B.
ETIOLOGY
List of basic etiology
Placental aging
Hormone oxytocin release
Decreased progesterone level
Release of prostaglandins
Cervical change and effacement
Loose-feeling joint
Actual etiology present in Rationale
patient
/ Advance placental age
decreases blood supply. This
events triggers uterine
contractions, thereby, starting
the labor.
/ Pressure on the cervix
stimulates production of
oxytocin from posterior
pituitary gland which lead to
the contraction of the uterus.
/ During late pregnancy, rise fetal
cortisol level inhibit
progesterone production from
the placenta. Thus, reduction of
progesterone formation
initiates labor.
/ Result of the uterine muscle
stretching stimulates
hypothalamus to release
oxytocin which increases
uterine contractions.
/ There is stretching in the
perineum which release the
chemical mediators such as
prostaglandins, histamine,
bradykinin, and serotonin are
synthesized and help transmit
the pain impulse along small,
unmyelinated C fibers and large
myenilated A-delta fibers to the
spinal cord. The pain impulse
ascends the spinal cord to the
brain cortex, where it is
interpreted as pain.
/ As the fetus sinks into the
pelvis, a woman may
experience shooting leg pains
from the increased pressure on
sciatic nerve, increased amount
of vaginal discharge, and urinary
frequency from pressure on her
bladder.
Fatigue / By the time a date of birth
approaches, a woman is
generally tired from the burden
of carrying so much extra
weight. They have backaches in
side-lying postion: they turn on
their back and the fetus kicks
and wakens them. It can make
the process of labor loom as an
overwhelming unendurable
experience unless they have
support people with them.
Stretching of the perineum / Additional discomfort in labor
may stem from the pressure of
the fetal presenting part,
including pressure on
surrounding organs, such as the
bladder, the urethra, and the
lower colon.
Vaginal tears Because of the great amount of
pressure experienced during
birth, the perineum feels
edematous and tender
immediately after birth.