NORMAL LABOR wang jingyin

Ⅰ. Definition Ⅰ. Definition Delivery is the process by which the mature or nearly mature (fetus and placenta) are expelled from the maternal body. Delivery is the process by which the mature or nearly mature (fetus and placenta) are expelled from the maternal body. The term delivery refers to the labor occurring between the beginning of the 37w to 42w. The term delivery refers to the labor occurring between the beginning of the 37w to 42w.

The premature delivery refers to the labor occurring between the 28w to the 37w. The premature delivery refers to the labor occurring between the 28w to the 37w. The postdelivery refers to the labor occurring over 42w. The postdelivery refers to the labor occurring over 42w.

Ⅱ. Agents of labor Ⅱ. Agents of labor 1. Mechanical theory 机械性理论 1. Mechanical theory 机械性理论 2. Endocrine regulating theory 内分泌控制理论 2. Endocrine regulating theory 内分泌控制理论 3. Neurohumor theory 神经介质理论 3. Neurohumor theory 神经介质理论

Ⅲ.Factors affecting labor. Ⅲ.Factors affecting labor. There are four factors affecting labor: expulsive force, the fetus (line position and presentation of fetus), passage (the bony pelvis and soft tissue), and psychological factors. There are four factors affecting labor: expulsive force, the fetus (line position and presentation of fetus), passage (the bony pelvis and soft tissue), and psychological factors. If the four factors accommodate each other, the fetus may be easily delivery, otherwise difficult delivery may occur. If the four factors accommodate each other, the fetus may be easily delivery, otherwise difficult delivery may occur.

1. The powers 产力 1. The powers 产力 1) uterine contraction 1) uterine contraction rhythm 节律性

symmetry 对称性 polarity 极性 retraction 缩复作用

2) abdominal muscles and diaphragm 腹肌、膈肌 腹肌、膈肌 3) levator 肛提肌 3) levator 肛提肌

2. Birth canal 产道 2. Birth canal 产道 1) bony pelvis 骨产道 1) bony pelvis 骨产道 pelvic inlet plane 骨盆入口平面 pelvic inlet plane 骨盆入口平面

mid plane of pelvis 中骨盆平面

pelvic outlet plane 骨盆出口平面

2) the soft part of the birth canal 软产道 formation of lower segment formation of lower segment changes in the cervix changes in the cervix changes in the floor of pelvis, vagina and perineum changes in the floor of pelvis, vagina and perineum

3. The fetus 胎儿 3. The fetus 胎儿 1) size of the fetus 1) size of the fetus

2) position of the fetus 胎位 2) position of the fetus 胎位 3) abnormality of the fetus 胎儿畸形 3) abnormality of the fetus 胎儿畸形 4. Psychological factors 精神心理因素 4. Psychological factors 精神心理因素

Ⅳ. The mechanism of normal labor in vertex presentation Ⅳ. The mechanism of normal labor in vertex presentation 1. Engagement 衔接 1. Engagement 衔接 2. Descent 下降 2. Descent 下降 3. Flexion 俯屈 3. Flexion 俯屈 4. Internal rotation 内旋转 4. Internal rotation 内旋转 5. Extension 仰伸 5. Extension 仰伸 6. Restitution and external rotation 复位、外旋转 6. Restitution and external rotation 复位、外旋转 7. Expulsion of fetus 胎儿娩出 7. Expulsion of fetus 胎儿娩出

Ⅴ. Threatened labor and in labor Ⅴ. Threatened labor and in labor 1. Threatened labor 先兆临产 1. Threatened labor 先兆临产 1) false labor 假临产 1) false labor 假临产 2) lightening 胎儿下降感 2) lightening 胎儿下降感 3) show 见红 3) show 见红 2. In labor 临产 2. In labor 临产

Ⅵ. Total stage of labor 总产程 Ⅵ. Total stage of labor 总产程 1. The first stage or dilatation of the cervical OS 初产妇 11 － 12h 1. The first stage or dilatation of the cervical OS 初产妇 11 － 12h 经产妇 6 － 8h 2. The second stage or expulsion of the fetus 初产妇 1 － 2h 2. The second stage or expulsion of the fetus 初产妇 1 － 2h 经产妇 数分钟－ 1h 3. The third stage or expulsion of the placenta 5 － 15min 3. The third stage or expulsion of the placenta 5 － 15min

Ⅶ. Clinical course and treatment in first stage Ⅶ. Clinical course and treatment in first stage 1. Uterine contraction 子宫收缩 1. Uterine contraction 子宫收缩 2. Fetal heart rate 2. Fetal heart rate 3. Dilatation of the cervix and descent of the fetal head 3. Dilatation of the cervix and descent of the fetal head 4. Rupture of membranes 4. Rupture of membranes 5. General menagement 5. General menagement

Ⅷ. Clinical course and treatment in second stage Ⅷ. Clinical course and treatment in second stage 1. Clinical findings 1. Clinical findings 2. Treatment 2. Treatment

Ⅸ. Clinical course and treatment in third stage Ⅸ. Clinical course and treatment in third stage 1. Clinical findings 1. Clinical findings 2. treatment 2. treatment