ROSECHELLE B.

SIUPAN,RN MAN

Labor is a process whereby with time regular uterine contractions brings about progressive effacement and dilatation of the cervix, resulting in the delivery of the fetus and expulsion of the placenta.

Delivery actual event of birth

1. Uterine Stretch Theory Any hollow muscular organ when stretched to the capacity will contract and empty
2. Oxytocin Stimulation Theory Increased production of oxytocin by the anterior pituitary increases as pregnancy nears term while production of oxytinase by the placenta decreases

3. Progesterone Deprivation Theory as pregnancy nears term, progesterone level drops, hence uterine contraction occurs

4. Prostaglandin Theory when pregnancy reaches term, the fetal membranes produces high levels of arachidonic acid
5. Theory of the aging Placenta as the placenta ages it becomes less efficient

INCREASE BRAXTON HICKS CONTRACTION Becomes stronger and longer. The occurrence of these strong contractions engagement and descent of the presenting part. (baby)

LIGHTENING- the settling of the presenting part tp the pelvic brim or inlet. - occurs about two weeks before labor onset for primis and just before or during labor in multis.

RIPENING OF THE CERVIX - the cervix becomes buttersoft when labor is near. It is a must (soften) in order for it to be readily dilatable.
INCREASE LEVEL OF ACTI VITY- increase or large amount of epinephrine or adrenalin. To provide the woman with energy for the strenuous work for delivery.

UTERINE CONTRACTIONS- surest sign that labor has begun is the initiation of effective, productive, involuntary uterine contractions. SHOW- (bloody show) pink tinge, blood mixed with mucus. RAPTURE OF THE MEMBRANE- (know as bag of water) characterized by a sudden gush or steady trickle of clear fluid from the vagina

FALSE LABOR

TRUE LABOR

No increase in intensity, duration Uterine contractions increase in and frequency of uterine contraction intensity frequency and duration Contractions disappear with ambulation Discomfort remains in the abdomen Contraction stops when woman is sedated Absence of cervical dilation Absence of show Ambulation increases contractions Discomfort radiates to the lowerback or lumbosacral area Contraction persists even if woman is sedated. Progressive cervical dilation Presence of show

1. PASSAGE- womans pelvis

Pelvis the bony ring through which the fetus passes during labor and delivery; consists of four united bones (two hip or innominate bones, the sacrum, and the coccyx) between the trunk and thighs. Size and type of pelvis, ability of the cervix to efface and dilate, and distensibility of vagina 2 pelvic measurement: to determine adequacy of pelvic size) 1. diagonal conjugate(A-P diameter of the inlet) 2. transverse diameter> narrowest diameter of the outlet

a. Gynecoid classic female pelvis inlet, well rounded (oval); ideal for delivery - most ideal for childbirth (50% of women) b. Android resembling a male pelvis, narrow and heart-shaped; usually requires cesarean section or difficult forceps delivery (20% of women) c. Platypelloid flat, broad pelvis; usually not adequate for vaginal delivery (5% of women) d. Anthropoid similar to pelvis of anthropoid ape; long, deep, and narrow; usually adequate for vaginal delivery (25% of women)