NORMAL LABOR (THEORIES OF LABOR ONSET) LENGTH OF LABOR

STAGE OF LABOR
1. Oxytocin Stimulation Theory PRIMI (VIRGIN)
2 .Uterine Stretch Theory MULTI (DIS-VIRGIN)
3. Progesterone Deprivation Theory 1ST STAGE
4. Prostaglandin Theory 10 – 12 HOURS
5. Theory of the Aging Placenta 6 – 8 HOURS
6 .Fetal Adrenal Response Theory 2ND STAGE
30 MINS – 2 HOURS
SIGNS OF LABOR (WRISLIR) Ave: 50 mins
20 – 90 MINS
• Weight Loss – 2-3 pounds (progesterone) Ave: 20 mins
• Ripening of the Cervix – “soft” 3RD STAGE
• Increased Braxton Hicks – “irregular, painless” 5 – 20 MINS
• Show – “ruptured capillaries + operculum = pinkish 5 – 20 MINS
color” 4TH STAGE
• Lightening – “the baby dropped” 2 – 4 HOURS
- 2 weeks (primi) and before or during (multi) 2 – 4 HOURS
● Relief of respiratory discomfort
● Increased frequency of urination ESSENTIAL FACTORS OF LABOR (5Ps)
● Leg pains 1. Passages
● Muscle spasms 2. Power
● Increased vaginal discharge 3. Passenger
● Decreased fundal height 4. Person
• Increased Level of Activity – large amount of 5. Position
epinephrine (AG)
• Rupture of Membranes – gush or steady trickle of PASSAGES
clear fluid FUNCTIONS (Sit Sit)
FALSE LABOR (CANDAC) ○ Serves as birthcanal
○ It proves attachment to muscles, fascia and ligaments
✓ Contraction disappear with ambulation ○ Supports uterus during pregnancy
✓ Absence of cervical dilation ○ It provides protection to the organs found within the
pelvic cavity
✓ No ↑ DIF (duration, intensity, frequency)
✓ Discomfort @ abdomen
TYPES (GAPA)
✓ Absence of show ○ Gynecoid – normal female type of pelvis
✓ Contraction stops when sedated - most ideal for childbirth
TRUE LABOR CUPPAD - round shape, found in 50% of women
○ Android – male pelvis
✓ Contraction persists when sedated - presents the most difficulty during childbirth
✓ Uterine contraction ↑ DIF (duration, intensity, - found in 20% of women
frequency) ○ Platypelloid – flat pelvis, rarest, occurs to 5% of
✓ Progressive cervical dilation women
✓ Presence of show ○ Anthropoid – apelike pelvis, deepest type of pelvis
✓ Ambulation increase contractions found in 25% of women
✓ Discomfort radiates to lumbosacral area
 DIVISION OF PELVIS
1. False Pelvis – “provide and direct”
2. True Pelvis – “the tunnel” IPO
○ Inlet or Pelvic Brim – entrance to true pelvis
ANTEROPOSTERIOR DIAMETER DOT
1. Diagonal Conjugate – midpoint of sacral promontory
to the lower margin of symphysis pubis (12.5 cm)
2. Obstetric Conjugate – midpoint of sacral promontory
to the midline of symphysis pubis (11 cm)
3. True Conjugate – midpoint of sacral promontory to
the upper margin of symphysis pubis (11.5 cm)
○ Pelvic Canal – situated between inlet and outlet
- designed to control the speed of descent of the fetal
head
○ Outlet – most important diameter of the outlet.
POWERS 3I’s
⦿ Involuntary – not within the control of the parturient
⦿ Intermittent – alternating contraction and relaxation
⦿ Involves discomfort (compression, stretching and
hypoxia)
PHASES OF UTERINE CONTRACTIONS
1. Increment/Crescendo – “ready, get set”
2. Acme/Apex – “go”
3. Decrement/Decrescendo – “stop”
⦿ INTENSITY - strength of uterine contraction
○ Mild – slightly tensed fundus
○ Moderate – firm fundus
○ Strong – rigid, board like fundus
⦿ FREQUENCY – rate of uterine contraction
- measured from the beginning of a contraction to the
beginning of the next contraction
⦿ DURATION – length of uterine contraction
- measured from the beginning of a contraction to the
end of the same contraction
⦿ INTERVAL – measured from the end of contraction
to the beginning of the next contraction
PASSENGER
⦿ HEAD (BOTu)
- Biggest part of the fetal body
- Olways the presenting part
- Turn to present smallest diameter
⦿ CRANIAL BONES 1 FOSE, 2 PaTe
1 frontal bone2 parietal bone
1 occipital bone2 temporal bone
1 sphenoid bone
1 ethmoid bone
⦿ SUTURE LINES – allow skull bones to overlap
(molding) and for further brain development (SFC La)
● Sagittal Suture – between 2 parietal bones
● Frontal Suture – between 2 frontal bones
● Coronal Suture – between frontal and parietal
● Lamdiodal Suture – between parietal and occipital
⦿ FONTANELS – intersection of suture lines
● Anterior Fontanel or Bregma – intersection of SFC
- diamond shaped, closes b/n 12 – 18 months
- 3 x 4 cm
● Posterior Fontanel or Lambda – intersection of Sla-
triangular shaped, closes b/n 2 – 3 months
⦿ DIAMETERS OF THE FETAL HEAD
AP > T (fetal head)
1.Tranverse Diameters BBB
● Biparietal – most important TD
- greatest diameter presented to the pelvic inlet’s AP
and at the outlet’s TD
- average measurement is 9.5 cm
● Bitemporal – average measurement is 8 cm
● Bimastoid – average measurement is 7 cm
2. Anteroposterior Diameters SOO
● Suboccipitobregmatic – smallest APD
- fully flexed (presenting part)
- measured from the inferior aspect of occiput to the
anterior fontanel
- average measurement is 9.5 cm
● Occipitofrontal – head partially extended and
presenting part