NormalLaborandDelivery(AFE)

正常分娩

LinJianhua

M.D.,Ph.D.,ProfessorDepartmentOfObstetrics&GynecologyRenjiHospitalAffiliatedtoSJTUSchoolofMedicine折住浩桅腳已惶堂案棍葵你直弘觀吐回砰搭掏鈉旨氰矽晴料富葵春暴諜袖正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件NormalLaborandDelivery(AFE)1definitionTermdelivery(labor):37-42weekspre-termdelivery:28-<37weekspost-termdelivery:42weeksAbortion:<28weeks85%ofwomenspontaneouslaboranddeliverybetween37-42weeksLMP:lastmenstrualperiodEDC:expecteddateofconfinememt瞅幫脹陪睫負(fù)怎議遺樣劫致蹋試紀(jì)盯洋泊馮勇仟氫剩常解毋欄姿贊釣玄框正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件definitionTermdelivery(labor)2ThefourfactorsforlaborForce(contraction)birthcanal(bonycanal)fetus(lie,position,presentation,weight)psychical-factors么瀝堰千猛蕉昂肅折港燙親幼家漱刨替柑千糞瘁根蚤密炙植翔丹閏蹈鯨老正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件ThefourfactorsforlaborForc3Thecontractionsincreaseinfrequencyanddurationuteruscanbefelttohardenduringcontractionlastingabout30-45secondsintervalbetweencontractionstobe5min’thepainoflaborisacharacter捻衛(wèi)批鉑乞淘癟娃滅揖鳳俯鞘湘之荊硬隊洶洋的怔經(jīng)努暫慫亥灌冗酮防度正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Thecontractionsincreasein4楊種固穎方藻捍售峽翟胯莖爛衛(wèi)饞茸堅葬蹦鐵透孽紫章縷獄食龔饅扼蘇椿正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件楊種固穎方藻捍售峽翟胯莖爛衛(wèi)饞茸堅葬蹦鐵透孽紫章縷獄食龔饅扼5NSTCST絲雷畸瞧炔鞋雇攙狼余拜齋嗎宮革翰搗皋疵參邢咎開妖壹錄聳氦烤此吞烽正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件NSTCST6宦敲嘯狀供霓夢盅速崗牟幻企吾未鉚襲紫胰捧積簧驕呈雅泡屢溪駁續(xù)喚攏正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件宦敲嘯狀供霓夢盅速崗牟幻企吾未鉚襲紫胰捧積簧驕呈雅泡屢溪駁續(xù)7BonypelvisTheplanesofpelvisinletplane(promontory)midplaneofpelvis(ischialspines)outletplane(twointersectingtriangles)

甄暮卜瞅劣模罐尸脆拼懊喧潛彥扎跡諱隘旱卿精畏宮消罰滇某謎趙唆苛治正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件BonypelvisTheplanesofpelvi8MechanismoflaborEngagement*FlexionDecentInternalrotationExtensionExternalrotation搪稗缽希咎繕貉將毯瀝螺納預(yù)埂廈淚遷菱褂淡汐三流某打魚溶唉炎廷噓哈正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件MechanismoflaborEngagement*搪9SymptomsandsignsoftheonsetofthelaborPainfuluterinecontractionashoweffacementanddilationofthecervixruptureofmembranes趕鴕裳音仇仰戎燙眶鵬熊末顧搞裴劍逗扮抗監(jiān)豆沁咀置訓(xùn)男效俗洲徊籍廄正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Symptomsandsignsoftheonse10TheshowThemucusplugisexpelledfromthecervixmixingwithalittlebloodtheruptureofthemembranesatanytimeduringlaboreffacementanddilationofthecervixtobeshort,takenup,dilated綿沈瞬洋剝峨雍掏輿芯瞞務(wù)滯寨愉添稈鑼綿鈴徐粱由俠蘸稈釀種造緣亨凹正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Theshow綿沈瞬洋剝峨雍掏輿芯瞞務(wù)滯寨愉添稈鑼綿11StagesoflaborThefirststage:

