Normal labour management Dr Sneha Rajiv Labour is

Normal labour & management Dr. Sneha Rajiv

Labour is a process by which a foetus of viable age is expelled from the uterus through the vagina

Normal labour Singleton At term ( 37 -40) Vertex presentation Onset : Spontaneous Duration: within normal limits/ without undue delay Vaginal delivery Assistance - minimal ( Episiotomy) Healthy mother & baby

Lightening The feeling of lightening occurs when the fatal head enters the pelvis

False labour pains? ?

Stages of Labour First stage: from onset of true labour pains till full dilatation of cervix

In Primigravida, effacement occurs first Multigravidae , Dilatation occurs first

Latent phase : 6 -8 hrs Active phase: 6 hrs in primi, 4 hours in multi Primi : @ 1 cm/ hour Multi @ 1. 5 cms/hr

Management Check for all the investigations Oral liquid diet IV cannula Cross match her blood Ambulation Bladder care Catheterisation of bladder : PIH, Abruption, VBAC Enema : helps in descent Maternal vitals at 30 minutes interval BP 2 nd hourly Temperature 4 th hourly Partogram monitoring Analgesics

Second stage From full dilatation of cervix till delivery of the head. !!! Not expulsion

Shift her to the labour cot once the patient has the sensation of bearing down FHR every 5 minutes Dorsal position with thighs flexed Lithotomy position

Clean the perineum Local anaesthesia to be given Timing of episiotomy Perineal support

Stage three Delivery of placenta & the membranes Suturing the episiotomy

Stage four After delivery of placenta x 2 hours Look for ?