR IS NOT BENEFICIAL EITHER TO MOTHER OR FETUS PAIN DYSFUNCTIONAL LABOUR UTERINE VASOCONSTRICTION FETAL ACIDOSIS HYPERVENTILATION Pco 2 MATERNAL CATECHOLAMINES PLACENTA PERFUSION
  • 159.
  • 160.
  • 161.
  • 162.
  • 163.
  • 164.
  • 165.
  • 166.
  • 167.
  • 169.
  • 170. Causes of maternal deaths worldwide. Group A,16th Batch,FMS,USJP.
  • 171.
  • 172. Uterine atony & PPH with fundal massage. Group A,16th Batch,FMS,USJP.
  • 173.
  • 174.
  • 175.
  • 176.
  • 177.
  • 178.
  • 179. Bakri balloon catheter. Group A,16th Batch,FMS,USJP.
  • 180. Condom attached to a catheter which can be inflated with saline after introducing in to the uterine cavity. Group A,16th Batch,FMS,USJP.
  • 181.
  • 182.
  • 183. B-Lynch suture. Group A,16th Batch,FMS,USJP.
  • 184.
  • 185.
  • 186.
  • 187. Controlled cord traction. Group A,16th Batch,FMS,USJP.
  • 188.
  • 189.
  • 190.
  • 191.
  • 192.
  • 193.
  • 194.
  • 195.
  • 196.
  • 197.
  • 198.
  • 199.
  • 200.
  • 201.
  • 202.

Notas del editor

  1. Shimmy - Start