/ / “theories 0 -failao% i) uberine muscle sities fom t fing sive oF B felus —» prostaghondias release, 2) ayihun Stimulation works & protaglandias t initiate contractions ) E:P eatio changes > f withdrawal y) placental age Mager mtractions 4 Fetal cobs levels oe? formation 4 prostaglemdin formation W fetal membrane produces prostaglondias ch Shmulate cantrackions Components, oF Loiloo% BS NAMIAGE (Reb ~ eto ASSENGER, (Fetus) - rene Wn Ageous position» preseatation OWERS of labor (uterine Fa) i SUCHE mans phil 3 serene -foute of & fetus frm uterus " Ywreugh % cervix and vagian ft extemal perintum/ / POSTERIOR Transverse, diameter ‘diameter ee vy teaa a OUTLET ertthr 4 pelvic ting ol mn ek structure tea fontaneiles, suture linec) and itr alignmeat & pelvis. TAL SKULL STRUCTURE 4 een peng Passenger - waether @ febal shall can pass 2 Panetal _ tA, 4 Otcipital childbirth FETAL SKULL DIAMETERS - to ft through & inlet of & birth canal bet, b fetus muct present & smaller diameter (transverse diameter) of & head te & cmaller chameter of @ widternal pelvic (dingonal conjugate) | BIPARIETAL/ TRANSVERSE OLMMETER ~Smallert diameter of % fetal skull - 9-3 on SUBOLLIPITDEREGMATIC DIAMETER = Smallect tantero posterior diameter - 46 Un; inferior aspect of E occiput tet Center oF & anterior fort oneile, OCLIPITD FRONTAL DLAMETER - Oni from % oudpital prominence + t bridge % & nose OWIPTDMENTAL DAMETER ~ widest anteropost erior diameter : ~ = BLOM, postere fontanelle ; $0 thin/ / - Ih em wide ppprw ; narrowest diameter ot % pelvic inles ; ~ but presettotion for viet is when ¢ rarer b biparietal diamett (nardwut fetal head) C priauple = natfow ® narfow - jl om wide (appre) - of & outkt, % fetus must rotate v t his aarrowest fetal head aitencter # Ht fetus presente one _of @ AP diameberc of & ckull { ¢ AP diameter of @ inlet, engagement Ccetrling of © fetal head into @ pelvic) may qot occur x if & telus does nk robate, leaving & Ap diameter of @ skull preseating 4) @ T diameter of € outlet, an arrest of progres: may —otcurFULL FLEXION - fekal head flexes sharply ; chin on chect, SOB pre @ bicth tonal wooed FLEXION ~ OF diameter orecents Pook FLEXION - head ig hyeetede, OM (largest diameter) will mot MOLDING - overlapping skull bones changing @ shape of @ fetal skull ty long Gnd narrow allowing passage in % narrw pelvic - cawced Wy % fore of uterine ond actions - molding lasts & day or 2 and will ad be a permanent Condition ~ row presentation: little. molding a- Aeccrives & degree of flexion a Fetus assumes © COMPLETE FLEXION - Good attitude ; spinal column bod forward, head is Flexed forward; chin tucher & sternum; arms are flexed & folded on @ att thighs are ane onte t Gbdemen; ca sted Oggi terior aspece of & thighs Pred genes pe ~ uval fetal partition advantageous for birth; S08 (Sub oceipito bregmatic) @ MODERATE FLEXION- chin \{ aot touching 2 chert but if in on alert or military porition ; = causes & OF (0cuipitofronttl) cigmeter f preceat at birth PARTIAL EXTENSION - brow presentation pre © COMPLETE EXTENSION - back it arched, neck is eatended, OM (ottipitomental) diameter presentation (fate preseatabon) - relahionthip between & = long (tephalocandal ) axis of t fetal wody Gad % “long Cuephalocandal) axis of @ Woman's body; whet @ fetus is lying in horisotal (Wvansverse) of verhcal Clongigudinal) position; tephalic ov breecha ® PHALC PRESENTAT|ON - most frequent o of presentation ; fetal head ia wa part that fick contact @ Cervix 1) verter - ideals effective molding Ww * caput succedanewm - edema on —an—oren—of —€ fetal skull eat often comes in contact t @ Cervix during Jaber | -t point of centahon can be andlyzed tm ¢ location of 2 DREECH PRESENTATION - buttocke or feeb art 2 fit body parks that will contact % cervix ~ffecked by & fetal attitude - b good wthtnde brings @ fetal knees againck ¢ fetal abdomen - 4 pow attitude means & knees Gad legs wre extended - wretch presentation (auce_a diffi: > Types: COMPLETC, FRANK, FooTLINGFrank Breech Complete Breech Footling Breech SHOULDER PRESENTATION - tameverte lie, ferws lies horizontally 2 lengat ttal axis ic perpendicular to dat of % mother es prefenhng part: admin process / shoulder. ihac crest, hand ow elyow/ / - & relationship of & presenting part +O Cpeaitio quadrant 2 side of a woman's MATERNAL PELVIS: a) Right Anterior b) Lete Anterior Right Posterior dh) Vett Porteyior elvis FETAL LANDMARKS : a) vertex - occiput (0) v) Face - mentum (mM) C) bfetth - Sactum (Sa) d) Shoulder- scapula (A) 4 Position ic indicated wy obbreviahon of 9 letters Ane letber + (Ri right w (L) lett (landmark) dnd eters fetal landmark 3rd letter = (A) anterior CP) potterior (T)_ broncverte a ah DY 5 Ay , dS a 0 fetus i¢ born factest fim LOA ci bon wW a pacino cp labor wan be aan considerably petterior (@oP /0P) wid may be more painful because ¢ ib % porition is rotation of & fetal head puts presure m ¢ Sacral nerves 4 NCC INT: envourag to Sims ee vomon Wrst i ‘4 oxition om € same side Os & fetal spine & we mh hands qnd Hates puition may encourage rotahion From Waipitvparkeion fo tn ocipi to anterior position w during labor/ / -t settling ot @ preceating art fetus for tnoug h iw! Tp (tot # vel? of & icchial spines, idlppink of % pelvis primipara, am a gement oft head veginain tf labéy tug gerts O pursible tompli cation (apn® wecentabion position, donormaiy & fetal head w (Ap) - dtgree of engagement: vaginal | cervical examination * Hoahing - not engaged o dipping ~ descin ing but not yet at @ icchial spines of 2 it re 2 mi in b -s: ~ relationchip oF @ enh bt e level tf eed t ischial spines 4 when 2 wanting part ic Gh & level of % ischial cnn it is & “0” stab a dl) « if fen part is above’ 2 (pints , ¢ distence, ie mekured # decuived Gi minus stations (-149-4) x IF t preenting part is : tow ign bl roias, i dittance it stated of glus stations (+1 40 t4) a4 a o 43 of +4 sahon, ee be if iF E Va ic 6/80/-1CARDINAL MOVEMENTS LAGOR memes om >)