NORMAL LABOUR: NORMAL ANATOMY

NORMAL LABOUR: NORMAL PHYSIOLOGY

Passenge
r
Passage
Power

NORMAL LABOUR
FIRST STAGE

LATENT PHASE: 0-4cm

ACTIVE PHASE: 4-10cm

SECOND STAGE

FULL DILATION TO EXPULSION OF FETUS

THIRD STAGE

BIRTH TO EXPULSION OF PLACENTA

Expectant (physiological) vs Active (CCT +OT)

Cervical effacement
vs
cervical dilation

Cervix closed,
3 cm long

Cervix effaced,
1 cm dilated

Cervix
5 cm dilated

Cervix
fully dilated

FIRST STAGE OF LABOUR:

LATENT vs ACTIVE PHASE

MODIFIED
WHO
PARTOGRAM

TERMINOLOGY OF
VAGINAL DELIVERY
1. Engagement of the fetal head in the transverse position.
2. Descent and flexion of the fetal head.
3. Internal rotation. The fetal head rotates 90 degrees to the
occipito-anterior position
4. Delivery by extension. The fetal head passes out of the birth canal
head is tilted backwards
5. Restitution. The fetal head turns through 45 degrees to restore its
normal relationship with the shoulders, which are still at an angle.
6. External rotation. The shoulders repeat the corkscrew movements
of the head, which can be seen in the final movements of the fetal
head.

WHAT IS NORMALITY
Term / Preterm / Post dates
Spontaneous rupture of membranes /
Prolonged rupture of membranes/
Preterm prolonged rupture of membranes
Fetal monitoring during labour:
Intermittent fetal auscultation / continous cardiotocograph
Analgesia during normal labour:
nothing/birth partner/ TENS/ 1-1 midwifery care/ drugs/ epidural
the Ferguson reflex
Bishop score

WHAT IS NORMAL?
Term: 37 completed weeks to 42 weeks gestation
Preterm: 24-37 completed weeks
Post-dates: after 42 weeks (postmature, prolonged pregnancy, post-term)
SROM = spontaneous rupture of membranes at term
PROM = prelabor or premature rupture of membranes at term
(labour doesn't ensue within 24 hours of ROM)
PPROM = preterm, premature rupture of membranes
ARM = artificial rupture of membranes (used for labor induction)

Fetal monitoring during normal labour:

Intermittent fetal auscultation

Continous cardiotocograph (CTG)

Analgesia during labour

Nothing
Water
birth partner
1-1 midwifery
care
Drugs
Epidural

the Ferguson reflex:

as pressure on the cervix increases, the Ferguson

reflex increases uterine contractions so that the second stage can go ahead.

Bishop score

Thank You