labour 2

Parturition
Means birth of the baby, toward the end of the pregnancy the uterus increase its excitability due to hormonal and mechanical factors.
Then strong uterine contraction develop ending by expulsion of the fetus.
1- hormonal factors: in the mother increase estrogen to progesterone ratio, and increased secretion of the oxytocin by the posterior pituitary.
in the fetus increased oxytocin, incr. cortisol, incr. prostaglandin from the fetal membranes.
2- mechanical factors: stretching of the smooth muscle lead to incr. contractility, so contractions can be induced by fetal movements and over distended uterus in twin pregnancy.
What is Fergusson reflex???
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Labor is defined as the onset of a sequence of painful regular uterine contractions that results in progressive effacement and dilatation of the cervix with descent of the presenting part and voluntary bearing-down efforts leading to the expulsion of the products of conception through the vagina.

physiologic Preparation for Labor
1- Lightening: settling of the fetal head into the brim of the pelvis.

2- Braxton Hicks contractions: increase in frequency.

3- Cervical ripening: the cervix begins to soften and become stretchable.

What are the Signs and symptoms of labour??
1- lower abdominal and back pain
2- increased vaginal discharge which may be bloody stained
discharge or watery (show).
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Stages of labour
First stage: from the time of the beginning of labour until 10 cm cervical dilatation.

Second stage: the period between full cervical dilatation (10 cm) and delivery of the infant.

third stage: the period between the delivery of the infant and the delivery of the placenta

Signs of placental separation
(a) a fresh show of blood from vagina,

(b) the umbilical cord lengthens outside the vagina,

(c) the fundus of the uterus rises up,

(d) the uterus becomes firm and globular.

Management of labour:
History and examination

Abdominalexamination by Leopold maneuver to assess ??
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Vaginal examination to assess:





station





Effacement: