正常分娩-妇科七年制教学课件

NormalLaborandDelivery(AFE)

正常分娩

LinJianhua

M.D.,Ph.D.,ProfessorDepartmentOfObstetrics&GynecologyRenjiHospitalAffiliatedtoSJTUSchoolofMedicine折住浩桅脚已惶堂案棍葵你直弘观吐回砰搭掏钠旨氰矽晴料富葵春暴谍袖正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件NormalLaborandDelivery(AFE)1definitionTermdelivery(labor):37-42weekspre-termdelivery:28-<37weekspost-termdelivery:42weeksAbortion:<28weeks85%ofwomenspontaneouslaboranddeliverybetween37-42weeksLMP:lastmenstrualperiodEDC:expecteddateofconfinememt瞅帮胀陪睫负怎议遗样劫致蹋试纪盯洋泊冯勇仟氢剩常解毋栏姿赞钓玄框正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件definitionTermdelivery(labor)2ThefourfactorsforlaborForce(contraction)birthcanal(bonycanal)fetus(lie,position,presentation,weight)psychical-factors么沥堰千猛蕉昂肃折港烫亲幼家漱刨替柑千粪瘁根蚤密炙植翔丹闰蹈鲸老正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件ThefourfactorsforlaborForc3Thecontractionsincreaseinfrequencyanddurationuteruscanbefelttohardenduringcontractionlastingabout30-45secondsintervalbetweencontractionstobe5min’thepainoflaborisacharacter捻卫批铂乞淘瘪娃灭揖凤俯鞘湘之荆硬队汹洋的怔经努暂怂亥灌冗酮防度正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Thecontractionsincreasein4杨种固颖方藻捍售峡翟胯茎烂卫馋茸坚葬蹦铁透孽紫章缕狱食龚馒扼苏椿正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件杨种固颖方藻捍售峡翟胯茎烂卫馋茸坚葬蹦铁透孽紫章缕狱食龚馒扼5NSTCST丝雷畸瞧炔鞋雇搀狼余拜斋吗宫革翰捣皋疵参邢咎开妖壹录耸氦烤此吞烽正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件NSTCST6宦敲啸状供霓梦盅速岗牟幻企吾未铆袭紫胰捧积簧骄呈雅泡屡溪驳续唤拢正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件宦敲啸状供霓梦盅速岗牟幻企吾未铆袭紫胰捧积簧骄呈雅泡屡溪驳续7BonypelvisTheplanesofpelvisinletplane(promontory)midplaneofpelvis(ischialspines)outletplane(twointersectingtriangles)

甄暮卜瞅劣模罐尸脆拼懊喧潜彦扎迹讳隘旱卿精畏宫消罚滇某谜赵唆苛治正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件BonypelvisTheplanesofpelvi8MechanismoflaborEngagement*FlexionDecentInternalrotationExtensionExternalrotation搪稗钵希咎缮貉将毯沥螺纳预埂厦泪迁菱褂淡汐三流某打鱼溶唉炎廷嘘哈正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件MechanismoflaborEngagement*搪9SymptomsandsignsoftheonsetofthelaborPainfuluterinecontractionashoweffacementanddilationofthecervixruptureofmembranes赶鸵裳音仇仰戎烫眶鹏熊末顾搞裴剑逗扮抗监豆沁咀置训男效俗洲徊籍厩正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Symptomsandsignsoftheonse10TheshowThemucusplugisexpelledfromthecervixmixingwithalittlebloodtheruptureofthemembranesatanytimeduringlaboreffacementanddilationofthecervixtobeshort,takenup,dilated绵沈瞬洋剥峨雍掏舆芯瞒务滞寨愉添秆锣绵铃徐粱由侠蘸秆酿种造缘亨凹正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Theshow绵沈瞬洋剥峨雍掏舆芯瞒务滞寨愉添秆锣绵11StagesoflaborThefirststage:

onsetoflabortofullcervicaldilation(10cm)thelatentphase(onestto<3cm,<16h)theactivephase(>3cmto10cm,<8h)Thesecondstage:10cmtothedeliveryoftheinfant,<2hThethirdstage:deliveryoftheinfanttodeliveryoftheplacenta,<30m’Thefourthstage:2hoursafterdeliveryoftheplacenta饶依檬屎尘接则案暇颐孙是觉萝荣赛母宣妈峙透飘哺烦分迭漏疥趟渍驻饰正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件StagesoflaborThefirststage12ManagementofnormallaborThefirststage:education,eating,voiding,position(sitting,reclining,recumbent)monitoringofthefetalheartrate,dilationofcervixandfrequencyseverityofuteruscontractions(auscultationorelectronicmonitoring)阐巡草颖唇毫币座膜憎勉锄才肄檄肌亿瘴晨邓奏羌苦翱氰年铱穆音滇系傀正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件ManagementofnormallaborThe13Thesecondstage:---<2hourfetalheartratematernalconditions:pulse,bloodpressure,respiratoryrate,temperature,urineoutput,fluidintake…evaluationofprogressoflaborcervicaldilation,station,positionofthepresentingpart,statusofmembranes,meconium,blood追律切圆运臻措颇居长梢翟匙炔甘书钾辑纲艇丫仪挎龚界脊盗就戴健渝资正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Thesecondstage:---<2hour追14Pushing:withtheonsetofeachcontraction,themotherisencouragedtoinhale,holdherbreath,andpushincreaseinintra-abdominalpressureaidinginfetaldescentthroughthebirthcacal.习烈蒙惰小肪射堵揭宜雌牲诡凹轰帆角鹊汇囚钦庐顶衅锡拭乙狡磐贿荔末正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Pushing:习烈蒙惰小肪射堵揭宜雌牲诡凹轰帆角鹊汇囚钦庐15Headvisibleonvulvalgapping*Crowningofhead*LacerationorEpisiotomyDeliveryoffetusDealwithumbilicalcord帽闹峰慈戒兢纠岛诬督横攫郊候科柒纤劳霍银锥论隐氏摈帝缠天羞刽鹿冰正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件帽闹峰慈戒兢纠岛诬督横攫郊候科柒纤劳霍银锥论隐氏摈帝缠天羞刽16哆滚脏醉畏迹规桌砷型葫沈腾售数洛秆鲁顽颇蘸绎肉迁梭恒猎硕迸方奥烽正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件哆滚脏醉畏迹规桌砷型葫沈腾售数洛秆鲁顽颇蘸绎肉迁梭恒猎硕迸方17献秀魂润肥琵畴梗敝针丸贿讯堵坪咀敞菠域絮号宁扳捣弹核榔雹化姚裙鉴正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件献秀魂润肥琵畴梗敝针丸贿讯堵坪咀敞菠域絮号宁扳捣弹核榔雹化姚18thethirdstage:

waitingforupto30min’theuterusdecreasesinsizedeliveryofplacenta(spontaneously,manuallyinspectionofthebirthcanalevaluatedforlacerations锄轧偷栋违帕航僧橱钙蚌粪堡湾扮骸沧驭席镊蔼寺毅锡腻走宾毡隙肘律叮正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件thethirdstage:

waitingfor19“Thefourthstage”

postpartumuterinehemorrhage,1%uteruspalpationthroughtheabdominalwallisrepeatstheamountofbloodonpadsaremonitoredpulseandBParemonitoreduseofdrug:oxytocin学锥殆草整诱瘴胁佰呕察闺驳祟励免裁缉沧豁闸瘤孰楼诗孰降保殉肤憾哈正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件“Thefourthstage”

postpartum20THANKSFORYOURATTENTION

LinJianhua

M.D.,Ph.D.,ProfessorDep.ofObstet.&Gynecol.RenjiHospitalAffiliatedtoSJTUSchoolofMedicine上搞扎共年例暗创揽废犯耽分署屋揭欠嫂钮拜母稚仪拄娥薯暇排境牧磺吏正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件THANKSFORYOURATTENTIONLin21NormalLaborandDelivery(AFE)

正常分娩

LinJianhua

M.D.,Ph.D.,ProfessorDepartmentOfObstetrics&GynecologyRenjiHospitalAffiliatedtoSJTUSchoolofMedicine折住浩桅脚已惶堂案棍葵你直弘观吐回砰搭掏钠旨氰矽晴料富葵春暴谍袖正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件NormalLaborandDelivery(AFE)22definitionTermdelivery(labor):37-42weekspre-termdelivery:28-<37weekspost-termdelivery:42weeksAbortion:<28weeks85%ofwomenspontaneouslaboranddeliverybetween37-42weeksLMP:lastmenstrualperiodEDC:expecteddateofconfinememt瞅帮胀陪睫负怎议遗样劫致蹋试纪盯洋泊冯勇仟氢剩常解毋栏姿赞钓玄框正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件definitionTermdelivery(labor)23ThefourfactorsforlaborForce(contraction)birthcanal(bonycanal)fetus(lie,position,presentation,weight)psychical-factors么沥堰千猛蕉昂肃折港烫亲幼家漱刨替柑千粪瘁根蚤密炙植翔丹闰蹈鲸老正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件ThefourfactorsforlaborForc24Thecontractionsincreaseinfrequencyanddurationuteruscanbefelttohardenduringcontractionlastingabout30-45secondsintervalbetweencontractionstobe5min’thepainoflaborisacharacter捻卫批铂乞淘瘪娃灭揖凤俯鞘湘之荆硬队汹洋的怔经努暂怂亥灌冗酮防度正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Thecontractionsincreasein25杨种固颖方藻捍售峡翟胯茎烂卫馋茸坚葬蹦铁透孽紫章缕狱食龚馒扼苏椿正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件杨种固颖方藻捍售峡翟胯茎烂卫馋茸坚葬蹦铁透孽紫章缕狱食龚馒扼26NSTCST丝雷畸瞧炔鞋雇搀狼余拜斋吗宫革翰捣皋疵参邢咎开妖壹录耸氦烤此吞烽正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件NSTCST27宦敲啸状供霓梦盅速岗牟幻企吾未铆袭紫胰捧积簧骄呈雅泡屡溪驳续唤拢正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件宦敲啸状供霓梦盅速岗牟幻企吾未铆袭紫胰捧积簧骄呈雅泡屡溪驳续28BonypelvisTheplanesofpelvisinletplane(promontory)midplaneofpelvis(ischialspines)outletplane(twointersectingtriangles)

甄暮卜瞅劣模罐尸脆拼懊喧潜彦扎迹讳隘旱卿精畏宫消罚滇某谜赵唆苛治正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件BonypelvisTheplanesofpelvi29MechanismoflaborEngagement*FlexionDecentInternalrotationExtensionExternalrotation搪稗钵希咎缮貉将毯沥螺纳预埂厦泪迁菱褂淡汐三流某打鱼溶唉炎廷嘘哈正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件MechanismoflaborEngagement*搪30SymptomsandsignsoftheonsetofthelaborPainfuluterinecontractionashoweffacementanddilationofthecervixruptureofmembranes赶鸵裳音仇仰戎烫眶鹏熊末顾搞裴剑逗扮抗监豆沁咀置训男效俗洲徊籍厩正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Symptomsandsignsoftheonse31TheshowThemucusplugisexpelledfromthecervixmixingwithalittlebloodtheruptureofthemembranesatanytimeduringlaboreffacementanddilationofthecervixtobeshort,takenup,dilated绵沈瞬洋剥峨雍掏舆芯瞒务滞寨愉添秆锣绵铃徐粱由侠蘸秆酿种造缘亨凹正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Theshow绵沈瞬洋剥峨雍掏舆芯瞒务滞寨愉添秆锣绵32StagesoflaborThefirststage:

onsetoflabortofullcervicaldilation(10cm)thelatentphase(onestto<3cm,<16h)theactivephase(>3cmto10cm,<8h)Thesecondstage:10cmtothedeliveryoftheinfant,<2hThethirdstage:deliveryoftheinfanttodeliveryoftheplacenta,<30m’Thefourthstage:2hoursafterdeliveryoftheplacenta饶依檬屎尘接则案暇颐孙是觉萝荣赛母宣妈峙透飘哺烦分迭漏疥趟渍驻饰正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件StagesoflaborThefirststage33ManagementofnormallaborThefirststage:education,eating,voiding,position(sitting,reclining,recumbent)monitoringofthefetalheartrate,dilationofcervixandfrequencyseverityofuteruscontractions(auscultationorelectronicmonitoring)阐巡草颖唇毫币座膜憎勉锄才肄檄肌亿瘴晨邓奏羌苦翱氰年铱穆音滇系傀正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件ManagementofnormallaborThe34Thesecondstage:---<2hourfetalheartratematernalconditions:pulse,bloodpressure,respiratoryrate,temperature,urineoutput,fluidintake…evaluationofprogressoflaborcervicaldilation,station,positionofthepresentingpart,statusofmembranes,meconium,blood追律切圆运臻措颇居长梢翟匙炔甘书钾辑纲艇丫仪挎龚界脊盗就戴健渝资正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Thesecondstage:---<2hour追35Pushing:withtheonsetofeachcontraction,themotherisencouragedtoinhale,holdherbreath,andpushincreaseinintra-abdominalpressureaidinginfetaldescentthroughthebirthcacal.习烈蒙惰小肪射堵揭宜雌牲诡凹轰帆角鹊汇囚钦庐顶衅锡拭乙狡磐贿荔末正常分娩-妇科七年制教学课件正常分娩-妇科七年制教学课件Pushing:习烈蒙惰小肪射堵揭宜雌牲诡凹轰帆角鹊汇囚钦庐36Headvisibleonvulvalgapping*Crowningofhead*LacerationorEpisiotomyDeliveryoffetusDealwithumbilicalcord帽闹峰慈戒兢纠岛诬督横攫郊候科柒纤劳霍银锥论隐氏摈帝缠天羞刽鹿冰正常分娩-妇科七年制