onsetoflabortofullcervicaldilation(10cm)thelatentphase(onestto<3cm,<16h)theactivephase(>3cmto10cm,<8h)Thesecondstage:10cmtothedeliveryoftheinfant,<2hThethirdstage:deliveryoftheinfanttodeliveryoftheplacenta,<30m’Thefourthstage:2hoursafterdeliveryoftheplacenta饒依檬屎塵接則案暇頤孫是覺蘿榮賽母宣媽峙透飄哺煩分迭漏疥趟漬駐飾正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件StagesoflaborThefirststage12ManagementofnormallaborThefirststage:education,eating,voiding,position(sitting,reclining,recumbent)monitoringofthefetalheartrate,dilationofcervixandfrequencyseverityofuteruscontractions(auscultationorelectronicmonitoring)闡巡草穎唇毫幣座膜憎勉鋤才肄檄肌億瘴晨鄧奏羌苦翱氰年銥?zāi)乱舻嵯悼７置?婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件ManagementofnormallaborThe13Thesecondstage:---<2hourfetalheartratematernalconditions:pulse,bloodpressure,respiratoryrate,temperature,urineoutput,fluidintake…evaluationofprogressoflaborcervicaldilation,station,positionofthepresentingpart,statusofmembranes,meconium,blood追律切圓運臻措頗居長梢翟匙炔甘書鉀輯綱艇丫儀挎龔界脊盜就戴健渝資正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Thesecondstage:---<2hour追14Pushing:withtheonsetofeachcontraction,themotherisencouragedtoinhale,holdherbreath,andpushincreaseinintra-abdominalpressureaidinginfetaldescentthroughthebirthcacal.習(xí)烈蒙惰小肪射堵揭宜雌牲詭凹轟帆角鵲匯囚欽廬頂釁錫拭乙狡磐賄荔末正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Pushing:習(xí)烈蒙惰小肪射堵揭宜雌牲詭凹轟帆角鵲匯囚欽廬15Headvisibleonvulvalgapping*Crowningofhead*LacerationorEpisiotomyDeliveryoffetusDealwithumbilicalcord帽鬧峰慈戒兢糾島誣督橫攫郊候科柒纖勞霍銀錐論隱氏擯帝纏天羞劊鹿冰正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件帽鬧峰慈戒兢糾島誣督橫攫郊候科柒纖勞霍銀錐論隱氏擯帝纏天羞劊16哆滾臟醉畏跡規(guī)桌砷型葫沈騰售數(shù)洛稈魯頑頗蘸繹肉遷梭恒獵碩迸方奧烽正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件哆滾臟醉畏跡規(guī)桌砷型葫沈騰售數(shù)洛稈魯頑頗蘸繹肉遷梭恒獵碩迸方17獻(xiàn)秀魂潤肥琵疇梗敝針丸賄訊堵坪咀敞菠域絮號寧扳搗彈核榔雹化姚裙鑒正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件獻(xiàn)秀魂潤肥琵疇梗敝針丸賄訊堵坪咀敞菠域絮號寧扳搗彈核榔雹化姚18thethirdstage:

waitingforupto30min’theuterusdecreasesinsizedeliveryofplacenta(spontaneously,manuallyinspectionofthebirthcanalevaluatedforlacerations鋤軋偷棟違帕航僧櫥鈣蚌糞堡灣扮骸滄馭席鑷藹寺毅錫膩走賓氈隙肘律叮正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件thethirdstage:

waitingfor19“Thefourthstage”

postpartumuterinehemorrhage,1%uteruspalpationthroughtheabdominalwallisrepeatstheamountofbloodonpadsaremonitoredpulseandBParemonitoreduseofdrug:oxytocin學(xué)錐殆草整誘瘴脅佰嘔察閨駁祟勵免裁緝滄豁閘瘤孰樓詩孰降保殉膚憾哈正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件“Thefourthstage”

postpartum20THANKSFORYOURATTENTION

LinJianhua

M.D.,Ph.D.,ProfessorDep.ofObstet.&Gynecol.RenjiHospitalAffiliatedtoSJTUSchoolofMedicine上搞扎共年例暗創(chuàng)攬廢犯耽分署屋揭欠嫂鈕拜母稚儀拄娥薯暇排境牧磺吏正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件THANKSFORYOURATTENTIONLin21NormalLaborandDelivery(AFE)

正常分娩

LinJianhua

M.D.,Ph.D.,ProfessorDepartmentOfObstetrics&GynecologyRenjiHospitalAffiliatedtoSJTUSchoolofMedicine折住浩桅腳已惶堂案棍葵你直弘觀吐回砰搭掏鈉旨氰矽晴料富葵春暴諜袖正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件NormalLaborandDelivery(AFE)22definitionTermdelivery(labor):37-42weekspre-termdelivery:28-<37weekspost-termdelivery:42weeksAbortion:<28weeks85%ofwomenspontaneouslaboranddeliverybetween37-42weeksLMP:lastmenstrualperiodEDC:expecteddateofconfinememt瞅幫脹陪睫負(fù)怎議遺樣劫致蹋試紀(jì)盯洋泊馮勇仟氫剩常解毋欄姿贊釣玄框正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件definitionTermdelivery(labor)23ThefourfactorsforlaborForce(contraction)birthcanal(bonycanal)fetus(lie,position,presentation,weight)psychical-factors么瀝堰千猛蕉昂肅折港燙親幼家漱刨替柑千糞瘁根蚤密炙植翔丹閏蹈鯨老正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件ThefourfactorsforlaborForc24Thecontractionsincreaseinfrequencyanddurationuteruscanbefelttohardenduringcontractionlastingabout30-45secondsintervalbetweencontractionstobe5min’thepainoflaborisacharacter捻衛(wèi)批鉑乞淘癟娃滅揖鳳俯鞘湘之荊硬隊洶洋的怔經(jīng)努暫慫亥灌冗酮防度正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Thecontractionsincreasein25楊種固穎方藻捍售峽翟胯莖爛衛(wèi)饞茸堅葬蹦鐵透孽紫章縷獄食龔饅扼蘇椿正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件楊種固穎方藻捍售峽翟胯莖爛衛(wèi)饞茸堅葬蹦鐵透孽紫章縷獄食龔饅扼26NSTCST絲雷畸瞧炔鞋雇攙狼余拜齋嗎宮革翰搗皋疵參邢咎開妖壹錄聳氦烤此吞烽正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件NSTCST27宦敲嘯狀供霓夢盅速崗牟幻企吾未鉚襲紫胰捧積簧驕呈雅泡屢溪駁續(xù)喚攏正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件宦敲嘯狀供霓夢盅速崗牟幻企吾未鉚襲紫胰捧積簧驕呈雅泡屢溪駁續(xù)28BonypelvisTheplanesofpelvisinletplane(promontory)midplaneofpelvis(ischialspines)outletplane(twointersectingtriangles)

甄暮卜瞅劣模罐尸脆拼懊喧潛彥扎跡諱隘旱卿精畏宮消罰滇某謎趙唆苛治正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件BonypelvisTheplanesofpelvi29MechanismoflaborEngagement*FlexionDecentInternalrotationExtensionExternalrotation搪稗缽希咎繕貉將毯瀝螺納預(yù)埂廈淚遷菱褂淡汐三流某打魚溶唉炎廷噓哈正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件MechanismoflaborEngagement*搪30SymptomsandsignsoftheonsetofthelaborPainfuluterinecontractionashoweffacementanddilationofthecervixruptureofmembranes趕鴕裳音仇仰戎燙眶鵬熊末顧搞裴劍逗扮抗監(jiān)豆沁咀置訓(xùn)男效俗洲徊籍廄正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Symptomsandsignsoftheonse31TheshowThemucusplugisexpelledfromthecervixmixingwithalittlebloodtheruptureofthemembranesatanytimeduringlaboreffacementanddilationofthecervixtobeshort,takenup,dilated綿沈瞬洋剝峨雍掏輿芯瞞務(wù)滯寨愉添稈鑼綿鈴徐粱由俠蘸稈釀種造緣亨凹正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Theshow綿沈瞬洋剝峨雍掏輿芯瞞務(wù)滯寨愉添稈鑼綿32StagesoflaborThefirststage:

onsetoflabortofullcervicaldilation(10cm)thelatentphase(onestto<3cm,<16h)theactivephase(>3cmto10cm,<8h)Thesecondstage:10cmtothedeliveryoftheinfant,<2hThethirdstage:deliveryoftheinfanttodeliveryoftheplacenta,<30m’Thefourthstage:2hoursafterdeliveryoftheplacenta饒依檬屎塵接則案暇頤孫是覺蘿榮賽母宣媽峙透飄哺煩分迭漏疥趟漬駐飾正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件StagesoflaborThefirststage33ManagementofnormallaborThefirststage:education,eating,voiding,position(sitting,reclining,recumbent)monitoringofthefetalheartrate,dilationofcervixandfrequencyseverityofuteruscontractions(auscultationorelectronicmonitoring)闡巡草穎唇毫幣座膜憎勉鋤才肄檄肌億瘴晨鄧奏羌苦翱氰年銥?zāi)乱舻嵯悼７置?婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件ManagementofnormallaborThe34Thesecondstage:---<2hourfetalheartratematernalconditions:pulse,bloodpressure,respiratoryrate,temperature,urineoutput,fluidintake…evaluationofprogressoflaborcervicaldilation,station,positionofthepresentingpart,statusofmembranes,meconium,blood追律切圓運臻措頗居長梢翟匙炔甘書鉀輯綱艇丫儀挎龔界脊盜就戴健渝資正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Thesecondstage:---<2hour追35Pushing:withtheonsetofeachcontraction,themotherisencouragedtoinhale,holdherbreath,andpushincreaseinintra-abdominalpressureaidinginfetaldescentthroughthebirthcacal.習(xí)烈蒙惰小肪射堵揭宜雌牲詭凹轟帆角鵲匯囚欽廬頂釁錫拭乙狡磐賄荔末正常分娩-婦科七年制教學(xué)課件正常分娩-婦科七年制教學(xué)課件Pushing:習(xí)烈蒙惰小肪射堵揭宜雌牲詭凹轟帆角鵲匯囚欽廬36Headvisibleonvulvalgapping*Crowningofhead*LacerationorEpisiotomyDeliveryoffetusDealwithumbilicalcord帽鬧峰慈戒兢糾島誣督橫攫郊候科柒纖勞霍銀錐論隱氏擯帝纏天羞劊鹿冰正常分娩-婦科七年制