NormalLaborandDelivery(AFE)

正常分娩2021/7/91definitionTermdelivery(labor):37-42weekspre-termdelivery:28-<37weekspost-termdelivery:42weeksAbortion:<28weeks85%ofwomenspontaneouslaboranddeliverybetween37-42weeksLMP:lastmenstrualperiodEDC:expecteddateofconfinememt2021/7/92ThefourfactorsforlaborForce(contraction)birthcanal(bonycanal)fetus(lie,position,presentation,weight)psychical-factors2021/7/93Thecontractionsincreaseinfrequencyanddurationuteruscanbefelttohardenduringcontractionlastingabout30-45secondsintervalbetweencontractionstobe5min’thepainoflaborisacharacter2021/7/942021/7/95NSTCST2021/7/962021/7/97BonypelvisTheplanesofpelvisinletplane(promontory)midplaneofpelvis(ischialspines)outletplane(twointersectingtriangles)

2021/7/98MechanismoflaborEngagement*FlexionDecentInternalrotationExtensionExternalrotation2021/7/99SymptomsandsignsoftheonsetofthelaborPainfuluterinecontractionashoweffacementanddilationofthecervixruptureofmembranes2021/7/9109、人的價值，在招收誘惑的一瞬間被決定。2023/2/32023/2/3Friday,February3,202310、低頭要有勇氣，抬頭要有低氣。2023/2/32023/2/32023/2/32/3/20235:01:14PM11、人總是珍惜為得到。2023/2/32023/2/32023/2/3Feb-2303-Feb-2312、人亂于心，不寬余請。2023/2/32023/2/32023/2/3Friday,February3,202313、生氣是拿別人做錯的事來懲罰自己。2023/2/32023/2/32023/2/32023/2/32/3/202314、抱最大的希望，作最大的努力。03二月20232023/2/32023/2/32023/2/315、一個人炫耀什么，說明他內心缺少什么。。二月232023/2/32023/2/32023/2/32/3/202316、業(yè)余生活要有意義，不要越軌。2023/2/32023/2/303February202317、一個人即使已登上頂峰，也仍要自強不息。2023/2/32023/2/32023/2/32023/2/32021/7/911TheshowThemucusplugisexpelledfromthecervixmixingwithalittlebloodtheruptureofthemembranesatanytimeduringlaboreffacementanddilationofthecervixtobeshort,takenup,dilated2021/7/912StagesoflaborThefirststage:

onsetoflabortofullcervicaldilation(10cm)thelatentphase(onestto<3cm,<16h)theactivephase(>3cmto10cm,<8h)Thesecondstage:10cmtothedeliveryoftheinfant,<2hThethirdstage:deliveryoftheinfanttodeliveryoftheplacenta,<30m’Thefourthstage:2hoursafterdeliveryoftheplacenta2021/7/913ManagementofnormallaborThefirststage:education,eating,voiding,position(sitting,reclining,recumbent)monitoringofthefetalheartrate,dilationofcervixandfrequencyseverityofuteruscontractions(auscultationorelectronicmonitoring)2021/7/914Thesecondstage:---<2hourfetalheartratematernalconditions:pulse,bloodpressure,respiratoryrate,temperature,urineoutput,fluidintake…evaluationofprogressoflaborcervicaldilation,station,positionofthepresentingpart,statusofmembranes,meconium,blood2021/7/915Pushing:withtheonsetofeachcontraction,themotherisencouragedtoinhale,holdherbreath,andpushincreaseinintra-abdominalpressureaidinginfetaldescentthroughthebirthcacal.2021/7/916Headvisibleonvulvalgapping*Crowningofhead*LacerationorEpisiotomyDeliveryoffetusDealwithumbilicalcord2021/7/9172021/7/9182021/7/919thethirdstage:

waitingforupto30min’theuterusdecreasesinsizedeliveryofplacenta(spontaneously,manuallyinspectionofthebirthcanalevaluatedforlacerations2021/7/920“Thefourthstage”

postpartumuterinehemorrhage,1%uteruspalpationthroughtheabdominalwallisrepeatstheamountofbloodonpadsaremonitoredpulseandBParemonitoreduseofdrug:oxytocin2021/7/921THANKSFORYOURATTENTION

LinJianhua

M.D.,Ph.D.,ProfessorDep.ofObstet.&Gynecol.RenjiHospitalAffiliatedtoSJTUSchoolofMedicine2021/7/9229、人的價值，在招收誘惑的一瞬間被決定。03-2月-2303-2月-23Friday,February3,202310、低頭要有勇氣，抬頭要有低氣。***2/3/20235:01:14PM11、人總是珍惜為得到。03-2月-23**Feb-2303-Feb-2312、人亂于心，不寬余請。***Friday,February3,202313、生氣是拿別人做錯的事來懲罰自己。03-2月-2303-2月-23**03February202314、抱最大的希望，作最大的努力。03二月2023**03-2月-2315、一個人炫耀什么，說明他內心缺少什么。。二月23*03-2月-23*03February202316、業(yè)余生活要有意義，不要越軌。**2/3/202317、一個人即使已登上頂峰，也仍要自強不息。***03-2月-23謝謝大家2021/7/9239、人的價值，在招收誘惑的一瞬間被決定。2023/2/32023/2/3Friday,February3,202310、低頭要有勇氣，抬頭要有低氣。2023/2/32023/2/32023/2/32/3/20235:01:14PM11、人總是珍惜為得到。2023/2/32023/2/32023/2/3Feb-2303-Feb-2312、人亂于心，不寬余請。2023/2/32023/2/32023/2/3Friday,February3,202313、生氣是拿別人做錯的事來懲罰自己。2023/2/32023/2/32023/2/32023/2/32/3/202314、抱最大的希